Black Triangles Between Teeth

Black triangles (open gingival embrasures) are dark spaces visible between teeth where the interdental papilla doesn't fully fill the area. They affect approximately 67% of adults over 20. The primary cause is bone loss from periodontal disease, but other factors include aging, divergent tooth roots, triangular tooth shapes, orthodontic treatment, and aggressive flossing. The distance from the alveolar bone crest to the contact point determines papilla presence: when this distance exceeds 5mm, the papilla is absent 100% of the time. Treatment options include: composite bonding to reshape contact points, porcelain veneers to close spaces, orthodontic repositioning, hyaluronic acid injection (temporary, 3-6 month effect), gum grafting, and the Bioclear method (injection-molded composite). Prevention focuses on maintaining periodontal health and gentle interdental cleaning.