Replacing Congenitally Missing Lateral Incisors

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My daughter has congenitally missing lateral incisors. Now that she is starting high school, she is quite embarrassed by her baby teeth when she smiles. Our dentist suggested that we extract her teeth and get braces to close up the space. I am afraid that will look weird. Can you tell me if there are any other options?

Dolores

Dear Dolores,

a smile with missing lateral incisors

Missing Lateral Incisors

 

I am glad you wrote. Your dentist is giving you very bad advice. I’m glad you picked up on the fact that it would look quite weird if you followed through with his guidance. As you can see from the image above, this girl had done what your dentist is suggesting for your daughter. As you can see, it does not look normal. In fact, it looks downright vampiric.

The baby teeth do need to come out, but I don’t suggest you use traditional braces. Instead, I think your daughter would be more comfortable with Invisalign. These use clear aligners. None of her friends will even know she is having her teeth adjusted. Then, once the space is opened up enough to fit adult-sized teeth, you can get her the replacement teeth she needs.

 

invisible braces

Invisalign Invisible Braces

 

The best tooth replacement is a dental implant. However, you will have to wait until her jaw is fully developed for that. In the meantime, she can use a temporary tooth replacement in order to hold the spot open for when she is ready for something more permanent. A dental flipper is inexpensive and will serve her well until she is old enough for the dental implants.

This blog is brought to you by East Cobb Dentist Dr. Cristi Cheek.

Can Dental Implants Replace My Baby Canine Teeth?

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I am sixteen years old and still have baby canine teeth on my top and bottom. Last year, I had the two bottom teeth taken out. For one of the canines, there was an adult tooth growing behind it. Over the last year, it has moved sort of into the right place. The other one did not have an adult tooth behind it so I am stuck with this empty spot. I still have the two baby canine teeth at the top. I don’t want empty spaces in those the way I did with my bottom teeth. Could I take those out and get dental implants so that I have teeth by the time I take my senior pictures?

Camilla

Dear Camilla,

Illustration of a dental implant

One of my questions before going into the solution is why are you having to handle this? Where is your dentist? Your parents? Don’t get me wrong, you are very mature and I am quite impressed at the fact that you are trying to take this on. Your dentist, however, should have dealt with this years ago. Dentists are instructed in exactly what to do in situations like yours.

The first thing you need is a good set of x-rays to see if you have adult canine teeth under there. If you do, dental implants will not be a good solution for you because there won’t be any place to put the implants. If it looks like they can erupt into the correct position, then making a surgical incision into the tissue will help them to erupt properly. Sometimes, they are not in a good position, though. In that case, you will need an orthodontist to help you. The canine tooth is an anchor tooth and very important. If there is too much crowding it would be better to remove a premolar to make room.

Now, let’s say that there are not any teeth to deal with. You will not want to get dental implants right away. Your jaw is still growing. While dental implants are the best tooth replacement, you will have to wait until your jaw is fully developed for them to function properly. In the meantime, you can have your baby canine teeth extracted and have a temporary tooth replacement, such as dental flippers placed, and you will look beautiful for your senior pictures.

This blog is brought to you by East Cobb Dentist Dr. Cristi Cheek.

Problem Lateral Incisors

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Both my lateral incisors have been a bit of a disaster. One of them is congenitally missing. The other is slightly deformed. I’m planning on getting this fixed. All of it. What do you recommend?

Amaya

Dear Amaya,

dental implant being placed in three stages

I’m glad you wrote. The first thing you’ll want to do is make sure the space is appropriately opened for the tooth replacement. Invisalign is the ideal treatment for this. You can straighten them invisibly and comfortably— no metal wires and brackets. Then it is time to make your smile beautiful.

Depending on the color of your teeth, you may want to whiten them. The reason for that is once your restorations are made, their color is permanent. You don’t want to have them a color you won’t completely love. If you are pleased with the color than no worries. You can skip the teeth whitening.

Once it is time to replace the tooth, I suggest a dental implant. This is the best tooth replacement around. It will be like having a healthy, natural tooth there. You will need to find a dentist who is experienced in placing dental implants. It requires post-doctoral training, so make sure you ask the dentist where they received their dental implant training. Dental school isn’t enough. If they’re offended by the question, they are not the best dentist to do it. Move on.

As for the deformed tooth. I haven’t seen the tooth, so a lot of it will depend on the shape and condition of the tooth. What I recommend for that is you see a great cosmetic dentist. Have them look at the tooth. Based on that examination they will either suggest a dental crown or a porcelain veneer. Make sure you check out their smile gallery to make sure you like the results they get. If you do, make a quick call to their office to make sure the images are from cases the dentist did himself and not just stock photos.

This blog is brought to you by Marietta Dentist Dr. Cristi Cheek.