Gap Between Teeth: Causes and Diastema Treatment Options

Genetics and Jaw-to-Tooth Size Mismatch

The most common cause of a diastema is a mismatch between the size of the teeth and the size of the jaw. If the jaw bone is wider than the teeth can fill, spaces appear between them. This is an inherited trait, similar to eye color or height. Some people naturally have smaller teeth relative to their jaw, creating gaps.

A diastema between the upper front teeth is especially common and often runs in families. In children, gaps between baby teeth are normal and actually a good sign. They suggest there will be enough room for the larger permanent teeth.

Tongue Thrust and Oral Habits

Tongue thrust is a swallowing pattern where the tongue pushes forward against the front teeth instead of pressing against the roof of the mouth. Over time, this repetitive pressure can push the front teeth forward and create or widen a gap.

Prolonged thumb sucking or pacifier use in childhood can also create gaps by pushing the front teeth outward. If the underlying habit is not addressed, gaps may reopen after treatment.

Gum Disease and Bone Loss

Advanced gum disease (periodontitis) destroys the bone that supports the teeth. As bone is lost, teeth can shift, drift apart, or tilt, creating new gaps or widening existing ones. Gaps caused by gum disease are a sign of a structural problem that needs treatment before any cosmetic correction.

If you notice that a gap between your teeth is getting wider, especially if your gums bleed or feel tender, see a periodontist. The gum disease must be treated first. Closing the gap without addressing the underlying bone loss will not produce a lasting result.

Other Causes

• Missing teeth: When a tooth is lost or was never present (congenitally missing), neighboring teeth may drift apart, creating gaps.
• Oversized labial frenum: The frenum is a small fold of tissue that connects the upper lip to the gum above the front teeth. If this tissue is unusually large or low, it can sit between the two front teeth and prevent them from closing together.
• Extra teeth or abnormal tooth shape: Teeth that are peg-shaped (smaller than normal) or extra teeth growing in unusual positions can disrupt spacing.
• Tooth loss from injury or extraction: When a tooth is removed and not replaced, the remaining teeth tend to shift over time.

Braces

Traditional metal or ceramic braces are the most reliable option for closing gaps, especially when multiple teeth need to move or when there are other alignment issues to correct at the same time. Braces apply controlled force to gradually shift teeth together.

For a simple gap closure with no other alignment problems, braces may only be needed for 6 to 12 months. If the gap is part of a broader spacing or bite issue, treatment typically takes 12 to 24 months. Braces range from $3,000 to $7,000 depending on the complexity and duration of treatment. Costs vary by location and provider.

Clear Aligners (Invisalign)

Clear aligners such as Invisalign are a popular option for closing gaps in teens and adults who prefer a less visible treatment. The aligners are custom-made, removable plastic trays that gradually move teeth into position. You switch to a new set of trays every one to two weeks.

Aligners work well for mild to moderate gaps when the teeth are otherwise healthy and there are no major bite issues. For a straightforward diastema closure, treatment may take as little as 3 to 6 months with a focused aligner plan. Full treatment for more complex cases takes 12 to 18 months. Clear aligner treatment typically costs $3,500 to $7,000. Costs vary by location and provider.

Dental Bonding

Dental bonding is a cosmetic procedure where tooth-colored resin is applied to the edges of the teeth on either side of the gap, making them wider and closing the space. It is the fastest and least expensive option for small gaps.

Bonding is done in a single office visit, takes about 30 to 60 minutes per tooth, and usually requires no anesthesia. The results look natural when done well. However, bonding material is not as strong or stain-resistant as porcelain. It typically lasts 5 to 10 years before needing repair or replacement. Bonding costs $300 to $600 per tooth. Costs vary by location and provider.

Porcelain Veneers

Porcelain veneers are thin shells custom-made to cover the front surface of the teeth. They can close gaps by making the teeth wider, while also improving shape, color, and symmetry. Veneers are a good option when the gap is small and you also want to address other cosmetic concerns like discoloration or minor chips.

Veneers typically require two office visits and involve removing a thin layer of enamel from the front of the teeth (about 0.5mm). This makes the procedure irreversible. Porcelain veneers last 10 to 20 years with proper care. Veneers cost $1,000 to $2,500 per tooth. Costs vary by location and provider.

Frenectomy (When the Frenum Is the Cause)

If an oversized labial frenum is causing or contributing to the gap, a minor surgical procedure called a frenectomy can remove or reduce the tissue. This is a quick procedure, often done with a laser, that takes about 15 minutes and heals within a week or two.

A frenectomy alone does not close the gap. It removes the tissue that is preventing the gap from closing. Orthodontic treatment (braces or aligners) is usually needed afterward to bring the teeth together.

Insurance and Financing

Dental insurance typically does not cover cosmetic procedures like bonding or veneers for gap closure. However, orthodontic treatment (braces or aligners) may be partially covered if your plan includes orthodontic benefits, typically up to a lifetime maximum of $1,500 to $3,000.

Many orthodontic and dental offices offer monthly payment plans. Some third-party financing options, such as CareCredit, allow you to spread costs over 12 to 24 months with low or no interest.