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Bridging gaps.

Gaps between front teeth do not have to be permanent. There are several remedies, suggests Frank Miranda, assistant dean for clinical affairs and professor of operative dentistry, University of Oklahoma Health Sciences Center College of Dentistry.

To determine the best method of correction, the reason for the spacing must be determined. "The majority of instances is developmental. From this standpoint, as the teeth grow, there is simply more room than necessary to accommodate all of [them]. Therefore, gaps appear. Another reason may relate to the muscle attachment [frenum] found between the upper lip and the upper dental arch in the area of the two front teeth. Very large or fibrous attachments may contribute to splaying of the teeth in that area.

"Many times, orthodontic are which involves selective extraction creates more room to accommodate the teeth and that can cause space between the two front teeth. Gaps can also occur from bad habits such as continually picking one's teeth. ...Dental restorations that have become worn also may create extra spacing, as well as teeth that do not grow fully or that are malformed."

There are various approaches to fill in the gap. "One of the most conservative ways, which is a long-term procedure, is to orthodontically move the teeth together by a retainer appliance. The technique places gradual movement on the teeth.

"If the space is a small, manageable gap, the acid etch composite technique can be effective. The procedure involves adding composite to the surfaces of the teeth on each side of the gap and basically restructuring the teeth. If a sizeable gap is involved, chairside or laboratory prepared veneers, which are shells shaped like teeth, can be used. They are affixed with acid etch composite.

"In severe gaps, in which the size is equivalent to the size of a tooth, the only way to manage the space may be with . . . either a conventional bridge, which involves the preparation of teeth on either side of the space and actually cements the tooth into place, or the bridge can consist of a |flipper,' or removable appliance that fills in the space."

Miranda points out that, if the teeth are in reasonably good condition with no staining or major restorations, the more conservative approach usually is the best--minor orthodontic correction. Many people elect to leave the gap untreated if it is not substantial. "It's usually a matter of cosmetics and being comfortable with the gap."
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Title Annotation:correcting gapping between teeth
Publication:USA Today (Magazine)
Date:Oct 1, 1993
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