My daughter is about to graduate high school. Since childhood, she has only one adult of the teeth next to the front one. I think it is called incisor. Our family dentist told us that once it fell out, her other teeth would shift into that space. It sort of did, but not as much as we were expecting. Now there is a gap there. She just doesn’t like to smile and isn’t even interested in getting senior pictures. I mentioned it to my dentist and he said we could just fill in the gap. I’m hesitant to do that because I’m worried it will make the teeth on one side look bigger than the others. Is there a better way to do this?
I am very glad you wrote. It appears this dentist has given you bad advice on two fronts. First, the original advice was not only bad esthetically but for the health of her bite in the long term. Let’s start with esthetics first. The tooth next to her lateral incisor is her canine tooth. It is thick and pointy. The Incisor is thin with a more rounded bottom. There is no way her smile will look balanced and normal trying to interchange those two. It also appears you have more of an artistic eye and common sense than your dentist for his latest suggestion, so I am with you. No, don’t just fill in the gap with dental bonding.
As for the damage to her bite, the canine tooth is also different in its root. It has a much longer, stronger root and handles all the sideways stresses of our teeth. If you move that out of its place, as he allowed, she will have long-term consequences.
Dealing with Congenitally Missing Teeth
What should have happened in the beginning is he have you get an inexpensive dental flipper for her to hold that spot open once the tooth came out. Then when she is old enough, you can replace it with a dental implant. As it is now, you will have to use orthodontics to get the teeth back into their proper position. I am going to suggest Invisalign. This will work faster than traditional braces and no one will be able to tell she is straightening her teeth.
From there, get the dental flipper and then have a dental implant placed when her jaw is fully developed. It won’t be that much longer, given her age.
This blog is brought to you by Philadelphia Cosmetic Dentist Dr. Michael Weiss.