Management of large teeth with orthodontics

A large tooth can be the result of different tooth development during tooth formation. One of the most common reasons for the appearance of teeth larger than normal is the occurrence of dental fusion. This fusion may occur between the buds of two teeth, and as a result, one tooth is missing from the dental units, or it is the result of the fusion of a tooth bud with an additional tooth, in which case the number of teeth is correct, but one of the teeth is out of proportion. The shape of the tooth will be large. Of course, the big tooth may be the result of another process called budding, which will be discussed in another article about the difference between these two teeth and their differential diagnosis.

What should be done with the big tooth resulting from fusion?

First of all, find out if the resulting big tooth has caused a problem for the patient or not. If the large tooth has decayed to the extent that nerve extraction is needed, the optimal treatment will be different than when we are dealing with a decayed tooth without dental nerve involvement. If orthodontics is needed, the equations are further messed up. In these cases, the opinion of an orthodontic specialist must be included regarding the treatment plan for the large tooth in question.

Under what conditions is the big tooth extracted from fusion?

Even if the patient needs orthodontics, in most cases, orthodontics without tooth extraction will be the best choice from the point of view of the patient and the orthodontist. But sometimes, if the patient needs orthodontics and also needs extraction, it can be considered lucky because by extracting the big tooth in question, the problem will actually be cleared!

Can it be treated without extracting the big tooth resulting from fusion?

This is definitely possible and sometimes even in the best interests of the patient. In this case, especially if the tooth needs nerve extraction, we may decide to change the shape of the tooth with shaving or restorative treatment and get closer to the natural shape. This is in favor of the beauty of the teeth in terms of achieving the proportion and symmetry of the teeth. However, if the tooth nerve is healthy, tooth grinding can cause tooth sensitivity or nerve death, and there is no justification except at the patient’s insistence and conscious will.