DD missing one lateral incisor

[Rubixeight]

Hi! My DD is missing one lateral incisor and the orthodontist has given us two option: close the gap and possibly file the canine or open a gap and put a Maryland bridge. Has anyone had this? What did you chose? What would you recommend?
thank you!

I have this! My missing incisor grew partially formed in my palate, and I had a small op to remove it when I was about 11.

As a teenager I then had braces which closed the gap (and generally straightened my teeth). I don't recall any filing of the incisor, but it's 30 years ago so could have forgotten. Nobody ever notices, including me. It's more apparent if you look at my teeth from below, as the chunkier molars start further forward on one side than the other. But the outside profile of my teeth is fine, and looks symmetrical to any casual observer.

Thank you so much for your message. It feels like such a big decision to make. It’s great to hear it’s been all ok for you and nobody ever notices. DD’s canine isn’t through yet, so we don’t know what the appearance of it will look like. The orthodontist just said that it was difficult to get the asymmetry centred and that the canines can be a different colour.

I would not file a healthy tooth for cosmetic reasons. Your canines eventually lose their points, anyway.

A bridge generally requires the healthy teeth on either side to be crowned in order to attach it. Again, why damage healthy teeth for cosmetic reasons? A Maryland bridge works differently, and causes less damage to the neighbouring teeth.

My dd damaged an incisor when she was 10. We are working on preserving as much of it as possible until she is an adult. So far, she has had the crown built up with resin several times, but each time it breaks and is repaired she loses more of the natural crown. A Maryland bridge is an option when the crown can no longer be rebuilt. Ultimately, she will probably end up with an implant.

Another of my dc has a canine missing. It was growing sideways in his palate and had to be removed. Ds has chosen to allow the gap to close naturally.

Is your dd's missing tooth on the upper or lower jaw? Lower teeth are generally less visible than upper teeth, so even less of a cosmetic issue.

I had a Maryland for the same issues for years. Every few years the adhesive would fail and it would have to be re-glued which was a pain. Eventually I had a crown on the front tooth with the bridge attached and I’m really happy with it.

A young relative, teenager, formed no incisors. Orthodontist advised close the gap with braces. In the future they could have further treatment to space them again and put implants in.
Closing the gap is the least invasive treatment and that is the treatment going ahead.

I’d go for a Maryland . Gives her the option of an implant later . This preserves the shape of the upper arch better . The canine is an important tooth & I’d much prefer to keep it . Narrowed arches are less aesthetically pleasing & can cause other problems with sinus drainage as the palate foramina can be compressed

I had neither incisor and my (very) wonky teeth were completely sorted with braces, no other intervention needed.
As it turned out, my canines were almost flat (filing had been mentioned as a possibility early on) and no real difference in colour.
I honestly believe no one has ever really noticed, unless it's come up in conversation. My teeth remain lovely and straight after nearly 40 years.

I had exactly the same - one incisor still in my palate, the other came through normally. Literally nobody notices now, even when I point it out to people they often struggle to see the difference! My teeth are perfectly straight and aligned and I’ve had no issues with it at all.

I am missing one lateral incisor and have a Maryland bridge. I have had it now for 12 years and so far it has never needed replacing or regluing or anything, I never really think about it. I was more cautious at first but I do eat the odd apple or toffee and try to avoid putting to much strain on the bridge as I do! Mines stuck onto the back of the front tooth next to it

Thanks so much everyone for the messages - it’s reassuring. I have been feeling so worried for DD that it would cause problems, and that I need to make the right decision for her.
It’s on the upper jaw which is why I am thinking the gap would be really annoying for her during adolescence. Teeth growing in very slowly, so I think the gap would still be there in Y10-Y11

i was wondering about how sturdy the Maryland bridge was , and thinking about the cost to replace this over the years.

This is great! Do you have a narrow arch or wide smile? I am trying to think if this makes a difference too. I just want her to be happy with her smile !

Thank you - I didn’t think of the impact it could have on sinuses too. Her arch is on narrow side with some overcrowding of teeth which is why I am thinking maybe not having the extra tooth might be good for spacing… I’ll discuss this more with the orthodontist

I was told they don’t recommend implants until much later now bc they have seen that adults jaw/teeth still move and therefore if you do the implant too early the rest of the teeth can still move and the root (metal) might show at the top of the gums

Thank you - it’s good to know all the options. I agree about trying to preserve the healthy teeth. This is why the orthodontist suggested a Maryland Bridge with one wing and possibly implant much further down the line.

DS now in his early twenties was missing both lateral incisors. The good news is that this meant he qualified for free braces as a teenager.
We opted for the Maryland bridge although I had no idea this is what is called until I read this post. I knew someone who’d had the canines moved in to close the gap, and to me it always looked a bit odd.

We had the free version of the bridge and he’s never had any problems with it. The bit that’s bonded to his other teeth is black though, so at some angles and in some lights you can kind of see it. Our plan was always to pay for something with a better cosmetic look when he’s fully developed - which is about now.

Upper Jaw.
Is it noticeable for your child who has the missing canine to close the gap?
I am trying to figure out health-wise also rather than aesthetic wise which is the better option?

This what I am nervous about! I don’t want her to have to worry about this every few years

I just sent an email to ask about this, whether it will be possible to do in future - I guess it depends on whether the space could be created further down the line.

Did you have to have a gap as a teenager?

I did, my canine had come through next to my incisor so I had braces to move the canine across then had a bit of a gap and then a fake tooth on my brace, then a fake tooth on a retainer before I had the bridge fitted. I think when the braces were still on they sort of “hid” the gap a bit then I had the fake tooth so I never remember being self conscious about having a big gap if that’s what your concern is

Thank you! Yes, I was worried that it would affect her self-esteem given her teeth will probably come through late - as my other DCs are still waiting on adult teeth as teens.

Also at least half of my friends had braces with springs and gaps and rubber bands and all sorts going on so it didn’t seem that big a deal!

I think if there’s a chance she’ll want the gap and either a bridge or an implant later much better to have it done as a teen then pay thousands as an adult and have to be lispy at work and have braces when no one else does

I’m a retired dentist . If I was having work done on me or someone I loved I would make sure whoever is doing the orthodontics is really considering the resultant face shape .

The shape of one’s jaws is hugely important both in terms of looking ‘conventionally beautiful ‘ & for proper function - incorporating breathing & sinus drainage considerations etc . If you have a look at a skull this really becomes clear .
Sometimes orthodontists concentrate on getting teeth beautifully straight but aren’t always perhaps as mindful of these other factors .

Thank you - I guess this is what I am wondering if the jaw is already narrow does it makes sense to try to expand. Sinus drainage is something I have to ask about. I will ask about this.