Canine Substitutions

                   Some people are congenitally missing their upper lateral incisors. Meaning that, genetically those teeth never develop and when the baby teeth fall out they are left with two missing teeth. The lateral incisors are the small teeth next to the front central incisors.

                Once this condition is identified a plan needs to be formulated to assure an optimum outcome. There are two ways to handle this, the first is canine substitution. In canine substitution we use orthodontics to move the upper canines into the lateral positions. There are some compromises aesthetically and functionally with this approach.

 Aesthetically canines are much wider and more triangular shaped than laterals. So if moved as is the smile looks unusual unless the canines are altered. If treatment is coordinated properly with the restoring dentist and the orthodontist, the canines can be narrowed and reshaped with composite bonding and the position of the tooth moved to mimic a lateral.

The bite or occlusion can be compromised as well since you are left with fewer teeth in the upper arch compared to the lower arch. Most of the time, the occlusion can be compensated for as part of the orthodontic treatment and an acceptable bite can be established.

The other approach is to maintain or regain the space that would normally be present with the lateral incisors. In this case, orthodontics is needed to move or hold the canines in their normal positions, and then later restore the missing teeth with implants or bridgework.

There are numerous factors that guide us into selecting the proper treatment plan, and unfortunately there will be compromises in either case. But if detected early and planned properly both treatment options can finish with beautiful results.