We often meet with patients who come to us with missing teeth or ones that seem to be malformed. These are not teeth that have suffered from decay or fracturing, but are either congenitally missing (missing from birth) or not developed “normally.” They are most often upper lateral incisors (the teeth next to the central incisors/the middle two), wisdom teeth, or lower bicuspids.
In regards to the laterals when they are missing, there are quite a few “permanent” restorative options that don’t involve taking an appliance in and out. There are bonded bridges (think of the missing tooth as a butterfly body and the wings as the connection to the adjacent teeth) and conventional bridges (crowns on the adjacent teeth with another crown splinted between them). Another choice may involve an implant with a metal root placed where the missing tooth is, restored later (about 4 months) with a crown; this assumes that’s there is enough bone available for the implant placement.
The malformed tooth can often be bonded with composite to a fairly normal shape or treated with a veneer or crown, which tend to be longer lasting and color stable. If the tooth shape is affected by the surrounding tissue or gum, gum contouring can easily be accomplished with the use of a diode laser. This allows for a more natural emergence of the tooth and a better contour.
Most, fortunately, there are solutions to these problems that are quite achievable, resulting in a natural and beautiful smile!