portrait-750780_640Tooth Size Discrepancy


What makes a beautiful smile?  Pearly white teeth comes to mind first. When teeth are dark or yellow, they don’t look so pretty and it’s an indicator of aging or habits like smoking and drinking a lot of coffee.

Location of the teeth is another consideration. But if the front teeth are asymmetrical, a perfect smile is difficult to accomplish.

Case Histories

I have one patient who is in braces. One of her upper central incisors is about 20% wider than the other. That is simply not aesthetic! The orthodontist is in charge of guiding how this goes. Up until now he has had me add some filling material to the narrow tooth, and he has trimmed a small amount of the wide tooth. Once enamel is trimmed you can’t put it back, so all trimming is done very conservatively. For me, do not want to commit the patient to have veneers to cover the whole tooth when I can conservatively add some bonded filling material that blends in nicely.

Another patient was missing an upper lateral incisor at birth. Though she had braces, the orthodontist at that time could not put the surrounding teeth in the correct place to make enough room to match the other side. To further complicate matters there is not enough room for a surgeon to place in implant in that position. So my restorative choices without another round of orthodontics would be to place a cantilever from the canine to the missing space (that is when a tooth is crowned and a tooth is made to hang off of the crown). This would not be an aesthetic final product for this young lady, and I referred her to an orthodontist to see if something could be done to create enough space to match the other side of her smile which looks great.

You have probably noticed people with straight teeth, but there are gaps between all of the teeth and the teeth look small. A more aesthetic result can be achieved for these people by either putting veneers on the teeth, or by adding a white filling material to the tooth that is polished until it looks natural. I use this technique regularly, especially when there is a space between the 2 front teeth (diastema is the space between teeth, and diastema closure is closing the gap) and the patient does not want to go into braces.