I have a complicated case and I am not sure what to do. I have a baby canine tooth that has finally succumbed to decay. That tooth never fell out because my teeth shifted a bit when I was a child after a dentist pulled a baby molar. Now my canine tooth came in but in front of my first and second bicuspids. They’ve formed a sort of triangle. Not only is it embarrassing, but it is nearly impossible to keep thoroughly clean, though I am as diligent as I can be with it. My dentist feels it is too far away and the root system too tangled to use orthodontics to get it in the right place. I do have to remove the baby canine and I just want to have a normal and hopefully attractive smile.

Kelly

Dear Kelly,

I would think most dentists, who love their field, would be thrilled to work on a case as complicated as yours. It is possible your dentist feels in over his head with this one. Every dentist goes into the profession with different goals. He may just love being a good bread and butter family dentist and like keeping people’s teeth healthy but not get into all the complicated cosmetic stuff. That’s okay, we need good family dentists.

The only problem for you right now is you need someone with experience in cosmetics. There are a few ways to handle this, but it would take someone looking at your specific bite and x-rays to give you a definitive answer. Here are some possibilities, though.

Options for Fixing This

First, you could extract the baby and adult canine teeth, then use Invisalign to get the opening the right size, along with giving the other teeth proper alignment, and then have a dental implant placed in the area where your canine goes.

Another possibility, if the canine can’t be moved, is to extract it, then have your first bicuspid shaped to look like a canine in the front. That has been done many times with good results.

The key for you, however, it to make sure the dentist you see has the training, experience, and artistry you need to give you a beautiful finished product. I would make sure you look at their smile gallery, which is a sort of brag book for dentists, to see what type of results they get. Then, if they’re good, trust their instinct on the best way to handle this situation.

When Baby Molars are Extracted

I don’t know if you are currently a parent, but I want to tell you how you can avoid this situation with your children. Whoever your pediatric dentist was made a critical error. Baby molars need to stay in place until a child is at least 12 years old. Otherwise, you risk the teeth shifting, which leads to crowding and a complicated bite such as you are facing now.

There are times, however, that a molar cannot be saved. When that is the case, it is imperative the dentist puts a space maintainer in the area in order to keep the teeth in proper alignment. It sounds like your childhood dentist neglected that. Make sure whatever pediatric dentist you have for your children, doesn’t make the same mistake.

I know finding the right dentist will give you a smile you are proud of.
This blog is brought to you by Marietta Dentist Dr. Cristi Cheek.