Some people never develop one or both upper lateral incisors, the teeth immediately next to the two upper front teeth. This is called congenitally missing teeth or hypodontia. In other cases a front tooth may be absent because of trauma or another developmental problem.
Why lateral incisors may be missing
Congenital absence often has a genetic component. Sometimes a primary tooth remains because no permanent tooth developed underneath it. Less commonly, trauma or developmental conditions may affect tooth formation or eruption.
There is more than one good treatment strategy
A dental implant is not automatically the best answer. Treatment planning usually looks at the patient's age, facial and dental proportions, bite, available space, gum and bone architecture and the appearance of the neighboring teeth.
Option 1: Orthodontically close the space
In some patients, orthodontic treatment can move the canine into the lateral incisor position. The canine may then be reshaped or bonded to better resemble a lateral incisor. This avoids placing a prosthetic tooth in the missing space.
Option 2: Preserve or create space for a replacement tooth
In other patients, orthodontics is used to create ideal space for a future restoration. Depending on age and anatomy, options can include a resin-bonded bridge or a dental implant. Implant timing is especially important in patients who are still growing.
Why interdisciplinary planning matters
Missing lateral incisors affect both aesthetics and the bite, so the best result often comes from coordinating orthodontic and restorative planning from the beginning.
At Palo Alto Oral Health we can evaluate the restorative side of treatment, including dental bonding and dental implants, and coordinate with orthodontic care when needed.
Sources
American Association of Orthodontists: Missing Teeth and Orthodontic Treatment
