Orthodontia-filter: Minding the gap, and mending the gap?

September 2, 2014 10:05 AM

Would like some AskMe advice on fixing my front tooth gap (midline diastema), especially from folks who have done or know people who have done a similar fix. I am 98% pro-orthodontics, but am undecided between traditional braces and invisalign, and then a small part of me is wondering if I'll have regrets about fixing it at all.

I've had a front tooth gap all my life - however it has been bothering me more and more recently because it is widening. (I have a bit of a tongue thrust (new dentist's observation when I asked why it may be happening) plus i believe i tend to push against my front teeth unconsciously) So they are a bit tipped out, gap is about 4mm I'd guess, and I on a few occasions I have noticed a bit of accidental whistling (but then again, i am hyper-aware of this -- no one has said anything to me)

So, I want this fixed before it gets really big/out of control, either fully closing it or leaving a small gap. Found a dentist and ortho who are on board with either, and aren't suggesting I do anything else like veneers, etc, so I am happy about that (eg they are not trying to give me the "perfect smile"). Found and am paying into an insurance program and HSA for help paying for it. (They even gave me the option of just fixing the upper teeth, and not my overbite, but it seems like I should take care of it all if I am fixing the uppers.) Other than the gap, no other dental issues as far as I know except jaw clicking w/o pain.

Here's where I'm stuck now: When I bring it up, many friends and my boyfriend say the gap is cute, it's my identity, they like it, etc. They support me and I know it's my decision, but now I am having second thoughts, so question 1) is: Have you/someone you know fixed a gap like this, and had regrets or has it been a positive experience?

And the other question is a practical one: 2) Invisalign or traditional braces?

Should be about 9 months treatment length either way. Invisalign is about 1k more out of pocket, but I like that it can be removed (I don't anticipate any major events in the next year, but who knows.) My concerns however are: may be a pain to take in and out, keep track of when eating, and compliance issues (will I tend to leave them out?). Admittedly, I like that it may prevent me from mindless grazing and noshing since I do that quite a bit.

I guess the pros for traditional braces is that they seem like they have better control (eg I see a person for adjustments... I think that is a plus? I don't know), I don't have to worry about compliance because they are stuck on there, and they don't look BAD (they actually seem pretty cute!)... but I have never had dental work other than wisdom teeth coming out (*knocks on wood*) so I really have no idea if the metal/wire aspect of it sucks.

I can't think of any other info to provide, but let me know. Oh, and I realized that a pic is probably warranted in this situation so I changed my profile pic on here for demo purposes. Thanks for your feedback on this long-winded explanation. :)

posted by NikitaNikita to Health & Fitness (15 answers total)

You will not regret straightening your teeth. The process is tedious, but the benefits are many. If you are over 12, you might prefer the less noticeable plastic ones to the metal 'tin grin'.
posted by Cranberry at 11:06 AM on September 2, 2014 [2 favorites]

I had braces as a kid, then Invisalign (or something very similar) as a a retainer. I wore the retainer for about two years full time, then nightly for another two, and as soon as I stopped wearing it my teeth shifted back apart. I asked my dentist (recently--this person had no connection to my childhood orthodontist) about it and she said that this is just how my skull/jaw is--it wants a gap. So, while I imagine there have been advances in both techniques over the past decade or so, I do suggest you consider the possibility that your teeth may still gap somewhat.

I found the retainers more pleasant to deal with, so that would be my recommendation, but I'd want a lot of information about the long term results before I did it.
posted by Meg_Murry at 11:08 AM on September 2, 2014 [1 favorite]

I had about the same size gap before I had braces (a million years ago) and I would highly recommend doing this if you can afford it (sounds like you can) and if having braces themselves won't be a burden on you (sounds like you're totally okay with it). I have absolutely zero regrets.
posted by cooker girl at 11:23 AM on September 2, 2014 [1 favorite]

My two front teeth were, once upon a time, yellowed from a youth iron deficiency and gapped. As a young teen, my parents opted for veneers for the two front, over a minor surgery that would clip the tissue and allow the teeth to grow back together (frenectomy?). My bite is fine, so there was no push towards braces.

So I've had the veneers for ... a while now. I'm glad for that choice, because from my reading, getting braces or invisalign as an adult comes with a) must wear retainer for most of the day, or b) all that effort goes to waste, teeth migrate back, and c) expensive and long!

The more-expensive version, that I've declined from cosmetically inclined dentists, is crowns. My major objection to those is breakage: veneers can be patched, but a chipped crown means full-out replacement, and they're much more expensive. And I do things like mountain bike that mean that, well, I've had a few chips over the years.

