What is a “black triangle”?
A “Black Triangle”, or clinically known as “Open Gingival Embrasure”, is the triangular space between two teeth that is not covered by gum tissue. Black triangles can make a person self-conscious because they can at times be mistaken for a black seed or pepper flake stuck between the teeth. These triangles can even affect speech or result in some patients “spitting” when talking. Moreover, these gaps can serve as food traps that encourage plaque build-up which eventually lead to tooth decay.
What causes “Black Triangles”?
There are three main reasons you may have black triangles:
- Triangular shaped teeth
Some people have teeth that are narrower at the gum line and wider at the bottom. When the wider portion of the two teeth touch, there is a space between the narrower end of the two incisors.
- Gum recession
The gum tissue that fills the space between your teeth is called the interdental papilla. It helps protect the roots of your teeth and keeps food from getting stuck between your teeth. Healthy papilla should be firmly attached to adjacent teeth. Papilla is susceptible to recession and damage due to improper brushing/flossing and gum diseases.
Aggressive brushing can irreversibly damage the sensitive gum tissue. Interdental brushes, tiny wand-like brushes used to clean between the teeth, can cause black triangles if they are too big for the space. Once lost from recession, papilla cannot grow back and you’re left with a black triangle gap.
- Bone loss
Periodontal disease can lead to bone loss near the base of a tooth. When bone is lost, the gum tissue including the papilla in that area will also recede permanently. The teeth will take on an elongated, aging look.
- Post-orthodontic treatment
If you have overly rotated teeth or overlapping teeth, the papillae in between the overlapped teeth are never properly formed. Once your teeth are properly aligned and rotated after orthodontic treatment, you may notice small gaps between your teeth where the papillae were missing in the first place.
How to hide/fix a black triangle?
There are several ways to fix a black triangle:
- Bioclear Matrix Technique
Bioclear Matrix for Black Triangle is a type of cosmetic resin bonding system that is uniquely designed to fix the appearance of black triangles. Your dentist will add composite resin to both sides of the triangular tooth. The resin matrix and the application technique make the bonding stronger and less porous (more resistant to wear and staining). Each triangle takes about 1-hour to fix and the patient will leave with instant results! The best part of this treatment is that no natural enamel structure is removed (i.e. no drilling) and therefore no local anesthetic is needed! Bioclear Matrix is a technique-sensitive procedure and requires the administering dentists to have undergone special training.
- IPR (Interproximal Reduction)
IPR is frequently used after orthodontic treatment such as Invisalign to reduce the side-to-side width of the incisor. If done conservatively (by no more than 0.25 to 0.5 mm), IPR is a safe way to make the triangular shaped tooth more rectangular. Depending on the size of the black triangle, the thickness of the enamel and your individual cavity risks, your dentist will determine on a case-by-case basis whether IPR is a good option to hide the appearance of dark triangles.
Porcelain veneer(s) are a good option particularly when there are other cosmetic concerns to be addressed (such as discoloration, chipping or enamel damage in the tooth) in addition to the black triangle. Unlike crowns, which cover the entire tooth, veneers only cover the front and a little over the sides of the teeth. Less natural enamel is removed and we can customize size, color and shape to match the surrounding teeth. Local anesthesia is usually required to ensure optimal comfort during the procedure.
- Gum surgery or fillers
Usually involves a soft tissue graft or hyaluronic acid filler.
In summary, the optimal treatment for black triangles will vary according to the tooth anatomy/condition, the size of the triangle and gum tissue health. In cases where the enamel is healthy, your dentist can close these gaps using the minimally invasive Bioclear Matrix method to improve the integrity of the gum and achieve predictable, attractive and long-lasting outcomes.
Interested in improving your smile? Dr. Wilhelms at Parkview Dental Associates, Sun Prairie is a Bioclear certified provider. Call our office (608-837-7394) or contact us via our website to schedule an appointment!