Tina first came to our practice when a friend told her how I’d “closed the gaps” between her own teeth. She shared with me that she’d had gaps between her baby teeth and permanent teeth for all 27 years of her life. Fellow teenagers had asked her if she “could spit sunflower seeds” from between them, in high school. She’d begged her parents for braces or some other solution.
Gaps between teeth occur for several different reasons. In Tina’s case, she was graced with a large mouth opening, wide top and bottom dental arches, and small front teeth. None had been removed. Other reasons for gapping include fibrous gum tissue between certain teeth which doesn’t allow them to merge closer together. This is most common in areas where a “frenum” exists. To discover what a frenum looks like, pull up your upper lip and look between your two front teeth. Sometimes, a frenum is surgically trimmed so it doesn’t interfere with the development of proper tooth placement. This procedure is called a frenectomy.
The third reason for gaps is a “tongue thrust” when swallowing. If you keep your teeth together and swallow, you will feel your tongue touch, or slightly push on, your front teeth. This is normal. It is abnormal when the touching or pushing is too strong, hence the use of the verb, “thrust”.
The fourth reason for gaps is periodontal disease. The bone supporting teeth is weakened or missing so their “foundation” is weak. It cannot hold up to biting forces when chewing food.
Tina just had tiny teeth. We referred her to an orthodontist for an evaluation, and he felt that short duration braces could pull the teeth into place. However, there would still be some spacing. The orthodontist believed that I would be able to compensate for this with a well-designed bridge, after her orthodontic treatment. Tina loved the idea, and promised to be diligent and patient. What made this case especially stand out is that Tina’s parents insisted on paying for every aspect of her treatment. I love happy endings!