What Are His Options for Replacing a Missing Lateral Incisor?

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My 17-year-old was born with a missing lateral incisor. Our pediatric dentist said that the canine tooth would eventually fill the space. The dentist was right, but my son’s smile looks weird. He is self-conscious about his smile, and I understand why. We saw another dentist yesterday who recommended braces and a dental implant. Does that make sense or will dental bonding work? – Thanks. Lydia from AL

Lydia,

Repositioning the canine tooth to its proper place, followed by placing a dental implant for the missing tooth, is recommended for a missing incisor. The canine tooth, its substantial size, and long root are designed to absorb sideways chewing forces to protect the back teeth. Allowing this tooth to remain displaced can lead to costly dental problems.

Model of a dental implant with the crown, abutment, and root form labeled

A dental implant is the healthies and most natural-looking way to replace a dental implant.

The canine’s natural bulk and shape make it very difficult to create a normal-looking smile when it substitutes for a lateral incisor, which is a much thinner and more delicate tooth. Attempting to reshape the canine requires excessive tooth reduction, potentially damaging the tooth. Dental bonding or a porcelain veneer is usually inadequate for altering the bulk of the canine. This aesthetic challenge is magnified when the lateral incisor is missing on only one side because the imbalance is more noticeable.

How Do Braces Help with a Missing Incisor?

Correct tooth positioning may require braces to create space for replacing a missing lateral incisor. A healthy smile is important for a teenager’s social development and confidence. Consult a cosmetic dentist with implant dentistry training to discuss your son’s options and the estimated cost.

Dr. Steven Brooksher, a Baton Rouge cosmetic dentist and a Fellow of implant dentistry, sponsors this post.

My permanent teeth grew behind the primary ones

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Three of my upper adult teeth grew behind my primary teeth. It has been this way for years.  I’m 24 years old, and now that I have employment and dental coverage, maybe I can afford to get this corrected. Are braces enough, or will I need something more complex? I guess that I will need extractions, too (?) Thank you. Morgan from TN

Morgan,

Although Dr. Brooksher would need to examine your teeth for an accurate diagnosis, your description sounds like orthodontics can correct the issue.

When Adult Teeth Grown Behind Primary Teeth

When adult teeth grow behind primary teeth, a dentist or orthodontist will extract the primary teeth. If your teeth are crowded overall, your dentist may recommend removing some permanent teeth to make room for proper alignment.

When a Primary Tooth Will Not Come Out

If a permanent tooth appears but the primary tooth will not automatically come out, a dentist may remove it. Removing the primary tooth makes room for the permanent one and helps it develop in the correct position. If you would still need orthodontic treatment in the future, removing the tooth will simplify treatment with braces.

Upper lateral incisor

Diagram of the phases of a dental implant for a comparison to a partial denture.

After braces, a dental implant can replace a missing primary tooth

Upper canine teeth often displace lateral incisors. After orthodontic treatment, a dentist may recommend dental implants to replace the missing lateral incisors.

Lower premolar

If you have a congenitally missing, lower premolar, your dentist may choose to keep the primary tooth if its position is good and it does not interfere with your bit. The dentist will watch the tooth and maintain it with fillings or other treatment as needed.

Depending on each patient’s case, after orthodontic treatment, a dentist might recommend a dental implant to fill in the space of a missing tooth.

 

Steven Brooksher, DDS, of Baton Rouge, sponsors this post.