Sometimes, a diastema is part of a set of problems that requires comprehensive orthodontic treatment. For some people, however, a diastema is the only problem that would require orthodontic treatment.

Often, people have a diastema treated for cosmetic reasons. They may be self-conscious about having a space between their teeth. However, a diastema also can affect your speech. When you speak, your tongue pushes forward to close the space to produce certain sounds (for example "S"). This constant tongue pressure can make the diastema worse over time.

If you're concerned that your child might need treatment for a diastema, you can find out by visiting an orthodontist. The American Association of Orthodontists recommends children have a consultation appointment by age 7, although treatment may not begin for several years.

Causes
In some people, the diastema is caused partly by lateral incisors (the teeth next to the two front center teeth) that are undersized. If this is the case, you also may consult with your dentist to determine whether these teeth should be made wider using crowns, veneers, or bonding.

A diastema also can be caused by an overly large frenum — the piece of gum tissue above and between your two front teeth. If your frenum is too thick, it can impede normal dental development and natural space closure between the two front teeth. Orthodontic treatment may not be effective unless the tissue is removed in a procedure called a frenectomy.

There are several kinds of fixed space maintainers. A band-and-loop maintainer is made of stainless steel wire. The maintainer is held in place by an orthodontic-type band around an adjacent tooth or a crown on the tooth. A wire loop attached to the band or crown extends into the space and touches the tooth on the other side of the space to hold both teeth in place.

Some people have permanent teeth that may have never developed, known as congenitally missing teeth. If the lateral incisors never develop, the extra space can allow the front teeth to move apart and create a diastema. If you are missing these teeth, there are several options for eventual tooth replacement, including implants, bridgework and orthodontic treatment that moves the canine teeth (eye teeth) into the positions where the lateral incisors should be. Which treatment is right for you will depend on many factors, and you should discuss it with your orthodontist.

Treatment
Treatment for a diastema starts with a consultation with an orthodontist, who will perform an initial evaluation and determine if treatment should proceed at his time. If the patient is ready for treatment, the orthodontist will take impressions of your teeth to make study casts, do a detailed clinical exam, take a series of facial and dental pictures, and take a full series of radiographs (X-rays), including a panoramic film and side head film.

Orthodontic treatment for diastema when it is the only orthodontic problem can consist of one or more of these options:

• Full braces (upper and lower)
• Full braces on only the upper teeth
• Partial braces on only some of the upper teeth
• A removable appliance (retainerlike appliance)

Which of these treatments you receive will depend on many factors, including your age, dental development and skeletal jaw relations. Discuss the options with your orthodontist to find out which is best for you.

After Treatment

Each space maintainer is custom-made by a dentist or orthodontist.

If you had braces put on to treat your diastema, you will receive a retainer after the braces are removed. The retainer will maintain the corrected tooth positions. You should consult with your orthodontist about time and duration of wear.

The risks of treatment for diastema are those involved with any orthodontic treatment.