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Esthetic Era - Treatment for Midline Diastema

Author: Dr. Nivedita Dalmia - Dental & Oral Health
Last reviewed at: 06.Sep.2018  



In this article, we will discuss various treatment options for a gap in upper front teeth, medically known as midline diastema.
Image: Esthetic Era - Treatment for Midline Diastema

What Is Midline Diastema?

Midline diastema is the gap present between the upper front teeth irrespective of spacing present between the lower front teeth.

If the gap present between the upper front teeth is more than 0.5 mm proximally, space is visible between the upper central incisors. Usually, midline diastema is seen in children during mixed dentition period (6 to 12 years), which is also called ugly duckling stage. Generally, the spacing present in the upper front teeth during mixed dentition period closes after the eruption of permanent canine.

Other Reasons for Midline Diastema

  1. Enlarged labial frenum.
  2. Oral habits such as thumb sucking, tongue thrusting, etc.
  3. Unerupted mesiodens (the extra tooth sometimes present between the upper front teeth).
  4. Abnormal maxillary arch (the upper jaw is known as maxilla).
  5. After mesiodens extraction.
  6. Missing teeth, leading to a shift of the incisors.
  7. Peg laterals and missing laterals.
  8. Hard and soft tissue pathologies such as a cyst, tumor, odontomes (benign tumor), impacted tooth.
  9. Other dental abnormalities.
  10. Periodontitis, that is gum disease.


  • Blanch test: Lift the upper lip and pull it outward and look for blanching (whitening of the skin) of the soft tissues at the backside of the tooth and between two central incisors. If the blanch test is positive, it indicates high frenal attachment as the cause of midline diastema.
  • Radiograph: to check for impacted tooth, cysts, tumors, or any other pathology present.
  • Check for oral habits such as tongue thrusting, and thumb sucking.


  1. Ugly duckling stage - no treatment required. It gets self-corrected after canine eruption takes place, in most of the cases.
  2. Fixed/removable appliance - breaking oral habits through guidance and fixed or removable appliances.
  3. Composite build-up.
  4. Veneers - if peg laterals are present, the space can be covered by veneers or crowns.

Thus, correction of midline diastema will improve the esthetics of an individual and also enhance the smile. It will build confidence, improve wellbeing, and the personality of an individual. Proper teeth alignment is the gateway to perfect smile.

For more information consult a cosmetic dental procedures specialist online --> https://www.icliniq.com/ask-a-doctor-online/dentist/cosmetic-dental-procedures



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