Crooked front tooth options

I hope you can help me. I’ve been trying (without success) to find a dentist to straighten my teeth. So far I have talked to three different dentists, and they all say different things about what the best way to do this is! Who am I supposed to believe? They all have really impressive credentials, so I can’t just look at the stuff hanging on their walls and know who to trust.

The tooth next to my front tooth on the right side is crooked. I mean REALLY crooked, and it is completely out of alignment, way behind my other teeth. It looks BAD. Are braces the only thing I can do in this situation? Is Invisalign a possibility? What would happen if I said I wanted to get the crooked tooth removed?

Thanks for your advice,

Becky in Honolulu

Dear Becky,

Invisalign is usually appropriate for adults with crooked teeth if all of their teeth are fully erupted. In some cases of extreme crowding Invisalign might not be effective, but a dentist certified to treat with Invisalign would certainly recognize such a situation and suggest treatment accordingly.

Another option that you have not mentioned is porcelain veneers. A porcelain veneer could work to create the appearance of a normal, straight tooth, though you do state that the tooth is misaligned. Again, a skilled, experienced cosmetic dentist will tell you whether or not a porcelain veneer is a possibility.

I would not recommend opting to have the crooked tooth extracted. From a cosmetic standpoint, an uneven number of front teeth is just never going to look right. Symmetry is extremely important in smile aesthetics, and an uneven number of teeth simply cannot be symmetrical. From a functional standpoint, a missing tooth will cause the teeth surrounding the gap to shift. This movement can create bite alignment issues, that in turn can lead to problems with your tempromandibular joint (TMJ).

For your best results, I would consult with a dentist that does both Invisalign and is accredited by the American Academy of Cosmetic Dentistry (AACD). Ask to see samples of their work through a smile gallery.