Aesthetics in Dentistry (Part 1- Gaps)

Dear readers

My apologies for the lateness. It is amazing how quickly 2017 went by! We nearing 2018 !! I hope your new year went alright!! Over here I am glad to announce that I have opened my own surgery and it is going wonderfully well.. Taking my time with my new patient base and giving the best care that I can give.

I realized that patients of all ages are very concerned by Aesthetics i.e how the teeth look like; how the smile looks like, whether it has gaps, chipped tooth, whether it has yellow spots, black spots, whether it is too crowded , whether it has too much gums showing, or the empty spaces due to missing teeth.

Your dentist is a little bit of a magician and if he/she has the eye for details, you can have a wonderful smile.
1. Gaps

Sometimes, the teeth seem to have spaces and some people might not like them particularly. Those spaces may be due to many a reason, some of which are missing teeth, so the existing ones drift/ migrate to the empty spaces hence making it seem like big gaps in the front.

I like to use the analogy of people sitting packed in a 3 seater car or bus, if one person gets off the vehicle, the other seated people will want to feel more at ease and take a little space of the person who has left. Similarly the teeth work the same way making discrete motions with time until eventually we see the gap.
If the gap is caused by periodontal disease, then periodontal treatment by a dentist or gum specialist (periodontist) is necessary. When gum health is restored, in many cases braces can be used to move the teeth into place. A splint can be used to attach teeth to other teeth and prevent them from moving again.

What can be done?

Depending on the degree of gaps, we can recommend a myriad of treatment options.

a. composite fillings

Bonding is adhering composite material (a combination of acrylic plastic and porcelain powders) to the sides of the teeth. This would be the least costly but would only last five to ten years, but we should keep in mind that discoloration may occur and the composite may chip off if proper care is not taken. If you want a quick simple improvement, bonding is most likely the answer. If you want a perfect result, it might even take some porcelain veneers to create the right proportions.

b. ceramic veneers

While cosmetic tooth bonding with plastic tooth colored filling material is a quick and economical approach towards closing a front tooth gap, ceramic veneers will offer a more permanent treatment option. This is because the ceramics are more color stable and stronger materials which renders them less likely to chip.

The best long term solution would be with porcelain veneers, and the best veneers would be ones that only cover a small portion of the fronts of the teeth.

d. orthodontic treatment

In regard to the orthodontic rubber bands that pull the teeth together, the gap will be transferred to the outer sides of the teeth. To hold the teeth in place afterward would require some form of retention, perhaps a wire bonded to the backside of the teeth

Diastema
A diastema (plural diastemata) is a space or gap between two teeth. Many species of mammals have diastemata as a normal feature, most commonly between the incisors and molars. (WIKIPEDIA).
I would like to point out in the recent years beginning of 2000s the teeth gaps have become a fashion statement, following suit of Madonna and the likes. Many models loved this gap smile and there has been many requests to have similar gaps in patients’ smile.

But artificially causing the gaps are not recommended, because it will cause more harm than good.

There are two techniques used to get the diastema and both of them can generate a bunch of problems. The dental stripping, also known as interproximal reduction, which consists in reducing up to 1mm of each tooth in the middle part using the filing technique, or the invisible orthodontics, a treatment with splints or removable clear aligners, that also separate the teeth.

Despite its current boom, this artificial separation of the teeth is not recommended. With this kind of interventions we lose the perfect gear of the teeth and a lot of abnormalities can appear. It provokes several oral problems like gum injuries, the probability of getting caries is higher, bacterial plaque and a periodontal illness can also appear just because food get stuck easily and it is harder to keep a good oral hygiene.

Changes in our teeth can influence also the rest of our body, generating sore muscles and cranial bones and they derivate in headaches and back, jaw, ear and neck pain. The beauty of a smile must be maximized and we have to smile with no fear. But this diastema trend and also the natural gap have to be supervised by a professional to avoid unexpected risks.

So we covered part one , Gaps .. we shall get into the other subtopics in the coming articles i.e discoloration, crowding, gummy smile etc . Hoping to hear from you soon. Cheers!

Best wishes

Dr Nesha