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ClosingtheGapBetweenFrontTeethCanCreateaMoreAttractiveSmile

Many otherwise attractive smiles have one noticeable blemish — a large gap between the two upper front teeth. If you have such a gap, there’s a solution that could transform your smile.

The most likely reason for the gap is an issue with a bit of muscle tissue between the gums and upper lip known as the frenum, part of the face’s muscular system. The frenum, though, can overdevelop and grow between the two front teeth into the front part of the palate (roof of the mouth). This can keep or push the teeth apart to form a gap.

To correct the issue, it’s first necessary to consult with an orthodontist, a specialist in bites and tooth alignment. It’s possible for there to be other factors contributing to the spacing including tongue thrusting or finger sucking habits, or missing or misaligned teeth. If the examination reveals an overly large frenum, then the treatment usually commences in two stages.

First, we would need to close the gap by the moving the teeth toward each other with some form of orthodontic appliance like braces or clear aligners. Once closed, the next stage would be to surgically remove the excess frenum tissue and cosmetically alter the gums if necessary.

The order of treatment is important — if you remove the frenum tissue first, any resulting scar tissue could prevent closing the gap with orthodontics. Further, cosmetic surgery on the gums beforehand could result in the loss of the papillae, the small triangular gum tissue between teeth, which results in an unattractive “black” hole.

A frenectomy, the procedure to remove the excess frenum, is a relatively minor procedure that can be performed by a periodontist (gum specialist), oral surgeon, or a general dentist with surgical training. The area is numbed with a local anesthetic, the tissue dissected with a small scalpel, and the resulting small wound closed with a few stitches (another option is to use a surgical laser to remove the frenum). Healing should be complete in about a week with only minor discomfort.

Depending on your individual circumstance, full treatment can take time. But in the end these otherwise routine dental procedures can have a huge impact — a more attractive smile without the noticeable gap.

If you would like more information on treating abnormal teeth spacing, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Space between Front Teeth.”

By Patrick H. Collins, PC
November 15, 2013
Category: Dental Procedures
Tags: orthodontics   frenectomy  
MinorProcedureCanHelpKeeptheSpaceBetweenTeethClosed

You have a beautiful smile, but with one noticeable flaw — there's a small gap between your two front teeth. It's a common occurrence that can be corrected with orthodontics.

There are a number of causes for this wider spacing, including an excessive overlap bite of the upper teeth over the lower, habits such as tongue-thrusting or finger-sucking, or extra (or even missing) teeth. But one of the most common is the presence of an overly large muscle attachment called a frenum or, as it's sometimes referred to, frenulum. If that's the case, you may need a minor surgical procedure in addition to orthodontic treatment to ensure the space remains closed.

The frenum is the fold of tissue that contains some muscle tissue that connects the gum to the lip. In certain people, a larger than normal frenum may extend further to the front of the roof of their mouth, just behind the teeth, and may also extend lower between the teeth and contribute to the gap. Unless some of this tissue is removed, it can force the teeth apart again after the gap has been closed through orthodontics.

This simple procedure is called a frenectomy. After numbing the area with a local anesthetic, we remove the excess tissue from the frenum extended into the space between the teeth, using either a small scalpel or a special laser. The resulting wound is generally very small and may require only a few stitches, if any. Healing usually takes no more than a week and any discomfort is easily managed by anti-inflammatory medication like aspirin or ibuprofen.

As a general rule, a frenectomy is best performed after the orthodontic treatment so that scar tissue resulting from the procedure won't interfere with the gap closure. With proper dental follow-up, the gap should stay closed — and your new enhanced smile won't fade away.

If you would like more information on treating spaces between teeth, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Space Between Front Teeth.”