I’ve enjoyed reading back through the different posts on this site, but I did not find one that addressed a situation like mine. I hope you can offer me some advice.
I am having a hard time finding a dentist that I feel comfortable with and could learn to trust. I’ve been to two different dentists now, both of them older, both male, if that makes any difference. Here is the problem: the tooth next to my front tooth on the right (my lateral incisor, according to my most recent records) is crooked, and set much too far back. Both dentists I went to had different suggestions for how to treat this.
I’m interested in Invisalign braces, so I’ve asked about them at both appointments. One of the dentists doesn’t do them, and said that he did not know whether or not they would work in my situation. He suggested referring me to an orthodontist for conventional wire braces, or maybe pulling the tooth. I didn’t like either of those suggestions at all, so I went to get a second opinion. The next dentist does do Invisalign, and said his preliminary exam did not reveal any reason why Invisalign wouldn’t work for me, but it is going to be pretty expensive!
I am wondering about the option of pulling the tooth. That would be the least expensive solution, wouldn’t it? The first dentist seemed to suggest that my other teeth would shift forward to “close the gap a bit”. Would that look right? Right now, there is not even room for a whole tooth where it should be. The tooth is pushed back, almost behind the other teeth, not “in line” at all. Would I really miss it?
Thanks for your help with this. I am really confused as to why I got such different advice from each dentist.
Lynn in Muskegon, MI
Dear Lynn,
The different advice you received reflects that areas of expertise and experience of the different dentists you saw. The first dentist almost certainly does not have any cosmetic dentistry training, and is not comfortable or knowledgeable enough about Invisalign to make any judgement about whether or not that would be a good treatment option for you.
Understand that this advice is theoretical, as we have not examined you, but as a general rule we advise against getting healthy teeth pulled just because they are crooked or out of place. In the short term it may be less expensive, but you are opening yourself up to issues down the road that could really cost a lot of money. If you pull the tooth, your other teeth will very likely shift. This could cause a mis-alignment in your bite that could lead to TMJ problems down the road. And from a cosmetic standpoint, your smile is simply never going to look right with an odd number of front teeth. The sides must be symmetrical.
Both Invisalign and porcelain veneers might be a possibility for you. I would continue talking to the second dentist, the one who does Invisalign. He will be able to give you a fair assessment of what your options are.