Palate Expander

S has one congenitally missing front tooth. Its the lateral incisor.

She had two fused teeth when she was little and when they fell (which was quite a drama in itself), only one tooth emerged.  I asked the dentist several times and she pooh poohed it, until they took an x-ray and saw that there was, in fact. no adult tooth root.

As a result, I have known that it would need to be addressed at some point. When she was nine, I took her to an ortho for an initial consult. 

We have two great dentists in our area. The young guy was super pushy and basically saying we had to start treatments in 6 months or else it would be too late. The other ortho had a more measured approach and wanted to wait until her canines came out to fully assess the situation. This same dentist is where my sister took her kids when they were in middle school, so we have had good experience with him.

After visiting him at intervals of 6 months over the past 2 years, we were finally ready to begin treatment in June.

Now other than the missing tooth, S has very nice straight teeth and would possibly have been a lucky one as the ortho said who only needed it for a year around 16 years old. But we have to deal with the missing tooth since its her smile and its the tooth to the left of the two front teeth so very visible.

There are usually two options - one is to file the canine so its less pointy and basically make it look like the incisor. The second is to make space for an incisor and put a fake tooth, which when she is older can be replaced with an implant.

I opted for the second since filing the canine seemed like a band aid solution and again - its her smile - for life, so no taking shortcuts.

In order to make room for the tooth, S needed to get a palate expander. We had it put about a month ago.

I was worried how she would adjust to it because she has a very low threshold for pain. The first day when we came home she started crying and saying one side hurt her so bad.  I figured it was because it had been difficult to fit the contraption to that tooth so they had to put it on and out, and back on, etc. I gave her some Ibuprofen hoping that was it.

Thankfully, I was right. The meds kicked in and some friends came to play and that was the last I heard of the pain. It did take her a while to get used to eating so we stuck with soft foods for 2 days and soon she was fine.

I was nervous (internally) of turning that key every night for 28 days, but it was quite easy.

S was a champ and bore the pain of the key turn very well, By day 10 we started to see her teeth separate and now she looks a lot like Sponge Bob -- so cute!

We were at the ortho on Monday and everything looked good. We don't have to turn the key any longer, but the expander stays on for  8 weeks for the palate to "set"  and on Aug 25 she gets her braces.

Once the have the space, they will put a fake brace in there so she does not have a gaping hole. Next when her braces come out, they will add a tooth with a bonded bridge that will match the shape and color of her teeth. And even later, when she is over 21 and all bones have fused, we can consider an implant.

Personally, I think she should just stay with the bonded bridge and not do an implant. My dental hygienist is 65 and has two missing incisors and she has a bonded bridge and I would never have known until she opened her mouth and tiled her head back so I could see the metal hooks holding her fake teeth in place. She never bothered with an implant, which has its own risks.

But we can cross that bridge (pun intended) when we come to it!