The Missing Laterals

We are excited about this case because often some of our patients have missing lateral incisors. This case is a wonderful example of bringing a beautiful smile together with missing laterals by using the right and left cuspids (canines) in their place. Missing lateral incisors are often the result of a condition known as hypodontia, where individuals are born with a congenitally missing tooth or teeth. This condition is quite common and ranks among the more prevalent dental phenomena, alongside having extra teeth.

A missing lateral incisor can cause many problems such as aesthetic concerns, difficulty speaking, other teeth shifting, and bone loss. The good news is missing laterals are an easy remedy to fix with orthodontics. Spaces for the missing teeth can be opened for eventual implant replacement. Or, using orthodontics, the patient’s canine can be moved then shaped to resemble the missing lateral incisor to fill in the space. The pros for this is a permanent solution with low additional maintenance.

If you are missing a lateral incisor or another tooth, orthodontics can help. In this case, the patient had been treated as a child with canine substitution (the missing lateral incisor spaces were closed, and the canines brought forward into the space). This patient came to Dr Salzer in hopes of completing this case without surgery, veneers, or implants. We used what he had to make it look amazing in time for his wedding. The major difference is in the symmetry of his face. He has a very strong lower jaw that had shifted to the left over time and it gave him an underbite, as well as, a cross bite on the left side. With the expansion of the upper jaw (with aligners), the lower jaw had more room to come to center, minimizing the underbite and crossbite. The midline doesn't shift as far to the left, and the smile and face are more symmetrical. Dr. Salzer and the patient are still continue working on his bite. The best part of this case was that his general dentist did an amazing job with the bleaching and some minor cosmetic bonding to make his canines even more look like lateral incisors (see more about that @doctorsalzer post on this case). Currently, he looks much more centered with a bigger, brighter smile. There is even more room for his tongue, which can help with breathing, sleeping, and speech. We can’t wait to see his wedding photos!