If you are still not happy with your peg laterals it's best that your Orthodontic treatment would allow space around the laterals so the small teeth can be made wider through bonding or Porcelain Veneers. If the space is completely closed the only change can be made is the color and the length.
It depends if the teeth are flared and if the teeth are undersized. If the teeth are flared they should be moved orthodontally. If braces are not an option then Clear Aligner therapy such as Invisalign is a valid treatment. If the gaps arent too bad they can be moved in 3-6 months. If the teeth are undersized the lack of tooth mass can be made up by bonding resin or Porcelain to the teeth. Porcelain is more durable but costs more. Some times the teeth are both flared and undersized and they may need Orthodontics first followed by bonding with resin or Veneers
If your teeth have been chipped for a while the new bonding may feel strange to your lips, tongue, and cheeks. I would give your nueromuscular system time to adjust. After that go back to the dentist and have him reduce the thickness without anesthesia. That way you can assess if the bonding is too thick or too long
Long term whitening can help. This usually involves custom fitte trays with reservoirs for the whitening material. It may take a few weeks and in some extreme cases a few months of wear. Usually an hour a day up to 8 hours sleep. The one hour in office system can be an adjunct or a quick start but cannot replace the longer duration trays. In my experience the best system to do this is the Kor whitening system that uses refrigerated bleach to maximize the potency. The other alternative is to do Porcelain Veneers with an experience dentist who can plan your case from begining ot end. This is a more expensive procedure and involves removing tooth structure to allow for the thickness of porcelain. These Veneers are made in layers to allow for the opaquing of the dark stains.
In most Dental offices including specialists there is a separate fee for extraction that is not included the cost of placing the implant and restoring the implant. In some cases where there is deficient bone (usally horizontally) a bone graft may be necessary before the implant placement and in some cases this may delay the placement of the implant. This also is usually a separate fee and depends on the type of bone graft place. I hope this helps Dr. Steven Glassman
