Diastema

introduction

A gap in the upper jaw between the two central incisors is called a diastema. Because it lies in the middle of the dental arch, it is also known as the diestema mediale. A diastema also rarely occurs in the lower jaw.

This gap is caused by a lip frenulum that has grown too deep (Frenulum), in very rare cases also by an additional, but stunted, tooth. Therefore, an X-ray should be taken for clarification. In some indigenous peoples, a diastema is also seen as a feature of beauty. A distinction is made between a real diastema and a false diastema.

Real diastema

In true diastema, the gap is caused by the lip frenulum that has grown through the gap. This form of diastema is hereditary. Diastema is normal in milk teeth. The gap between the teeth is removed by an operation in which the lip frenulum is shortened. Then an orthodontic treatment takes place. A physical gap between the canine tooth and the first small molar tooth only exists in mammals and is therefore referred to as the "ape gap".

False diastema

In the case of the false diastema, the cause lies in the eruption of the central incisors at different times. After the rest of the teeth have erupted, the false diastema can even out itself. The lack of lateral incisors can also lead to a fake diastema. An x-ray can provide clarification. Adjustments are made by the orthodontist.

Medial diastema

The medial diastema describes a gap between the two incisors in the upper jaw. This tooth gap, which is called a blemish in many regions, is due to the shape of the lip frenulum. The lip frenulum is a connection between the inside of the upper lip and the mucous membrane between the two large incisors in the upper jaw. If this lip frenulum is set very deeply, it leads to a tooth gap between the two large incisors.

The stronger and deeper this band is pronounced, the larger the gap is usually. The shape of the lip frenulum shows in the deciduous dentition to what extent it influences the position of the teeth. A deep lip band creates a medial diastema in the primary dentition. However, this diastema only becomes worthy of treatment between the ages of six and eight when the teeth change, when the permanent incisors erupt. The gap between the teeth can lead to a poorer speech image, as the S sounds are primarily formed on the front incisors and the gap can disrupt sound generation.

The medial diastema can also be caused by the failure of a tooth. Due to the increased space available, there are usually several teeth with gaps to the neighboring tooth. Another reason for a medial diastema can be incisors that are too small, which cannot fill the space, or a dental arch that is generally much too large. Especially in the Afro-American and African region, this tooth gap is widespread due to the anatomy, but is considered an ideal of beauty.

In Europe, on the other hand, the tooth gap between the incisors is often a reason to have it closed by an operation, long-term orthodontic treatment or by a dental prosthesis. In most cases, however, this procedure would only be an aesthetic procedure that is not always necessary.

therapy

As already stated, the treatment of the true diastema consists in the surgical removal of the throughgrown lip frenulum and the tissue in the gap. The gap can also be closed by a crown or a veneer. However, in these cases the gap should not be too big. It would therefore be better to have it regulated by the orthodontist after the causes have been eliminated.

Can a diastema be closed?

A medial diastema can be closed, whereby there are several treatment options. If the medial diastema is attached due to a genetically too deep lip frenulum, it can be treated with a surgical procedure. The tape is cut and sewn at a higher point so that there is less tension on the oral mucosa in the upper jaw and the oral vestibule has more room to move. This procedure is minimally invasive and is performed under local anesthesia. The duration of the procedure is only about ten to fifteen minutes.

If the tooth gap is due to a non-application, the gap is usually closed by orthodontic gap closure with loose or fixed braces. The duration of treatment depends on the severity of the individual case and can last between one and three years.

Read more on the topic: braces

If the dental arch is too big or the teeth are too small, the gap can be closed with dentures. Veneers or crowns are chosen to create a highly aesthetic result. The entire duration of therapy is around two to three weeks until the finished denture can be inserted.

Read more on the topic: dentures

When does an operation become necessary?

If the lip band is set very low genetically, it is often only possible through surgical therapy. The lip band is cut through and sewn up again at a higher point. This procedure is minimally invasive and usually only takes ten to fifteen minutes, which is why it is performed in children between the ages of six and eight. During this period, the upper two incisors erupt and the lip frenulum should not cause a diastema mediale to develop. Furthermore, in the case of an orthodontic gap closure, surgical relocation of the lip frenulum may be necessary in order to ensure that the teeth are properly and optimally moved into the gap and to close it.

Treatment costs

Surgical cutting of a lip frenulum in childhood is fully covered by the health insurance. The orthodontic gap filling is either completely covered or at least subsidized by the health insurance company before the age of eighteen, depending on the severity.A treating orthodontist is the contact person.

When the medial diastema is closed with crowns or veneers, the affected person pays a large part of the dentures privately. The health insurance company pays a maximum of thirty percent depending on the bonus. For example, if it is only necessary to take care of the two upper incisors, you can expect around 1000 euros for crowns and around 800 to 1200 euros for veneers. The more teeth need to be looked after, the more expensive the treatment becomes.

Does the health insurance fund the treatment costs?

The health insurance company completely bears the operative treatment of the medial diastema. In the case of orthodontic treatment, it depends on the severity of the individual case. The health insurance company pays proportionally or in full before the age of eighteen, after which the procedure is a complete private service.

forecast

A diastema does not describe a disease, but rather an aesthetic problem. After eliminating the causes, the prognosis is very good.

Summary

The diastema is an increase in the space between the upper central incisors. A distinction is made between one, depending on the cause real and one fake Diastema. Therapy is carried out either through surgery or with crowns or veneers. Orthodontic measures are also necessary.