Gaps and Spacing Between Teeth: Orthodontic Correction
For adults with one gap or several between their teeth: the types of spacing, why gaps occur, when moving teeth may be enough, when restoration is also needed, and why closed gaps can reopen. In general, teeth too small for the space may need both moving and building up, and retainers help hold the result.
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Clinically reviewed by Dr Ibraheem Ijaz, dentist · GDC 301711
Medical disclaimer: This page is for general information only. It does not replace an examination or treatment by a dentist.
Dr Ibraheem Ijaz, principal dentist, reviewed this page. He is a General Dental Practitioner: BDS, BSc (Hons), MSc (Leeds), PG Dip Implant Dentistry, PG Cert Restorative and Aesthetic Dentistry.
What types of spacing between teeth are there?
Spacing between teeth can be one gap between the two upper front teeth, or gaps spread across several teeth.
The first is a midline diastema; the second is generalised spacing, where teeth take up less room than the arch provides.
A review of midline gaps says treatment type, timing and retention depend on the cause, so it needs diagnosing first.
Why do gaps between teeth occur?
Gaps can occur for many reasons, the British Orthodontic Society (BOS) says, such as larger than average jaws or smaller than average teeth.
In generalised spacing both may apply. A one-time comparison of 312 normal, crowded and spaced casts from Sudanese people aged 16 to 26 found spaced arches widest, with teeth significantly narrower than in normal arches, apart from some premolars (molars were not measured), and concluded both contribute. In 240 orthodontic casts, a 2007 study found narrower teeth in spaced arches than normal ones, significant only for combined lower incisor width.
Sometimes adult teeth do not come through, leaving spaces, BOS adds. University College London Hospitals (UCLH) NHS guidance says hypodontia, where teeth fail to develop, is seen in about 5% of people, and the teeth present usually drift and leave unevenly sized gaps. In hypodontia, it adds, microdontia (teeth smaller than normal) often results in gaps.
UCLH's hypodontia guidance says a large frenum, the fleshy gum under the lip between the front teeth, can contribute to a gap there.
BOS says incisor spacing can follow drifting due to periodontal (gum) disease, and braces can close it once the disease is stabilised. NHS guidance says to see a dentist if your gums bleed when you brush your teeth or eat hard foods, your gums are painful and swollen, or you have bad breath. Ask for an urgent dentist appointment if you have gum disease and other symptoms such as very sore and swollen gums, teeth becoming loose or falling out, ulcers or red patches in your mouth, or a lump in your mouth or on your lip.
If you do not have a dentist or cannot get an emergency appointment, call 111.
When is orthodontic treatment alone enough?
Moving teeth alone can sometimes close all the gaps, UCLH guidance on hypodontia says.
Large gaps between the teeth are one reason braces may be needed, NHS guidance says. For clear aligners, BOS counts mild spacing as a routine use. Brace and aligner types sit among the options in this section.
In a 2011 report illustrating options in five adults with midline gaps, three had appliances; one had composite for small teeth and generalised spacing; one had veneers for discoloured teeth.
When is restoration also needed?
In general, teeth too small to fill the space once moved may need a combined pathway: moving plus restoration.
A tooth size discrepancy is a disproportion in tooth widths, within or between arches, and a Bolton discrepancy measures it as a ratio of lower to upper widths. A 2006 UK review says studies report significant discrepancies in 20 to 30% of people for front teeth and 5 to 14% overall, but most used samples unlikely to represent orthodontic patients, Bolton's original sample was not suited to showing their size or prevalence, and studies are needed to determine what size matters clinically.
UCLH says that in hypodontia braces can create the ideal amount of space, restorative techniques then replace missing teeth, and small or wrongly shaped teeth frequently need composite or a veneer. Building these teeth up is sometimes the only treatment required, it adds.
A 2023 paper reports two cases of tooth size discrepancy managed with clear aligners plus minimally invasive restorative procedures.
