One common question I get, especially from some of my older patients, is why they have dark spaces in between their teeth. Dentists usually call these “black triangles” and they tend to appear as you get older but can appear at any age. Black triangles can appear for several reasons.
- Bone loss around your teeth. Your gums follow the shape of the bone around your teeth. When you lose bone, the gum tissue slowly follows. One of the first places people lose bone with gum disease is in between the teeth. As this bone recedes, the gums are no longer able to fill in the space between your teeth all the way.
- Gum recession from brushing too hard. If you brush too hard you can actually damage the gum tissue which will recede. If it recedes enough these dark areas can show up.
- The specific shape of your teeth. Teeth that only touch each other lightly at the tip have a much larger space that needs to be filled in by the gum tissue than teeth that have a more broad contact area that is closer toward the gum tissue.
- After scaling and root planing. This is an extension of the gum disease and bone loss part of the equation. Many people with gum disease don’t know they have it. The bone loss has already occurred but the gum tissue hasn’t followed yet. In fact, the gum tissue when it is unhealthy tends to be larger than normal. Once the gum tissue is healthy again it starts to follow the bone. This tends to open up those spaces.
This diagram explains a little better what measurement is important for minimizing black triangles. As the bone recedes or the point where the teeth touches goes more towards the tip of the tooth that measurement gets longer. Beyond a certain length your body can no longer close it all in with gum tissue.
So what can be done about black triangles?
Bonding or veneers to widen your teeth and cover the areas. This works well when the black triangles are relatively small. When the black triangles are larger, you can’t always close them all the way as it would make the teeth look disproportional.
Flattening and lowering where the teeth make contact (by removing some enamel on the sides) and then using braces to pull everything back together. This is a pretty aggressive type of treatment just to help get rid of the black triangles. Most people aren’t willing to go through this unless they are already having braces done for another reason.