How to fix one tooth that is out of line

Dr. Malone,
What is the best procedure that can be done to a front tooth that is out of line with the other ones, besides using braces?
– Mark in New York

There are two main ways that we would usually use to fix your smile if you have one tooth that is out of alignment, without using braces. And there is another possible way that could sometimes be used.

The fastest way, and this can be done in just a couple of main appointments, is to use porcelain veneers. Veneers are placed over your teeth. Usually the teeth are shaved just a little bit first, about the thickness of a fingernail, so that they don’t end up being too thick once the veneers are on. Even if your teeth are pretty badly out of line, they can be made to look perfectly straight. A good illustration is the patient, Bea, in our smile gallery. She had crooked teeth that were corrected with porcelain veneers.

The second major way is with Invisalign. While these are called “invisible braces,” they’re not really braces, in that metal brackets aren’t put on your teeth. And they’re twice as fast as metal braces. We use a series of clear plastic aligners that you snap in, and they push your teeth into the correct positions.

And if you have, say, just one tooth that is out of alignment, some people like us to use direct tooth bonding on just the one tooth that is out of line. This can look great when it’s done, but the bonding material isn’t nearly as durable as porcelain, and it tends to pick up stain over time.