My new dentist says I have “peg laterals” and suggests that I have porcelain crowns placed to correct them. My old dentist always said I would need braces to close those gaps in my teeth. I am confused about what to believe! My old dentist retired, and I don’t really know this new one very well yet. What are “peg laterals”, and what is usually done to correct them?

–Anthony in Topeka

Dear Anthony –

It is hard to develop trust with a new dentist. I would suggest you talk honesty with your dentist about your concerns regarding these apparent differences in opinion about how to address your dental issue.

Simply put, “peg laterals” are when your lateral incisors (the teeth on either side of your front teeth, or central incisors) are too small. This discrepancy in size makes them resemble small “pegs”, hence the term “peg laterals”. Without an examination, I could not presume to tell you how your particular case should be addressed, but I can tell you that you should really trust the dentist you choose to help you.

In some cases, a porcelain crown can be used, if there is adequate space surrounding the peg lateral. If there is not, some orthodontic work might be necessary to create a space for a natural looking crown or veneer. In your case, it could simply be that your teeth have shifted, and therefore the professional advice you have received has changed.

Whatever the case, it is very, very important that you trust your dentist. If you are unable to have an honest conversation with him about the best way to fix your peg laterals, then it is definitely time to seek a different dentist. We strongly recommend you find the services of an expert cosmetic dentist to help you with this – make sure they are accredited through the American Academy of Cosmetic Dentistry, and that they have pursued specialized training above and beyond that required by general dentistry schools.