Have small teeth or spaces in between them?

Having small lateral teeth, so called “peg” laterals is fairly common.  These are the two small front teeth on either side of your two front upper teeth.

I mostly tend to see “peg” laterals in men, although they can certainly happen in women too.  I recently saw a young man who didn’t have peg laterals but had very small lateral teeth, with large spaces between all of his front teeth.  He was unhappy with his smile and wanted to know what I could do for him.   The next step was a consultation with him and his mother, as he was still a minor.

Initially he just wanted me to “bond” his teeth to close the spaces.  That’s when I use white, tooth colored composite material and bond it to the existing teeth, building them up to close the spaces.  The issue there was that the spaces were so large, by the time I closed them the teeth would be as wide as they were tall, which would be out of proportion and look very strange.

At that point I started to talk to them about all their options, which were to bond all the front six teeth, from eye tooth to eye tooth, porcelain veneers on all the front six teeth, or have him go back into braces to close the spaces entirely.

Complicating the matters is that this young man isn’t done growing, so I didn’t want to do porcelain veneers on him yet.  I usually wait until age 21-22 on men to do anything like implants, crowns or veneers as I want the skeletal growth to have completed.

So that left doing bondings on all six teeth for either a permanent or temporary solution, or orthodontics.  While there’s nothing the orthodontist can do about the shape of the teeth, they can close the spaces.  I feel that orthodontics is very elegant, as I don’t have to pick up my drill and take away tooth structure that will never come back again.

The patient and his mother agreed and decided to go back to the orthodontist to get a consultation and then determine the best course of action.

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