Our pages compare bonding or clear aligners for gaps and cover gaps between teeth as a cosmetic concern.
To ask about orthodontic treatment, book online or call 0114 288 2121.
Can closed gaps between teeth reopen?
Yes. Gaps closed by moving teeth can reopen, because teeth tend to return to their original positions, which BOS calls relapse.
In 30 patients given fixed braces from about age 13, with removable upper retainers for about 1.4 years, the average midline gap rose from 0.04 mm after treatment to 0.49 mm a mean 5.6 years after retention. Reopening occurred in 18, by 0.78 mm on average; 8 of the 30 finished with some space left, which the authors say might have influenced relapse. Gaps beside the central incisors reopened in 5 on each side, not a significant change.
A follow-up of 96 patients with midline gaps, 4 to 9 years after treatment, classed 49% as relapsed, meaning a measurable space, treatment to reclose it, or continued retainer use to control it. Of 35 patients with midline gaps followed for a mean 11.4 years after retention, 12 had measurable relapse, mostly 0.6 mm or less and at most 3.0 mm.
All three follow-ups selected midline gaps, so may not reflect generalised spacing. None gives an aligner figure or compares aligners with braces, and the 30-patient study excluded, among others, missing front teeth, generalised microdontia, gum disease with bone loss and teeth widened by restoration. If a closed gap starts to reopen, show it to a dentist.
How are closed gaps held in place?
In general, closed gaps are held long term with retainers, which BOS says almost everyone needs after orthodontic treatment.
A 30-patient study suggested lifetime wear of a fixed upper retainer for midline gaps, but it excluded patients with one, so did not test that. A 2023 Cochrane retention review after braces, excluding aligner studies, found low to very low certainty evidence and could not draw firm conclusions about any one approach over another.
Where a missing tooth is to be replaced, UCLH's hypodontia guidance says retainers should be worn all the time after orthodontic treatment until that is done, as spaces can easily change in size. Our page on retention after treatment covers retainers.
Does Deepcar Dental Care treat gaps and spacing?
Yes. Orthodontic treatment at Deepcar Dental Care is for adults only, and mild to moderate crowding and spacing are among the problems treated.
Options offered include fixed metal, ceramic and lingual braces and clear aligners; see orthodontics at Deepcar Dental Care.
Composite bonding options include gap closure.
Frequently asked questions
How long does closing gaps with braces or aligners take?
It depends on how far the teeth need to move, and your plan confirms your timescale. The NHS describes fixed braces staying in place for 1 to 2 years. As general guidance, clear aligners can take a matter of months for small front-tooth corrections, while fuller treatment often takes 12 months or more.
Does spacing always suit clear aligners?
Not always. The British Orthodontic Society says aligner treatment may need fixed appliances or other additional techniques in cases such as severe crowding, treatments that require tooth extraction, complex tooth movements, or problems that reflect an underlying discrepancy in the size or position of the jaws.
Am I too old to have gaps closed with braces?
Age alone is unlikely to rule it out. British Orthodontic Society guidance for dentists says it is really never too old to have orthodontic treatment, assuming good dental health, good oral hygiene, and sufficient teeth and supporting bone. It adds that not all cases suit less visible appliances.
What if I have crowns or a bridge near a gap?
Orthodontic treatment can prove more challenging for some adults, British Orthodontic Society guidance for dentists says. Bridges fixed at both ends need sectioning before active tooth movement, and special measures may be needed to bond brackets to porcelain. Patients should be told such restorations may need replacing afterwards.
Does an abnormal frenum make a closed gap more likely to reopen?
Two studies suggest not. A follow-up of 96 patients with midline gaps found no association between relapse and an abnormal frenum, although those with one had wider gaps before treatment, a risk factor in that study. In 35 patients with midline gaps, abnormal frenums did not appear to be a risk factor, and no pretreatment predictor could be established.
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