A Conservative Fix for Peg Laterals — No Drilling, No Enamel Removed

When two teeth are noticeably smaller than the rest, the whole smile can read as uneven — even when every other tooth is perfectly healthy. That was the situation for this patient, who came to SOL Dental Arts in Maspeth wanting to address two small, pointed upper teeth and the gaps they left on either side of the front teeth. The diagnosis was peg laterals, and the solution was about as conservative as cosmetic dentistry gets: no drilling, no anesthetic, and not a millimeter of healthy enamel removed.

What are peg laterals?

The lateral incisors are the two teeth that sit directly beside your central front teeth. When they develop smaller and more cone- or “peg”-shaped than usual, they’re known as peg laterals — a common, usually inherited form of microdontia. Because the laterals are undersized, the central teeth can look oversized by comparison, and small spaces tend to open up on either side. The result is a smile that reads as gappy or asymmetric, even though the teeth themselves are healthy.

What we saw

This patient’s two upper lateral incisors — teeth #7 and #10 — were narrow and tapered, sitting back from the arch with open spaces flanking the central incisors. Everything was healthy; the concern was purely one of size, shape, and symmetry.

Why we chose a no-prep, additive approach

There’s more than one way to widen a small tooth. Traditional veneers or crowns can do it, but they usually require shaving down healthy enamel to make room — an irreversible trade-off for teeth that have nothing structurally wrong with them. Orthodontics can reposition teeth, but it can’t add the width a peg lateral is missing.

For this case, we used 3D-printed, no-preparation crowns — restorations designed digitally and bonded directly over the existing teeth. The approach is purely additive: we add structure rather than remove it. Nothing was drilled, and because no natural tooth was altered, the treatment is far more conservative — and, in principle, far more reversible — than veneers or conventional crowns.

The treatment, step by step

After digital scans, a restoration for each lateral (#7 and #10) was designed to match the proportions of the surrounding teeth, then 3D-printed and bonded into place over the natural tooth. Because the teeth weren’t prepped, the appointment is comfortable and typically requires no anesthetic. The printed crowns build the laterals out to a natural width and length, closing the side spaces and bringing the arch into balance.

The result

The rebuilt laterals fill the spaces that used to flank the front teeth, the centrals no longer look oversized, and the smile reads as even and symmetric — all while leaving the underlying teeth untouched.

Frequently asked questions

Are no-prep 3D-printed crowns reversible?

Because no enamel is removed, the natural teeth stay intact — so the restorations can generally be adjusted or replaced in the future without the underlying teeth having been altered.

How long do no-prep crowns last?

With good hygiene and regular checkups they are a durable, long-lasting option. Like any restoration, they can be polished, repaired, or replaced over time.

Do peg laterals have to be treated?

No. Peg laterals are healthy, so treatment is entirely elective and cosmetic — worth doing only if the size or spacing bothers you.

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Could this work for your smile?

No-prep, additive treatment isn’t right for every situation, but for healthy teeth that are simply too small — peg laterals, worn edges, minor gaps — it can deliver a dramatic visual change with very little done to the natural tooth. If two small teeth are throwing off your smile, the team at SOL Dental Arts can tell you whether a conservative, additive option like this is a fit.

Request an appointment → SOL Dental Arts · 66-43 Grand Ave, Maspeth, NY (Queens) · Cosmetic & General Dentistry

More from SOL Dental Arts: composite bonding. Related cases: bonding peg lateral teeth and front-tooth reshaping with bonding.