Braces are used to correct different types of malocclusions. These can be gaps or spaces between teeth, crowding, missing teeth, rotated teeth or a combination of two or more of these. One of the more common questions that orthodontist gets asked is “How long do braces take to close a gap?”, by the patients. Before we answer this question, let’s understand why gaps exist, the different types of differences that exist and the right way to close each of these gaps.
Why Do Gaps Exist in India?
Spacing between teeth is very common in kids with milk teeth. This is because the body takes into account the larger size of the permanent teeth that will erupt as the child turns 6 years of age, and hence the milk teeth have spaces between them. But, these spaces are not a cause of worry and are meant to be natural.
When gaps are present between the permanent teeth, it is considered a problem and needs to be closed. The most common cause for a difference or spacing to occur in permanent teeth is when the jaw size is large, whereas the teeth size is small. Wondering how can that be possible? Well, we inherit our teeth size, shapes and even jaw size from either of our parents. So, if you inherit a larger jaw size from one parent and a smaller teeth size from the other, there is excess space in the jaws that that is needed by the teeth. This gives rise to generalised spacing, and almost all teeth have spaces between them.
Other reasons that give rise to a gap in teeth include
- Missing teeth
- Crowding in one part of the jaw and spacing in the other
- Impacted teeth that fail to erupt leaving a space
- Extraction space that arises when a tooth is removed
- Presence of a thick frenum that prevents a tight contact between the two teeth on its either sides
Different Types of Gaps In India
Based on the cause which gives rise to the gap, there are gaps of different types:
- Midline diastema– this gap is probably the most common type of gap or spacing that is treated using orthodontics. This is usually seen in between the upper two front teeth and is because of a thick frenum or fold of tissue that connects the upper lip to the upper jaw. We all have a frenum, but in some people, this frenum is thick and prevents the teeth from coming in contact with each other leading to a gap or diastema.
- Extraction Spaces– There can be many reasons why your dentist may extract or remove one or more teeth – cavities, crowding, extra teeth, etc. When a tooth is removed from its location, without a replacement in its place, it leaves a gap called an extraction space.
- Jaw-size and Teeth-size mismatch– As we saw earlier, in many individuals, there is a generalised gap between all teeth in one or both jaws leading to widespread spacing.
- Odd tooth Shape– Have you ever noticed people who have a slightly narrower or conical-shaped upper front teeth? These are called peg laterals and are thinner and smaller in size than the original form of the tooth. Due to this changed shape, there is a gap created between the tooth and its adjacent teeth.
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Why Should we Close Gaps in India?
Have you ever wondered – why these gaps in teeth must be closed? Just as crowded teeth can cause problems to the gums and teeth, the spacing between teeth also has some inherent problems:
- Lodgement of food in these spaces between the teeth
- Cavity formation
- Excess stress on the teeth on either side of the extraction space
- Poor aesthetics
- Difficulty in speaking and pronouncing
How To Close these gaps | Braces Take to Close a Gap
Now that we know the different types of gaps or spaces and why we should close them, let’s understand how to close them. Each of the different types of spaces we mentioned above needs to be closed to ensure that all your teeth are in function and good health. Missing a tooth or having space between teeth is not normal and therefore needs to be addressed.
The best way to close gaps is by orthodontic treatment using braces or clear aligners. However, when there are large extraction spaces in an otherwise well-aligned mouth, the best way to close the area is to replace the tooth using an implant or a bridge.
In the case of odd-shaped or conical-shaped teeth, using cosmetic procedures like veneers, composite fillings or crowns is the best way to close the gap.
However, when there are generalised spaces, midline diastemas, extraction spaces in poorly aligned dental cases, orthodontics is the best and the most natural way to close spaces. Many patients find that orthodontics takes much longer than the other procedures. But, it is important to understand that in the case of crowns, bridges, and veneers, the existing natural teeth are shaped and ground to place an artificial tooth. This can cause some problems like sensitivity, pain, etc.
Closing a small gap such as the midline diastema can take about 3-4 months and also involve shaping or trimming of the frenum so that it doesn’t cause the gap to occur again after the braces treatment is completed. In the case of generalised spacing, the entire treatment can take up to one year with both braces and clear aligners.
Why Can’t Extractions Gaps Be Closed Using Braces?
Many patients visit the orthodontist’s clinic, asking to close an extraction space using braces. But it is not always possible. When a tooth is removed, space gets created, which is the size of the removed tooth. Many a time, the patient fails to replace this tooth causing the adjacent teeth on either side of the tooth to start moving into this space or tilting towards this space. So, when such patients visit the clinic for the closure of the extraction space, space is much lesser than it was just after the tooth was removed.
In such cases, the orthodontist evaluates the teeth and bite of the patient and determines whether the readily available extraction space can be used to correct the alignment of the patient’s teeth. However, just because there is space open in the jaw, an orthodontist cannot put braces and a wire to close these gaps. The closure of gaps occurs following the existing teeth, the bite, facial and skeletal profile other and such parameters. But, in many cases, the orthodontist use as much of the space as is available from the extraction case to align the teeth and correct the patient’s bite.
So, one must note that not all extraction gaps can be closed using braces.
Gaps in the front teeth after completing braces treatment
When the gap in the front teeth or the midline diastema is treated using braces, many patients come back to the orthodontist complaining of relapse or re-opening of the gap a few months after the braces have been removed. Why does this happen? The simple cause is that the actual problem of the gap, i.e. the presence of a thick frenum has not been addressed.
A right orthodontist advises the frenum to be snipped off or removed before he/she removes the braces. This ensures that the gap doesn’t arise again.
Cases of midline diastema should be given a permanent retainer which is a thin metallic wire fused to the backside of the front teeth to prevent relapse.
Closing Premolar Gaps in India
If you have to crowd in your teeth, it is highly likely that your orthodontist will advise you to get two or four of premolar teeth removed to make space for the crowded teeth to get aligned properly. Most patients wonder how the orthodontist will close these gaps. The simple answer is using braces or aligners. These gaps are closed by utilising the available space to decrowd the crowded teeth. These gaps are deliberately created to make space for other teeth which are required to perform specific functions of biting, chewing and aesthetics (we have 8 premolars in our mouth and removing 2 or 4 doesn’t affect the bite, facial profile or alignment of the jaws)
So, it is quite a regular practice to close the premolar gaps using orthodontic treatment.
Power Chain to Close Extraction Gaps
Power chains are basically elastics that are used to speed up the closure of extraction spaces when the premolars are extracted as part of the treatment. They are o-shaped and linked together to form a chain. Though regular braces and wires can perform the same function of space closure, the power chain does the job more quickly.
How to fix the gap in front teeth without using braces
Though braces are the best and the most natural way of closing a gap in the front teeth, there are other options available too. These include – crowns, veneers, composite(filling material) build-up. These options are quicker than braces but involve grinding of teeth or using artificial material to close the gaps.
Aligners are best suited for such cases of the gap in front teeth. They do the job efficiently and comfortably without the pain of fixed braces.
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