Unsightly spaces between teeth, known as black triangles, are often caused by gum recession, bone loss, gingivitis or periodontitis, or faulty cosmetic dental procedures involving porcelain veneers. The black triangles can expose the gum line to bacteria and plaque, which will lead to permanent decay and possible tooth loss. There are no simple, at-home solutions for fixing black triangles between teeth, and cosmetic dental surgery is often needed to repair receding gums and replace lost bone.
Since the black triangles are caused by a loss of gum tissue, the ideal treatment would be the regeneration of that part of the gum called the interdental papilla. But to date, there are no techniques for restoring the papilla. Therefore, the only possibility we have is to modify the shape of the tooth in such a way as to fill the space left empty by the recession of the gum. The modification of the shape of the tooth can take place through:
1. Dental Veneers: Dental veneers are thin ceramic plates that are placed on the outer surface of the teeth and are used to improve the aesthetics (making the teeth whiter, closing the black interdental spaces, creating symmetrical shapes, centering the midline) or to recover masticatory functions following trauma (fractured teeth, chipped margins) or dental wear. Veneers work because they are able to change the change the shape of your teeth, generally widening them at the bottom, eliminating the triangle-shaped spaces.
2. Dental bonding: Dental bonding essentially works like veneers, except instead of using a ceramic plate, the teeth are re-shaped with composite material that is built up over the teeth and then cured with ultraviolet light.
3. Orthodontics: Orthodontics can re-align the teeth to eliminate the triangles.
4. Gum treatment or plastic surgery: Treating this issue with the gums can be painful and a long process, but a surgeon can re-vitalize the papillae through surgery that will cosmetically and physiologically regenerate the gum tissue between the teeth.
If you start to notice the appearance of the black triangles, you should make an appointment with your dentist as soon as you can. In the meantime, you can start gently cleaning the gum line to help reduce inflammation due to gum disease. In order to work towards a solution, when you consult the dentist, they will determine how severe the damage is. During the consultation, the dentist will recommend different procedures based on the severity of the gum recession and black triangles. In the event that the black triangles were caused by a prior improperly performed dental procedure, a new dentist may be able to repair the fault. If the triangles and damage are the result of an improperly performed crown or porcelain veneers, your dentist will most likely be able to resolve this issue. This could mean having the old crowns or veneers removed and replaced completely if the original procedure was done improperly.
If the triangles are due to gum recession only, your dentist might recommend you undergo corrective surgery, such as papilla regeneration, which regrafts the gumline and repairs the soft tissue between the teeth. This surgery will not only fix black triangles, but it can help the cut root expose to permanent damage. If the black triangles appear due to the shape of your teeth, either naturally or combined with gum recession, your dentist might want to treat the problem with new veneers, dental bonding, crowns, or orthodontics to re-align your teeth.