Using First Molar as a Cuspid

[dgtlctzn]

I've had braces now for 4 months and recently had a palette expander removed. Currently, my right cuspid is set high in my gum and will need to be moved down (the tooth is also very exposed with little gum above it).
My ortho made the comment that because of the way cuspid is positioned, and because of the crowding, they could remove the cuspid and use the first molar as the cuspid.

Has anyone had this done? If so, how is it aesthetically?

[MCOMarkhamOrthodontist]

You'd use the first premolar as the cuspid. Looks good in most cases. May have slightly different gingival height on one side compared to the next, and need to smooth down the cusp on the palatal side. Most of the time, it is ideal to bring the canine tooth in, but certain circumstances may warrant its extraction.

Discuss the pros and cons with your orthodontist to make the best decision. Good luck .

[dgtlctzn]

Thanks Dr. Tam for the response and the detailed insights.
My next appointment is coming up in a couple of weeks, so your feedback is very appreciated!

[Sunny]

Hi dgtlctzn

My right canine was impacted and wouldn't budge due to it being attached to my jaw bone. To close the gap my premolar has been brought forward, and all the teeth behind that. So now my premolar acts as a canine.

From the front their is no difference and I doubt anyone would notice a difference from the side. If a professional looks at my upper arch, obviously they can see, but that's fine by me.

Talk to your ortho, as to be honest, if I'd been a suitable candidate for an implant, I'd have chosen that path, as then I'd have the same number of teeth on either side of my mouth. My oral surgeon would not put an implant in this spot, due to the canine not being able to be removed, due to it being attached to the bone. It has meant my treatment has lasted over double the expected time ... but it will end soon ... and that's a relief!

Good luck with finding out as much as you can and making the best decision for your mouth!