The appearance of teeth influences confidence, leading many people to seek solutions for disproportionately small or spaced teeth. Orthodontic treatment, like braces, is known for correcting alignment and closing gaps. However, confusion often arises over whether braces can physically enlarge a tooth. Understanding the difference between a tooth’s physical dimension and its spatial arrangement is key to achieving a balanced smile. Solutions for teeth that look small often combine alignment correction and restorative procedures.
Defining Small Teeth: Size vs. Spacing
The perception of “small teeth” stems from two issues: a true size deficiency or a spatial illusion. True microdontia is a clinical condition where one or more teeth are genuinely undersized compared to average dimensions. This is often localized, frequently affecting the upper lateral incisors, which may appear conical or “peg-shaped.” Teeth can also appear small due to relative microdontia, where normal-sized teeth look undersized because the jawbone is larger, creating excess space.
An excessive display of gum tissue, known as a “gummy smile,” can also make normally sized teeth look short. In contrast, gaps between teeth, or diastema, result from a lack of contact between adjacent teeth, often due to a mismatch between tooth size and jaw space. Orthodontic treatments correct the spatial arrangement of teeth, not their physical size. Braces can close a diastema by moving teeth closer, but they cannot add material to the tooth crown.
How Braces Manage Alignment and Gaps
Braces and clear aligners apply continuous, gentle pressure to the teeth, gradually remodeling the surrounding bone. This process allows teeth to shift into desired positions over time. For patients with gaps (diastema), the primary function of braces is space closure, directing teeth to slide along the archwire until they meet.
Orthodontic forces are calibrated to close gaps symmetrically and establish an ideal arch form. Specialized components, such as elastic or power chains, are often used in the final stages to apply tension and pull teeth together. By correcting misalignment and spacing, braces make existing teeth appear more balanced and proportional. Orthodontic treatment can also intentionally create precise spaces needed for subsequent restorative work, ensuring the best aesthetic outcome for cosmetic additions.
Restorative Options for Increasing Tooth Size
When teeth are too small to fill the arch even after alignment, cosmetic dentistry procedures are necessary to physically increase tooth size. The two most common methods are dental bonding and porcelain veneers, both of which add material to the tooth surface.
Dental Bonding
Dental bonding involves applying a tooth-colored composite resin directly to the tooth, shaping and polishing it to achieve the desired dimensions. Bonding is a fast, cost-effective, and minimally invasive procedure, excellent for small size enhancements like minor increases in width or length. However, this resin is not as durable as porcelain and may be susceptible to staining, often requiring touch-ups or replacement every few years.
Porcelain Veneers and Crowns
For more significant changes in size, shape, or color, porcelain veneers offer a more robust solution. Veneers are thin, custom-fabricated shells bonded to the front surface of the tooth after minimal enamel removal. Porcelain mimics natural enamel and resists staining better than composite resin, providing an aesthetic and durable result that can last a decade or more. If a small tooth is structurally compromised due to wear or damage, a full dental crown may be used, covering the entire visible portion to add size and strength.
The most comprehensive results are achieved through an interdisciplinary approach combining orthodontics and restorative dentistry. Braces are used first to position the teeth correctly, sometimes intentionally leaving a small space. Restorative materials, such as bonding or veneers, are then applied to the aligned teeth to build them up to their ideal size, achieving a harmonious smile.