Completing Her Smile
Conservative veneers for peg lateral incisors
Treatment Plan
- Professional teeth whitening for optimal shade matching
- Gum lift to establish symmetrical tooth length
- Digital smile design to address uneven spacing
- Two custom shade-matched porcelain veneers on lateral incisors
When Nature Needs a Finishing Touch
Peg lateral incisors are one of the most common dental developmental variations, affecting approximately two percent of the population. These congenitally small teeth—shaped somewhat like tiny cones or pegs—occur when the lateral incisors simply don't develop to their full size. For this young patient, her peg laterals had been a source of self-consciousness throughout her teenage years. She and her mother came to us seeking a solution that would be both conservative and lasting.
She had already completed orthodontic treatment to create adequate space for properly sized lateral teeth. However, orthodontics alone couldn't address the underlying issue: the teeth themselves remained undersized, and the spacing between her teeth was still uneven. Creating a harmonious, natural-looking smile would require precision beyond what braces could achieve.
"The most conservative approach isn't always the smallest—it's the one that achieves lasting results with minimal intervention."
Understanding Peg Laterals
Peg lateral incisors result from genetics affecting tooth development. The lateral incisors—the teeth immediately adjacent to the front two teeth—fail to develop their normal width and shape, instead forming small, pointed teeth that appear disproportionate to the surrounding dentition. This creates visible gaps and asymmetry that orthodontics can help manage but cannot fully resolve.
Treatment options for peg laterals range from composite bonding to porcelain veneers to full crowns. For a young patient with otherwise healthy teeth, we always prefer the most conservative approach that will deliver lasting, natural-looking results. In her case, that meant porcelain veneers—more durable than bonding, less invasive than crowns.
Patient Goals
Natural, symmetrical smile. Conservative treatment appropriate for her young age. Properly proportioned lateral incisors that blend seamlessly with her existing teeth.
The Challenge of Uneven Spacing
Even after orthodontic treatment, the spacing between her teeth wasn't uniform. This is a common challenge with peg laterals—creating enough space for normal-sized restorations while maintaining even distribution is technically demanding. Simply adding width to the undersized laterals wouldn't address the asymmetry; it might even emphasize it.
Achieving a harmonious result required meticulous digital design. We analyzed the spacing discrepancies and created a treatment plan that would distribute the proportions evenly across her smile. Every fraction of a millimeter mattered. The goal was teeth that looked like they had always been there—natural, balanced, and effortlessly beautiful.
A Multi-Phase Approach
We began with professional teeth whitening. This wasn't just cosmetic—it served a practical purpose. Porcelain veneers are fabricated to match the patient's natural tooth shade. By whitening first, we established a brighter baseline that the veneers could match, ensuring the final result was both uniform and naturally luminous.
Next came the gum lift. Proper tooth proportions depend not just on the teeth themselves but on how much tooth is visible. A gum lift allowed us to establish symmetrical tooth length between left and right sides, creating the framework for properly proportioned veneers.
- Teeth whitening to optimize final shade
- Gum lift for symmetrical tooth display
- Digital planning to address spacing asymmetry
- Custom porcelain veneers shade-matched to whitened teeth
The Result
Two porcelain veneers transformed her smile completely—yet subtly. The undersized peg laterals are now properly proportioned teeth that integrate seamlessly with her natural dentition. The spacing is even. The symmetry is natural. Most importantly, she has a smile that looks like it was always meant to be.
For someone so young, this conservative approach preserves maximum tooth structure while delivering results that will last for years. Unlike composite bonding, which would require regular maintenance and eventual replacement, porcelain veneers maintain their appearance and integrity over time. It's the kind of minimal intervention that delivers maximum impact—a smile she can be confident in throughout her adult life.
"Two veneers. One complete transformation."
Frequently Asked Questions
What are peg lateral incisors?
Peg laterals are congenitally undersized lateral incisors—the teeth immediately next to your two front teeth. Instead of developing to normal size and shape, they remain small and often cone-shaped. This is a genetic variation affecting approximately 2% of the population, and it's more common in women than men.
Why choose veneers over bonding for peg laterals?
While composite bonding is less expensive initially, porcelain veneers offer significant advantages for young patients. Bonding stains over time, chips easily, and typically needs replacement every 5-7 years. Porcelain veneers maintain their color and integrity for 15-20 years or longer. For a patient who will live with these restorations for decades, the durability of porcelain makes it the more conservative long-term choice.
Why was teeth whitening done before the veneers?
Porcelain veneers are custom-fabricated to match your natural tooth shade at the time of treatment. By whitening first, we establish the brightest possible baseline for shade matching. This ensures the veneers blend seamlessly with your whitened teeth for a naturally luminous result.
What does a gum lift involve?
A gum lift, or gingival recontouring, reshapes the gum line to reveal more tooth structure and establish symmetrical tooth display. It's a minimally invasive procedure that heals quickly and creates the proper framework for veneer placement. For peg lateral cases, it's often essential for achieving balanced, natural-looking proportions.
How long does treatment for peg laterals take?
This case was completed in approximately 8 weeks. The timeline includes whitening treatment, healing time after the gum lift, and fabrication of the custom porcelain veneers. Each case varies based on individual needs and the complexity of spacing corrections required.
Dr. Kiyan Mehdizadeh, DMD
Doctor of Dental Medicine
Unlike corporate dental centers where you'll meet multiple providers, Dr. Mehdizadeh personally handles every aspect of your treatment journey—from initial consultation through final restoration. This continuity of care ensures exceptional results tailored to your unique anatomy and aesthetic goals.
With advanced training in implantology, bone grafting, and prosthodontics from institutions across Europe and the United States, Dr. Mehdizadeh brings a comprehensive perspective that corporate chains simply cannot match. His boutique Beverly Hills practice focuses on quality over quantity, treating each case with the attention and precision it deserves.
Education & Credentials
- Mastership in Implant Dentistry, Loma Linda University/gIDE Institute
- Advanced Implant Therapy and Grafting, UCLA/gIDE Institute
- Certificate in Guided Bone Regeneration & Ridge Augmentation, gIDE
- Certificate in Sinus Elevation and Augmentation, gIDE Institute
- Master Program in Fixed Prosthodontics, Fradeani Education, Italy
- Certificate in IV Sedation, University of Alabama, Birmingham
- Certificate in Periodontal Micro-surgery, Huerzelr/Zuhr, Munich
- Doctor of Dental Medicine, Boston University (Cum Laude)
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