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Gap After Congenitally Missing Tooth

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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?

Petra

Dear Petra,

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

Diagram of a dental implant

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.

Smile Makeover During Pregnancy

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I was planning on getting a smile makeover but just found out I’m pregnant. Can I go through with it or do I need to wait?

Avery

Dear Avery,

A woman smiling with a beauttiful smile

Congratulations on your upcoming blessing. Babies are the best. Whether or not you can go forward with treatment depends on a couple of things. The first is what procedures you were planning. The second is whether or not you’re in a high-risk category in your pregnancy.

Let’s start with the procedures.

Teeth Whitening

Getting your teeth whitened hasn’t been officially cleared for pregnant women. It’s not because there is evidence of it doing harm to the baby, it is because we’ve had no tests to say it doesn’t do harm. As you can imagine, there aren’t a lot of women lining up to have their unborn child be a test subject.

I’m sure you can find a dentist to do it for you. Just make sure you understand the risks. By that I mean we don’t yet know the risks.

Invisalign

These are clear aligners you wear over your teeth to straighten them. It’s perfectly safe to use during pregnancy. However, if you are prone to morning sickness and vomiting, you may find this an inconvenient time to straighten your teeth. The aligners have to be worn almost full-time, with the obvious time exceptions being during meals.

Vomiting will mean thoroughly cleaning out the aligners so you don’t get stuck with anything acidic in them. This will lead to massive decay.

Porcelain Veneers

Porcelain veneers are a safe procedure, even during pregnancy. The only chemical used would be the Lidocaine which is used for numbing during tooth preparation. Lidocaine is one of the medicines which has been FDA approved as safe to use during pregnancy. It’s even sometimes used during the delivery process.

The only cautionary tale I’d offer here is to make sure you see an expert cosmetic dentist or you will be disappointed with your smile makeover results.

All that being said, if you are in a high-risk pregnancy group, you’ll need to scrap everything I just said and talk to your obstetrician and get clearance on everything first. There will likely be special considerations.

Best of luck to you and your baby.

This blog is brought to you by Philadelphia Cosmetic Dentist Dr. Michael Weiss.

Solutions for a Tooth Gap

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I have a tooth gap which is really starting to bother me the older I get. I’m looking into solutions and wanted to opinion of a cosmetic dentist.

Ben

Dear Ben,

woman smiling with a tooth gap
There are several solutions for a gapped tooth

When you have a gapped tooth, there are three great solutions. Which you choose depends on what you’re going for with the rest of your smile.

Solution One: Invisalign

Invisalign Aligner
Invisalign Aligner

If you want to truly close the gap, you can use orthodontics. It’s no longer necessary for patients to wear unsightly and painful wire and metal braces. These days adults (and teens) prefer Invisalign. It uses clear aligners to straighten your teeth.

It has a secret benefit of allowing you to simultaneously whiten your teeth at the same time. Your dentist can provide you with the teeth whitening gel and the aligners will double as the trays.

Solution Two: Dental Bonding

before and after dental bonding

You can see from this case which Dr. Weiss did the gap is completely closed. He also reshaped her whole smile at the patients request. When done by a skilled cosmetic dentist dental bonding blends perfectly and looks completely natural.

You don’t have to have bonding done on the entire smile as this patient did. It can just close the gap. It can be matched to whatever color your teeth are. If you’re happy with the whiteness, just do the bonding. If you’d like them a little whiter, first whiten them, then have the bonding done after that is completed.

Solution Three: Porcelain Veneers

porcelain veneer being placed on a tooth
Porcelain Veneers

This is only a useful option if you’re unhappy with other aspects of your smile. Porcelain veneers can change everything about your smile.— the shape, the size, the color.

This is the go-to procedure for a complete smile makeover. It can give you the smile of your dreams. However, I would consider it an expensive over-treatment if all you want to do is close a tooth gap.

This blog is brought to you by Philadelphia Cosmetic Dentist Dr. Michael Weiss.