I am 30+ and have crooked teeth and crowding, and one of my upper lateral incisors is hidden behind the central incisor/canine. I am having a hard time deciding how to proceed with regard to that tooth. I have been to three orthodontists about a treatment plan. One advised extracting it and shaping the canine to look like an incisor, one advised extracting premolars and moving the incisor into proper place, and the last one essentially presented both options, but noted that the lateral incisor, if properly positioned, would then require a crown or build up of some sort as he says it is is worn down in size relative to the other.
I’m leaning toward salvaging the incisor as I don’t care too much about the longer treatment time to move it forward nor the cost of a crown if it means I’ll have a better smile long term. Then again, maybe the hassle/complications of a crown just makes it not worth it? I did read that canine substitution for incisors is fairly common, so maybe it’d be fine to go that route? Though in my case it’d be substitution on just one side so not how the asymmetry would look.
Anyway, as you can tell I’m conflicted. Thoughts? Has anyone had a similar case as mine? What did you decide and how do you feel about the results? Thanks!
Having trouble deciding on treatment - extract lateral incisor or not?
Moderator: bbsadmin
Re: Having trouble deciding on treatment - extract lateral incisor or not?
Santino,
I can see your dilemma, there are extractions involved with either treatment option. Following the wisdom teeth, the lateral incisor is the most common tooth to be congenitally missing so it is not all that uncommon. For people who are missing the lateral incisor there are essentially two options, maintain the space and replace with an implant or as you describe, move the cuspid into the lateral position and reshape the tooth for cosmetics. Since you have your lateral moving it into the proper position is a good option. The only caveat I would advise you about is that it is very difficult to maintain good color match between a single crown and the adjacent teeth over time. Our natural teeth change color over time and the crown does not resulting in a likely mis-match down the road. This can be managed with bleaching and the like but be aware. Moving the cuspid into the lateral position eliminated that potential pitfall. Good luck with your decision!
I can see your dilemma, there are extractions involved with either treatment option. Following the wisdom teeth, the lateral incisor is the most common tooth to be congenitally missing so it is not all that uncommon. For people who are missing the lateral incisor there are essentially two options, maintain the space and replace with an implant or as you describe, move the cuspid into the lateral position and reshape the tooth for cosmetics. Since you have your lateral moving it into the proper position is a good option. The only caveat I would advise you about is that it is very difficult to maintain good color match between a single crown and the adjacent teeth over time. Our natural teeth change color over time and the crown does not resulting in a likely mis-match down the road. This can be managed with bleaching and the like but be aware. Moving the cuspid into the lateral position eliminated that potential pitfall. Good luck with your decision!