Scott H. Pope, DDS, FAGD, FICOI

If you are missing your front four teeth and are interested in possibly having implants placed, there are a number of factors involved to determine if implant restorative options are possible.  How long have the teeth been missing?  The longer they have been missing can have a negative effect on the remaining bone as you will lose bone in areas where teeth are not present.  This also affects the gum tissue, which is critical for good esthetics.  If there is bone loss and/or gum tissue loss, the results may be compromised even with possible future bone grafting and/or gingival grafting.  The costs will only increase the longer you wait.  I recommend having a consultation with a cosmetic/implant dentist and have a CBCT image taken to evaluate bone levels.

Thank you for your question and concerns.  Looking at your photo, there appears to be extensive crowding and displacement of your front teeth and narrowing of you arch.  I strongly recommend you seek a consultation from an orthodontist to discuss treatment options.  They can also review costs and possible payment options and you might find a way to afford treatment that is within your budget.

I am assuming the x-rays taken 6 months ago were 2D images.  My recommendation is to have a CBCT image taken.  This is a 3D image and can help determine the cause of the pain you are having.  I would contact your dentist and get a referral for a CBCT image and evaluation.

There are several options to improve your smile.  From looking at the photos, the lateral incisors appear to be smaller, enhancing the appearance of the two front teeth.  Improving the size and shape of the laterals can help with the appearance of the two front teeth.  This can be accomplished with bonding or no-prep veneers.  You can also reshape the two front teeth, but looking at the display of the front teeth, I like the shape and size.  I would recommend a consultation with a cosmetic dentist that can do a quick mock-up on the laterals to show you what the teeth would look like after improving their size and shape.  This could be a simple solution to your concerns.

If the roots are still present,  this can often times helps preserve the bone levels and increase the possibility that implants can be placed.  It really comes down to how much bone is present.  If you have sufficient bone, then implants should be the ideal treatment plan option.  I recommend having a consultation with a dentist skilled in implant dentistry.  Best of luck.