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Tooth Replacement Choices
Question:
I'm a 45 year old woman. The permanent teeth for my two top lateral incisors were congenitally missing.
The permanent top cuspids grew into the empty space for my lateral incisors instead of pushing my baby cuspids out.
I've had two orthodontic consultations at age 16 and 35. Both recommended to pull the baby cuspids, use braces to move the permanent cuspids back, and insert bridges for the lateral incisors.
My philosophy is to not pull healthy teeth and replace them with false ones. (My baby
cuspids are healthy and still seem as soundly planted as my other teeth). I'm not looking for a hollywood smile. I would be happy to settle for something just a little less weird.
Answer:
That's a difficult but common esthetic dilemma. Yes, ideally the canines are moved into the proper place and the lateral incisors are replaced either with an esthetic bridge or implants. It is difficult to make the canine tooth appear as if it were a smaller lateral incisor because it is a far bulkier tooth usually with a higher gumline than the adjacent central incisor (front tooth).
Since you are willing to accept an esthetic compromise than perhaps the time and commitment involved in moving the canines orthodontically is not your best option. The cuspids (canines) can be reshaped, usually veneered, to appear more like laterals and the primary canines can be "filled out", also
with veneers or bonding, to closer approximate the size of a permanent canine.
This is assuming that the primary tooth has an adequate root length to predict it's longevity and that it is out of occlusion (doesn't have biting forces on it in any direction). Every case is different and should be analyzed by an experienced cosmetic dentist.
Editorial Staff
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