Maria came to me at her consultation: «I've hated my smile for 30 years. Every photo, lips closed. People call it ‚cute', I can't.» She had a 3 mm diastema between her upper central incisors. Fixable in 3-12 months depending on the route.
A diastema (Greek for «interval») is a gap larger than 0.5 mm between the front teeth. It's not a disease. 5-20% of adults have it as normal anatomy. Many want it closed for cosmetic reasons. or because food keeps getting stuck there.
5 causes of diastema
Understanding the cause is the key to choosing the right treatment.
Large lip frenulum (Frenulum labii)
Most common cause in adults, 40% of cases. The tissue band between upper lip and gum extends far between the incisors, preventing them from closing. Diagnosed in 2 seconds during exam. Treatment: frenectomy (band cut) with laser, 10 minutes, 200-400 € private.
Tooth-jaw size discrepancy
Small teeth in a large jaw, or large teeth with a normal jaw. Hereditary. 25% of diastema cases. Treatment: orthodontics (braces, Invisalign) or composite restoration (tooth buildup).
Missing lateral incisors
If lateral incisors (teeth 12 and 22) are missing congenitally or extracted, the central incisors drift outward and create a central gap. Treatment: implant for missing teeth or orthodontic space closure.
Childhood habits
Thumb sucking, prolonged pacifier use, tongue thrusting. all create pressure that pushes the front teeth apart. If the habit continues past age 6+, the effect persists. Treatment: orthodontics in adolescence or after age 25.
Periodontitis (bone loss)
Progressive periodontitis causes tooth support loss and drift. New gaps appear or existing ones widen. Treatment: first periodontitis therapy (PAR), then orthodontics to reposition teeth.
4 treatment options (cheap to expensive)
Which option fits depends on gap width, cause, age, budget. Real 2026 Hamburg data.
Composite restoration (bonding)
Fastest and cheapest option. The dentist adds composite to the side surfaces of the incisors, making them wider. Duration: 1 visit, 1-2 hours. Cost: 300-800 € private (2 teeth). Lifespan: 5-10 years, then refresh. Suitable for: gaps up to 2 mm, no bite issues.
Porcelain veneers
Thin ceramic shells on the front teeth. Aesthetically perfect, very durable. Duration: 2-3 visits, 3-4 weeks. Cost: 800-1500 € per tooth (private), 2-4 teeth, 1600-6000 €. Lifespan: 15-20 years. Suitable for: gaps up to 4 mm, also when you want to improve shape and color.
Orthodontics (Invisalign)
Clear removable aligners that gradually move the teeth. Most physiological option, no tooth tissue removed. Duration: 6-18 months. Cost: 3500-6500 € (full course, private). GKV doesn't pay for adults. Suitable for: gaps 2-5 mm, especially combined with other bite issues.
Braces (metal or ceramic)
Classic orthodontics. Brackets are bonded to teeth, wire moves them. Duration: 12-24 months. Cost: 2000-5000 € (private, adults). For under-18s with KIG 3-5, GKV covers partially. Suitable for: large gaps 4-8 mm, complex cases.
What GKV covers
The aesthetic part of diastema isn't covered. it's not a disease. But there are exceptions.
✅ GKV-covered: treatment of the underlying medical cause (periodontitis, cyst removal); orthodontics for kids under 18 with KIG 3-5; extraction of supernumerary teeth (mesiodens); basic filling if there's caries.
💰 Private: composite restoration on front teeth (bonding), veneers, orthodontics for adults (Invisalign, lingual braces), implants for missing teeth.
🛡 Zahnzusatzversicherung: covers 70-90% of veneers, orthodontics, implants. provided you complete the 8-month waiting period. SIGN UP BEFORE your consultation, not after (otherwise rejected as pre-existing).
How to choose: checklist
Which to pick depends on your priorities. Checklist for your conversation with the dentist.
📐 Gap width: up to 2 mm, composite. 2-4 mm, veneers or Invisalign. 4-8 mm, Invisalign or braces.
⏱ Time: composite, 1 day. Veneers, 3-4 weeks. Invisalign, 6-18 months.
💰 Budget: under 1000 €, composite. 1500-4000 €, veneers. 3500-6500 €, Invisalign.
🦷 Tooth structure: composite minimal, veneers require 0.3-0.5 mm enamel removal (irreversible), Invisalign zero.
🌱 Other bite issues: if there are crooked teeth or bite problems, only orthodontics gives a complete result.