March 01, 2015
Spaces between the teeth may occur naturally or develop as a result of dental arch alterations such as tooth loss and subsequent drifting. The presence of diastema can be due to an abnormally large labial frenulum or tongue thrusting. These spaces are a result of a naturally occurring imbalance between teeth and arch size or a result of teeth (usually the maxillary ones) that have ‘flared’ as a result of a decrease in occlusal vertical dimension and an increase in stress concentration on the lingual surfaces of the maxillary anterior teeth.
The extent and rapidity of opening up of interproximal tooth contacts is usually augmented by the presence of periodontal disease around the involved teeth. Spaces between teeth that are 2mm or wider are self-cleaning and the risk of getting tooth decay is quite low. However food impaction may still be a problem and orthodontic treatment may be indicated. Diastema closures are usually prescribed for aesthetic purposes. Faulty dental restorations may also result in open contacts which could lead to food impaction and the risk of gingival and periodontal inflammation.
A supporting cusp occluding with a pair of improperly formed marginal ridges can have a wedging effect and cause transient separation of the opposing teeth with resultant food impaction. Such a cusp is called a plunger cusp. In these cases there is a strong indication for operative and prosthetic procedures leading to proper contacts of the opposing teeth and eliminating the interproximal food impaction.