Gapped Teeth, Peg Teeth and Weak Enamel: Tooth Spacing and Shape Problems

A gap between the front teeth, a small “peg” tooth or teeth with thin, yellowish enamel can be harmless traits, part of normal growth, or occasionally a sign of a medical condition. MedlinePlus, from the National Library of Medicine, explains common causes and the dental options that can improve both appearance and function.

Widely spaced teeth (diastema)

MedlinePlus says widely spaced teeth can be temporary, related to normal growth and development of adult teeth. Wide spacing can also result from several diseases or continued growth of the jawbone.

Causes

• normal growth (temporary widening)
• tooth shifting due to gum disease or missing teeth
• a large frenum
• teeth that never formed (congenitally missing teeth)
• injury
• conditions such as acromegaly, Ellis-van Creveld syndrome, Morquio syndrome and Sanfilippo syndrome

Gum disease can make teeth shift. See signs of gum disease. For more on the frenum, see tongue-tie and frenectomy.

Options

MedlinePlus suggests asking your dentist whether braces can help if the appearance bothers you. Crowns, veneers, bridges or implants may also improve appearance and function. See veneers vs bonding vs crowns.

Abnormally shaped teeth

MedlinePlus notes that normal teeth vary in appearance, especially molars. Alternative names for unusual shapes include peg teeth, conical teeth, Hutchinson incisors, mulberry molars, microdontia (small teeth), macrodontia (large teeth) and conjoined teeth.

Causes

Diseases that can affect tooth shape include congenital syphilis, cerebral palsy, anhidrotic ectodermal dysplasia, incontinentia pigmenti achromians, cleidocranial dysostosis, Ehlers-Danlos syndrome and Ellis-van Creveld syndrome. MedlinePlus says some diseases also affect tooth color and timing, and some lead to missing teeth.

Correction

Braces, bonding and restorations such as crowns, veneers or bridges may be used to correct the shape and improve appearance and spacing. See dental bonding.

Thin, weak enamel: amelogenesis imperfecta

MedlinePlus describes amelogenesis imperfecta as a tooth development disorder that makes enamel thin and abnormally formed. It is passed down through families as a dominant trait, so the variant gene from one parent is enough.

• Enamel is soft and thin, and teeth look yellow and are easily damaged.
• Both baby and permanent teeth can be affected.
• A dentist can diagnose it.
• Full crowns may be needed to improve appearance and protect the teeth.
• A low-sugar diet and very good oral hygiene reduce the chance of cavities.

MedlinePlus says treatment is often successful in protecting the teeth. Left untreated, the enamel is easily damaged.

When to see a dentist or provider

• Your child’s teeth or jaws seem to be developing abnormally, or the shape of their teeth looks abnormal.
• Other health symptoms appear along with widely spaced teeth.
• You notice signs of thin or easily damaged enamel.

What to expect

The dentist examines the mouth, teeth and gums, and may take dental X-rays or facial or skull X-rays. For a child, MedlinePlus says you may be asked about medical conditions, when and in what order the teeth appeared, and other tooth problems such as color or spacing.

Frequently asked questions

Will my child’s gap close on its own?

It may. MedlinePlus says spacing can be temporary during normal growth. Ask your dentist.

Is a gap a sign of disease?

Usually not, but it can be linked to gum disease, missing teeth or, rarely, other conditions.

Sources

• MedlinePlus: Teeth – widely spaced
• MedlinePlus: Tooth – abnormal shape
• MedlinePlus: Amelogenesis imperfecta

By the Dentist Review Editorial Team.

This article is for general information only and is not medical advice. Talk to a licensed dentist about your own situation. See our disclaimer.

Featured image: “Laughing Laotian woman showing her teeth” by Basile Morin, via Wikimedia Commons, licensed CC BY-SA 4.0. Resized and compressed for the web.