What is an Interdental Papilla? How does it relate to Dental Esthetics?

The interdental papilla is the small amount of gum tissue that comes between the teeth. It is located between the gum line and the contact of the teeth.

When someone smiles people usually don’t pay attention to the papilla UNLESS it is missing. The absence leaves behind a black triangle which is just not attractive, and perceived as an esthetic sign of age.

I recently spoke with my periodontal surgeon about implants for one of our mutual patients. This patient is missing 3 teeth in the front and will need dental implants. The surgeon’s proposal is to put 2 dental implants and make a bridge to replace the missing tooth in the middle rather than placing 3 dental implants. I asked him why. He said that the interdental papilla will not form if the implants are placed that closed to each other. The remaining black triangle is just not attractive.

You don’t have to have dental implants to have this condition. With periodontal disease the entire bone level is lower and there is not enough bone to support an interdental papilla.

Sometimes gum surgery can be performed to build up the papilla. This is great if it works.

What does someone do to hide the spaces if gum surgery will not work? If it’s small enough, some bonding can be placed. This works well as long as the final product looks like normal teeth. For more severe cases, a removable gum prosthesis can be fabricated to fill in the space. This is not a permanent fixture but a removable cosmetic fix.