IF YOU have a space between your teeth that you do not like, but you have not had it closed because you were told that it would take years of orthodontic treatment, then this article is for you. In addition to orthodontics, spaces between teeth can be corrected with bonding, composite veneers, or acrylic crowns among other options. But don’t be surprised if people don’t recognise exactly what is different about you. Just get ready for comments like, “You look terrific!”

Many people don’t realise the effect a space between the front teeth can have on a person’s appearance. Consider the story of a man in his 40s who had a gap closed between his front upper front teeth. A week after the crowns were placed he said, “Some of my friends thought I had a new hairstyle. Others actually thought I’d had a facelift! They don’t realise that the only thing different is that the space between my front teeth is gone.” This same phenomenon happens over and over again. Why? Because for the first time people are actually looking at the person’s face instead of the space between his or her teeth.
Spaces between teeth are most often caused by heredity. However, they also may be caused by personal habits such as tongue thrusting or by abnormal tongue or swallowing movements. The loss of bone under the gum tissue can also cause teeth to separate, as can loss of the back of the teeth, which often transfers chewing activity forward. This is called teeth migration. How a space is treated has a lot to do with its cause.

There are several ways to close unsightly gaps. Which method is chosen depends on the cause of the space, its size, its location, and the condition of adjacent teeth. Both are relatively expensive and your personal needs will play a significant role in your choice of treatment. Correcting space problems, however, usually involves one of the three Rs.
Repositioning teeth with orthodontics. When teeth are attractive and healthy, repositioning is the ideal treatment, as it involves no loss of enamel. Some alternatives, such as full crowns, require sacrificing healthy tooth structure for cosmetic correction.
Restoring teeth through bonding, or crowns. Patients frequently prefer immediate results. In such cases, bonding or laminating with composite may be the answer. In other cases, a combination of therapies offers the best results.

Removal of teeth, followed by replacement with a bridge or implant. Removal is used only as a last resort. Depending on the situation, I usually complete an implant in one to five months. But just keep in mind that the goal of treatment is always to fill the space while avoiding the loss of teeth or tooth structure as much as possible.

The removable acrylic overlay is a device formed from thin acrylic or plastic made to cover the space and blend with adjacent teeth. It is easily snapped in, and the intimate fit of the appliance to the teeth holds it in place. Removable acrylic overlays were more commonly used before the advent of bonding. They were often worn by models, actors, and others who didn’t want to crown their teeth just to close a space.

While these overlays may look attractive from a distance, they often do not bear up well under close scrutiny. They add bulk to the natural teeth. However, because the plastic is so thin, it’s difficult to make overlays look natural, they can fracture and discolour easily. Moreover, eating with them can be a problem. They are relatively cheap and can be considered temporary, but I personally would not want them for myself.

In some cases, however, the removable acrylic overlay may still be a desirable alternative. On the positive side, it’s inexpensive, and it hides spaces well, particularly for photographic purposes. If you have a special event coming up or just want a trial smile to see how you would look without your gap, talk to your dentist about getting a removable acrylic overlay.