Expert: Mark Bornfeld DDS - 4/8/2009

Question
Hello. I am 30 yrs old, female.I told my dentist that I have been noticing my front teeth spreading apart. I have not lost any teeth and my mouth/teeth are in great shape. I've had regular dental care since I was six (same dentist). He agreed with me. I am getting a gap between my front teeth which is getting worse little by little....and the bottom front teeth used to be more overlapped than they are now. The dentist says this is unusual.

Is it unusual ??

He said he can make me a retainer to wear at night, but I will have to wear it every night and the teeth may spread back apart some during the day.

I've also been seeing a neurologist for migraines. Now I am also having vertigo when I lay down and when I turn side to side in bed. I am still going through testing for everything with the neurologist. So far the MRI was ok with "slight ossification of falx" and a spot in the right frontal lobe that is often seen with migraine patients. (?).

I also have TMJ and used to wear a retainer for that at night.

Anyway, just wondering ....IS IT rare for teeth to spread apart in the adult patient ?

Thanks.  

Answer
Dear Melissa,

It is not uncommon for teeth to spread apart in an adult patient, but the phenomenon is strongly associated with either loss of posterior (back) teeth or the development of periodontal (gum) disease. Less frequently, tooth spreading may be due to some oral habit, or the development of systemic bone or connective tissue disorders. It is also possible that an improperly designed night guard (your "TMJ appliance") may be implicated in the shifting of your teeth. I am inclined to believe that the MRI findings and the presumptive diagnosis of migraine are unrelated to the spreading of your teeth.

I would recommend that you ask your dentist to evaluate you for periodontal disease, as well as assess the fit and design of your night guard. Additionally, some thought should be given to replacing any missing posterior teeth, if deemed appropriate by your dentist.

Hope this helps...

Mark Bornfeld DDS
www.dentaltwins.com
Brooklyn, NY