Did you know that approximately 178 million Americans are missing at least one tooth? This is a common problem, and while this could be a result of both poor diet, and gum disease, there are also situations where the person’s lateral incisor teeth never formed. Those are the teeth right next to the two upper front teeth. What happens is that now the arch is bigger than the number of teeth occupying that space. The eye teeth (which are the sharp teeth at the corners of the mouth) begin to drift into the missing tooth space. Sometimes braces are placed on children missing their lateral incisors to either maintain their spare or regain it for future dental implant placement. If not, the space can close and the sharp canine will drift to the lateral incisor position. Now you have sharp teeth in front of the smile rather than to the side and often spaces remain.
Many times there is an associated “gummy look”. If the spaces are closed or almost closed the best way to correct this is to regain that space back with braces. However, adult patients are resistant to go through this step because basically you are creating a space for an additional tooth that will show during the treatment. The alternative option is to improve the esthetics with porcelain veneers. This requires very skillful knowledge of the problem and artistic capabilities to give the illusion that the smile never had any problems. If the space has been maintained with a removable tooth or with a bonded metal based fixed tooth (Maryland Bridge), there are different ways to esthetically place a non-removable tooth with no metal. These would include a couple of types of all-porcelain bridges or implants.