Wide Space Between Front Teeth

My twin seven-year-old daughters have fairly wide spaces between their front teeth. Their dentist has recommended a procedure to allow them to grow closer together. He recommends cutting the piece of flesh that lies between the gum and inside top lip. He says this will allow the teeth to grow closer together. May I have your opinion on this procedure?


The space between teeth is known as a diastema. Diastemas in the anterior teeth can be quite common as the permanent central incisors (middle front teeth) erupt. Part of the normal growth of the upper permanent central and lateral incisors is for the crowns (the visible portion) of these teeth to be tipped away from each other, while the roots are tipped towards each other. This tipping creates diastemas. When the canines (also known as cuspids or eye teeth) erupt, usually about 11-13 years old, they tend to push the crowns of the incisors together, thereby closing the diastemas. Therefore, it might be prudent to wait until your daughters are older to determine if nature will take its natural course.

If the tissue to which you refer, the frenum, is attached to the crest of the bone and is quite tough, this will keep the central incisors apart. Generally, this can be determined with a radiograph (x-ray) of the area. If a notching in the bone between the central incisors is noted, then a frenectomy (cutting or removal of the frenum) should be done. Orthodontics may also be required to close the diastema(s).

The procedure itself is quite simple and easily done with local anesthetic. By far, the most difficult part is the suturing. This must be done sufficiently to prevent recurrence of the tissue growth.

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