Glenn A. MacFarlane, DMD

Because we have great technologies today, removing the tooth is best for the health and of your mouth. Replacement with a dental implant is the best for stability and a conservative approach for restoration.

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If the teeth on either side of the peg tooth are virgin, or have small filings, I would place an implant. If the teeth on either side of the missing tooth space are broken down and need considerate restoration, then I would consider a bridge. The problem with opting for a bridge in your case is shade match for all your front teeth. If you don't get it right, it can be an expensive nightmare.

If the tooth was chipped due to a habit (nail biting, ice chewing, etc.) the habit has to be stopped first or the chip will keep occurring, or worse, get larger. If the chip was due to trauma, a composite bonding can be done to repair it. Nothing is permanent, so if you get 5 years out of it that is low average with 7 years being high average. Any longer is a plus.

Remove as much metal as you can from your mouth when you have the opportunity. Replace it with all-ceramic or zirconia or an ceramic/zirconia mix. Healthier and looks great too,

Usually when you replace the restoration on the very front tooth you replace the restoration on the tooth next to it. The reason is for the problems you are having...size and shade. Both can be made evenly and from the same shade porcelain. Whether crowns or veneers or a combination...a well trained cosmetic dentist can make the match as close as possible to your other teeth. Wish I had a picture to go off of.