Missing lateral and a peg shaped tooth. What should I do? (photo)

Question

I have a congenitally missing latetal tooth and the other lateral is a peg shaped with crowding in the lower jaw.. My orthodontist says that the best solution is extracting the peg shaped with orthodontic treatment and shaping both canines into laterals but I want to have a symmetrical smile without doing this because I'm not convinced..

Sean Mohtashami, DDS · Answer

Hello!
If you do not wish to wait and go through the process of orthodontics I would suggest setting up a consultation with a dentist who does veneers. You can cosmetically enhance your smile with Veneers without going through the orthodontic process. 
Best of luck!

Nirav Patel, MDS, PhD · Answer

u have two options.op1. as per yr orthodontist, extract peg incisor , close that space by braces or aligners and convert canines to lateral.op2. create space for lateral incisor on right side by braces or aligner, place implant, and restore left lateral incisor with veneer [for proper shaping].

Kourosh Maddahi, DDS · Answer

Hi:The best option would be to orthodontically creating a space for an implant to be placed in the place of the missing lateral.  At the same time creating more space around the peg lateral to put a veneer over it to make it look like a regular size lateral.

Neal Nealis, DDS (retired) · Answer

This is a common and difficult problem. The real question is, "How good do you want your teeth to look and function?" The best treatment would be to move your cuspids back orthodontically and create space for an implant where the lateral incisor is missing and for a veneer where the lateral incisor is peg shaped. If you do not want to incur the expense or commit to the time, then compromises can be made. One such compromise is to shape the cuspid to look like a lateral incisor. I've seen this done, but hesitate to recommend it for two reasons. First the cuspids are shaped the way that they are because they perform an important function of protecting your back teeth when sliding your jaw side to side. When the cuspid is repositioned forward into the location of the lateral incisor, it is no longer where it needs to be in order to protect your back teeth. This is part of the discipline in dentistry called "Occlusion", and I think it is very important. The other problem is that no matter how much the cuspid is reshaped, it will always be much larger than a lateral incisor and never look natural. It's a cheap alternative, but finishes with compromised aesthetic and functional results.

Missing lateral and a peg shaped tooth. What should I do? (photo)

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