Januari 26, 2017
often, patients will come in, and i'll askthem what their number one concern is, why are they here. and a lot of times the reasonis, "i've got a space in between my two front teeth." and you see that all the time. it'svery common, and they want it fixed. sometimes it's something they have dealt with for awhile and they finally thought, "okay, i'm ready to get this fixed," or it's somethingthat just recently pops up. so i wanna talk a little bit about what causes the spacingin your teeth, and then how we can fix it. the number one cause for spacing in betweenthe front two teeth, which is a little bit more common, you actually have a muscle, andwe call it a frenum attachment. so you have a muscle that attaches your upper lip to yourgums, right about here. everyone has it, and
it allows your upper lip to be mobile andmove. but it also causes your lip to be fixated a little bit. otherwise, you may be able topull your upper lip over your nose or something like that. now, everyone's muscle attachesa little bit differently. on some people, that muscle attaches a little bit lower thannormally. and it will actually attach right in betweenyour two front teeth. when that happens, you're much more prone to have a space develop there.reason being, is any time you eat, any time you talk, you chew, any time you're movingyour upper lip, you're actually pulling on that little muscle. you're pulling on thatattachment, and that actually causes a little bit of force there and pulls those front twoteeth together. if you have a case where you
have no space anywhere except between yourfront two teeth, chances are you've got a low muscle attachment. so how do we fix that? there are a coupleof different ways, a couple of different methods that we can use to do that. and really, itdepends on how the teeth are fitting together and how big the space is. if it's a very minorspace, if it's something that just started to open up, or if it's something that's almostjust a crack or a hair, that's something that's very easy to fix and it can be done in a numberof different ways. and the easiest way is probably just with a regular retainer that'sa little bit tight. so, we have a clear plastic retainer that'sbeen tightened in a couple of spots and it'll
pull the teeth together, push them back towhere they need to be. and it usually is done in a week or two. now, that's really in straightforwardcases. and those are more cases where someone has had treatment before, and that space opensup a little bit again. maybe they lost their retainer, or for whatever reason, the spacein between the teeth has decided to open again. those we can typically fix just with a retainerin a couple of weeks. now, if the space is a lot larger, we haveto think about how the teeth are coming together. so i've got a set of upper and lower teethhere. so now, if you can imagine we had a big gap or a big space in between our frontteeth, when we pull those together, the teeth don't come together. they don't just slidetogether. they also come back a little bit,
and that's just the nature of closing theteeth. if we were just to pull the teeth together, you can imagine there would be spaces on theother sides of the teeth. so in order to close that space, as well as to keep the spacesclosed on the backsides of the teeth, we actually pull the teeth slightly inwards. not enoughto where you would notice a change of position of the teeth or a change in profile, but enoughto where it would effect your bite. so, sometimes, because of the way the topteeth and the bottom teeth come together, if there isn't a lot of overbite there andyou do have a lot of spacing, you will actually need lower braces even if your lower teethare completely straight. because we're pulling those upper teeth back, and if we were tojust pull them back, you would start hitting
on those lower teeth. so we need to do lowerbraces to get those in a better position and to have everything fit together nicely. now,if you do have a bit of an overbite, if do have a little bit of a gap, then it's prettyquick and easy to close that space and have those teeth fit together really nicely. now, the question is how do we keep the spaceclosed once it is closed, especially if you have, again, that low muscle attachment. thereare a couple of things we can do. one, we can have a gum specialist actually removethe attachment there, and put it in a different place. that's kind of a long term fix. itworks very well. at the same time, people usually don't wanna go through a surgicalprocedure to ensure that their teeth are gonna
stay the way that they need to stay or theway that they want them to stay. so, oftentimes what we'll do, is right behind the teeth,we'll glue a little wire, and acts as a permanent retainer. and the nice thing is it's very small, verysmooth, very low profile. you don't even know it's there after we've done it. and then whatthat does is it just keeps those teeth together, and it works very well. it takes a littlebit more diligence keeping that clean. you're gonna have to floss under it just like youwould with the braces. but it's not like it's on all of your teeth; it's just the fronttwo teeth there. and that does a really good job of keeping those front teeth togetheronce we close that space, if you do have that
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