If I had to choose, or in your position, I really would go with the veneers. Cheaper, easier, won't re-gap.
posted by Dashy at 11:29 AM on September 2, 2014

Ask your dentist if he can fill the gap reasonably by bonding some composite there (even if only temporarily) so that you can see what your friends think, or whether you feel that this changes your identity for good or for bad. it might cost a few bucks, but it might also help you answer whether you want to have something more definitive done or not. not every gap lends itself to this, but it's worth a go.
posted by OHenryPacey at 12:06 PM on September 2, 2014

I had a gap corrected with braces when I was in highschool. I had a lot of trouble with the gap coming back for a couple of years, until all of a sudden it didn't. For what it's worth, I miss my gap and regret having it corrected.
posted by Gonestarfishing at 1:19 PM on September 2, 2014 [1 favorite]

I and several of my friends have bonding on our teeth to close gaps and chips. I had my first bonding for 20+ years before they replaced it due to discoloration. If theres not an enormous amount of bonding needed, you don't want to look like you have horse teeth, then that might be an option. I do like orthodontia and retainers too. Also you might want to have the dentist take a good look at how thick your labial attachment is too. Sometimes if they're real thick it may influence teeth movement.
posted by PJMoore at 1:23 PM on September 2, 2014

I had diastema (and other toothy issues) corrected with braces as a teenager. I can't remember all the details, but it included braces for a while, then a retainer (which I was bad about using), and finally a permanent retainer across the back of my front two teeth which I am currently tonguing 20ish years later.

I have no regrets from having it done, and the only lasting "issue" is that flossing around the permanent retainer was kind of a pain.

The first time I was able to bite down on something cold without pain shooting up my gums was a revelation. Good luck!
posted by sparklemotion at 1:45 PM on September 2, 2014 [1 favorite]

i had my gap fixed during round 1 of braces when i was a kid. i don't regret it, as i hated the gap. i had the regular braces.

unfortunately, my orthodontist was not very good when i was a kid, and while he fixed the gap and my overbite, he left a whole host of issues undone. so for round 2 (july of last year to july of this year), i did invisalign. i made a deal with my orthodontist that if i didn't like the invisalign, or was amazingly non-compliant with the treatment, that he would switch me to regular braces with me eating the overage. i was fine with that deal.

invisalign was surprisingly easy. it was great because i could take them out and eat whatever i wanted. the wearing wasn't bad at all - the real pain in the ass is brushing your teeth all the time. but that was literally the worst thing about the process as far as time. my regular dentist doesn't like them because the trays basically trap bacteria, but i started using those brushes that go between your teeth, and he was much happier after that.

if you'd like more info, you can memail me about experiences.
posted by koroshiya at 2:57 PM on September 2, 2014 [1 favorite]

I had a gap that was fixed by braces as a teen. I did not regret it one bit. My gap came back within a couple years and I got mini braces to fix it again. It came back a second time. I lived with it for over a decade until I got two veneers on my front teeth to close it. I love them! They look great, was so much cheaper and easier than braces for me, and nearly 10 years later they are still in perfect shape. I love my smile without the gap, even tho others at the time told me the gap was cute.
posted by Rapunzel1111 at 4:21 PM on September 2, 2014 [1 favorite]

I had a pretty big gap between my front teeth despite braces. I also had a dead front tooth. I never smiled.

Due to a lot of dental phobia, I didn't do anything about it for a long time. Finally the dead tooth got too bad and I had it pulled and a bridge put in. That also got rid of the gap. Now I smile without being embarrassed.

You won't regret getting it fixed.
posted by kathrynm at 5:57 PM on September 2, 2014 [1 favorite]

Ask your orthodontist whether you'll need to have buttons put on your front teeth for the invisalign to work. They're absolutely hideous and totally undo the invisible aspect of them if they're on the front teeth, and if you're closing a gap, my hunch would be that they'll be necessary. If they are, I'd go with the tin grin.

That said, I am about 75% of the way through invisalign treatment and it has been totally worth it for me. I got used to them (it was awful at the beginning, now I barely notice their existence in my life) and I've lost a fair bit of weight because I don't ever snack. I love having straighter teeth (and my teeth were already pretty straight) and it's more healthy, too. Having the whole mouth fixed at once makes much more sense than just addressing one issue and leaving the others.
posted by Capri at 6:40 AM on September 3, 2014 [1 favorite]

I had braces as a kid, but was not very good about the retainer. Fast forward to 10 years later and I had a gap between my front teeth. When I mentioned it to people, they shrugged it off as "tiny", "unnoticeable", or "part of your look." But the thing was it bothered me and made me feel self-conscious about smiling. So I did Invisalign. I was very happy with the whole process, and have no regrets. (I'm also much better about using the retainer.)

So I would say if it bothers you, if you are at all self-conscious about smiling, or it is going to get worse, you should consider it. The clear plastic retainers also have the added benefit of not irritating your lips as much as the metal brackets and wires do.

Ask if they will be putting in a permanent retainer following the end of treatment, even if it is just between the front two teeth. While you will have a removable retainer to put in at night, the additional permanent wire might be better considering you push on your teeth with your tongue.
posted by gagoumot at 8:16 AM on September 3, 2014 [1 favorite]

Response by poster: Thanks all for the great input! Mulling on this and will update when I make some sort of commitment either way! (right now heavily leaning towards fixing with invisalign.)

(veneers were not suggested as an option for my case btw)
posted by NikitaNikita at 5:42 PM on September 3, 2014

Response by poster: I went for it, and chose the invisalign -- it was miserable and painful the first 4 days or so, but it is really working for me now. I do have attachments on the front teeth but they really aren't noticeable. I will decide towards the end of treatment whether I want to keep a little of the front gap or close it all the way.
posted by NikitaNikita at 7:04 PM on November 20, 2014