The central incisors can then be moved together predictably by the orthodontist because the bonding that has been placed on these teeth has made their width ideal. Once they touch, he’s done! Also, he can then make additional room for the laterals, allowing for a more conservative preparation of these teeth, too. As we talked about before (See text here), one of the BIG advantages of involving the orthodontist is the ultimate outcome. The teeth are ideally positioned, the preparations can be more conservative, and the case will look better and be more stable.

The gum specialist asked about the size/proportion of Suzanne’s teeth. After examining her I thought the best solution was a combination of bonding and orthodontics. Since her front teeth were too small width-wise (from left to right) they appeared skinny and thin. These teeth will ultimately need veneers to correct this discrepancy. But until then, bonding is the solution. We decided to make her central incisors (her middle two front teeth) the CORRECT size with bonding. The orthodontist could then pull them together until the bonding touches. This way we know these teeth will be in the correct position to allow for very conservative veneer preparations.

Let’s take a closer look at her teeth.

Both the central and lateral incisor, the two pictured above, appear slightly small. They are quite long, but not wide enough. So this gives a thin, unflattering appearance to these teeth. Also, they are not the ideal size for her face (not pictured here). There are many causes for this, including the reasons we discussed before (gum tissue in the wrong place or improperly contoured). But to keep things moving, the answer is that these teeth are simply too narrow. They have the proper tissue height/contour. They just need to be wider to fit the space and her facial characteristics.

Let’s look at another case. Suzanne was referred to me by a gum specialist. She had braces successfully, but the space between her two front teeth continued to open. The gum specialist removed a small amount of fibrous tissue from between these teeth and asked me to look at the size of her teeth before she returned to the orthodontist. Here’s the way she looked at our first visit: