So the photo in the post below shows a ‘peg’ lateral that is very small proportionally compared to the other teeth around it. Knowing this, the orthodontist and I discussed our options. We could do one of two possible treatments. Both would lead to my eventual bonding of the tooth, or in this case, BOTH laterals, to increase the size and correct the proportion between all of this young lady’s teeth.
Your discussion should revolve around the ultimate goal for these teeth. If the size discrepancy is small, then everyone may agree to simply close the spaces during the orthodontic treatment. However, many times the size difference is too great to do this:
Many, many people have teeth that are undersized, or too small, compared to their other teeth. Often these are the lateral incisors. When they are very small they are often called ‘Peg’ laterals. If these are found in a child you should have a frank discussion with your dentist and orthodontist about the ultimate plan for these teeth. Here’s an example of this:
So this piece of a crown was broken, and we needed to get the patient fixed up as quickly as possible.
Broken porcelain
The solution? We quickly re-bonded the piece back into place.
Bonding broken porcelain
These two teeth were in need of some help. The one had a large, old tooth-colored filling that had begun to discolor and decay. The tooth behind it also had a very large tooth-colored filling and was also starting to develop a cavity. You can see the margin of an old porcelain crown on the tooth behind it.
Old filling
A ‘wake board’ is what took care of the edge of this tooth. Ideally we’d like to retain the fractured portion of the tooth and try and bond it back onto the remaining tooth structure. When fit properly the crack is almost imperceptible and the tooth remains stable for a very long time. But since this was long-gone (sitting at the bottom of a lake somewhere) we would have to re-build the tooth out of composite.
Fractured tooth
Cracked tooth
A fun day of boating led to this cracked tooth. There was no hot, cold, or bite sensitivity so it became and esthetic issue. What was the best course of action to quickly repair this tooth?
And the final portrait photo of our pretty patient and her new, gorgeous smile!
As I said earlier, I’ve seen many more of these ‘hidden’ cavities. They’re tough to detect but are still really large. Here’s another example. This is what the tooth looked like beforehand:
Here’s something that we’re seeing more and more of…cavities that are tough to diagnose, but still substantial in size. I really think this is due to the hardness of enamel from fluoride use over the years. Don’t misunderstand…I think fluoride is an excellent means to deter cavities. The problem is when the bacteria finally break through the enamel. Let’s start with this case:
Yes, you can see the dark grooves that indicate a cavity. But wait….there’s more!
