Hi, Dr. Hall.
I’ve read just about everything I can find on your website and I have developed a serious respect for your opinion. You really know your stuff! So I wanted to ask you about my situation to see what you think.
I am 34 years old and have been living with a complicated situation on my upper left for close to 20 years. I have a decaying baby canine which never came out due to the adult canine growing in in the wrong place and never displacing the baby. The adult canine #11 grew in over the top of bicuspids #12 and #13 and, I’m told, is too far away from where it belongs and too complicated in the root structure to be moved with braces. Number 11 is partially obscuring the two bicuspids behind it and creating a triangular inner area which is difficult to keep clean, not to mention embarrassingly unattractive. (My general dentist isn’t even sure what kind of decay might be going on up in there, but so far it doesn’t hurt or have an odor so I’m keeping my fingers crossed.)
That whole area needs some serious work, but I’m not sure what the best option is. Do I extract the canines and get braces to widen the space where the baby was so a full-sized canine implant can be put in? Or do I extract the canines and get a bridge? Or can something else be done with a smaller implant plus veneers or something to create the illusion of normal teeth?
– Diana in Southern California
Diana,
Thank you for your kind comments.
#12 (your first bicuspid) can be made to look like a canine from the front, so if your canine can’t be moved, I’d consider that option, too, after having the permanent and baby canines extracted. Or one dental implant could work – replacing the baby canine with a permanent canine implant. I wouldn’t do the bridge to replace the canine because your bone will shrink in that position over time if you do that and it will be hard to keep it looking natural. But it’s really tough for me to say without seeing you, seeing the x-rays, and doing a clinical examination. You sound like you have a very interesting case–I’d love to have had you come in my door and be given the opportunity to solve it.
My recommendation – just find an excellent cosmetic dentist and trust his or her judgment. You have excellent choices in almost every direction. Just check our Southern California cosmetic dentists page. I am confident, because of the care I exercised in choosing each one, that any one of them could give you a beautiful smile with this situation. I wouldn’t ask your general dentist to do this.
– Dr. Hall
Related links:
Braces
Invisalign
Adult braces
About David A. Hall
Dr. David A. Hall was one of the first 40 accredited cosmetic dentists in the world. He practiced cosmetic dentistry in Iowa, and in 1990 earned his accreditation with the American Academy of Cosmetic Dentistry. He is now president of Infinity Dental Web, a company in Mesa, Arizona that does advanced internet marketing for dentists.
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