By Dr. John White
Smiles by White

Parents often come into my office worried that their child is missing a tooth or teeth. I always reassure them that it is not uncommon to be missing a bicuspid or two or a lateral incisor (the tooth just off center in the upper arch) and we deal with it routinely.

When you have a missing tooth, the challenge is to figure out what to do to fill the space. Basically, there are three options. We can move the back teeth forward with braces or Invisalign to fill the space, or resize the space and place a dental implant or bridge to replace the tooth.

Approximately two percent of the population is missing a lateral incisor (including my middle daughter along with also missing 2 bicuspids). In the case where we move posterior teeth forward to fill the space they are bigger and pointier than the smaller, flattened tooth that should be there, we can reshape it to make it look more natural.

All three options are viable treatments, so it becomes partially a patient preference. Although cuspid substitution may take a little longer, the patient keeps his or her natural gum tissue and natural root form and, when reshaped, the result is natural looking.

It is important to note that not all patients should be treated the same. Since every patient is unique, I consult with each of them and their parents on a case-by-case basis to achieve a beautiful and healthy smile.