Peg-shaped lateral incisors: bonding, veneer, crown or braces
Small, pointed side teeth are common and harmless, but many people dislike how they look. The good news is that they are usually one of the easiest teeth to improve without heavy drilling.
Medically reviewed by Dt. Hüseyin Yavuz Özbek, implant surgeon · Updated October 2026A peg-shaped lateral incisor is an upper side tooth that formed smaller and narrower than usual, often cone-shaped. Around 1.8% of people have one or both. Because the tooth is small, it can usually be built up to full size by adding material rather than removing it, with composite bonding or a minimal-preparation veneer. Orthodontics is often used first to place the right amount of space around it. A full crown is rarely needed unless the tooth is already heavily filled or damaged.
Your lateral incisors are the teeth either side of your two front teeth. In some people one or both grow in small, narrow and pointed, a shape dentists call "peg-shaped". They often leave gaps around them and make the smile look uneven or younger than you are. People with peg laterals often ask about crowns. In most cases a crown is the heaviest option on the list, and there are lighter ways to get the same look.
How common peg laterals are
A meta-analysis of 36 studies put the overall prevalence at about 1.8% of people. It was more common in women than men, and more common in people seeking orthodontic treatment. Unilateral (one side) and bilateral (both sides) cases were about equally common, and when only one side was peg-shaped, the lateral on the other side was missing in over half of cases (Hua and colleagues, 2013).
That last point matters for planning. If one lateral is peg-shaped and the other is missing, the treatment has to deal with both sides together, not just the small tooth.
Why adding is usually better than cutting
The problem with a peg lateral is that there is too little tooth, not too much. Most cosmetic crowns and many veneers start by removing tooth to make room for the new material. With a peg lateral, the room is already there, in the gaps around it. The job is to fill that space with material that looks like tooth.
A crown preparation reduces the tooth all the way round. Laboratory work found that full crown preparations on front teeth removed about 63% to 72% of the visible tooth, compared with as little as 3% for some veneer designs (Edelhoff and Sorensen, 2002). On a tooth that is already small, that is a lot to lose for no structural gain.
The options compared
| Option | Drilling | What to expect |
|---|---|---|
| Composite bonding | Little or none | Built up in one visit; can be repaired or redone; may chip or stain over years |
| Ceramic veneer | Often minimal on a peg lateral | Keeps colour and polish longer; made in a lab; harder to repair |
| Crown | All round the tooth | Rarely needed unless the tooth is already damaged or heavily filled |
| Orthodontics first | None | Moves teeth so the space around the peg lateral is the right size for a natural-looking tooth |
Composite bonding
Bonding means adding tooth-coloured resin to the surface and shaping it by hand. For peg laterals, it is often done with little or no drilling, which also means it can be redone later without losing more tooth. A systematic review of front-tooth composite work reported annual failure rates between 0% and 4.1% across studies, with fracture of the tooth or restoration the most common reason (Demarco and colleagues, 2015). In practice, a chipped bonding can usually be patched.
Ceramic veneer
A veneer is a thin shell made in the lab and bonded to the front of the tooth. On a peg lateral, the veneer may wrap around more of the tooth than usual to make it full width. The Oral Health Foundation notes that veneers can be used to change the shape and colour of teeth and close small gaps. Ceramic keeps its colour and shine better than composite, which some people prefer for a tooth in the middle of their smile. Our page on crowns vs veneers explains the difference in more detail.
A crown
There are cases where a crown makes sense: the peg lateral already has a large filling, has had root canal treatment and darkened, or has been crowned before. Then a full-coverage restoration such as an E-max crown may be the right choice. For an intact peg lateral, it is rarely the first one.
Space comes first
A well-known paper on managing peg laterals described two orthodontic routes. One is to remove the small tooth and close the space, which the author noted often gives a narrow smile because the canine then sits in the lateral's place and looks too yellow and too tall at the gum. The preferred route was usually to open space either side of the peg lateral so it could be built up to the size of a normal lateral (Counihan, 2000).
So the first question is whether the space is right. If the gaps either side of the tooth are uneven, building up the tooth directly can give a lopsided result: one side too wide, the other too narrow. A few months of aligners or braces can move the tooth into the centre of the gap and make the space match the other side. After that, bonding or a veneer can make it look full size without guesswork.
If you are planning orthodontics, the bonding or veneers usually come after the teeth have finished moving.
Matching both sides
If only one lateral is small, the new tooth has to match the natural lateral on the other side, in width, length and colour. That is a bit like matching a single front crown, and many of the same points apply. Our article on matching one front crown explains shade, translucency and why a try-in helps.
If both laterals are small, it is often easier, because the two new teeth only need to match each other and the front teeth.
Living with a built-up lateral
Whichever option you choose, a built-up peg lateral needs some looking after. Composite picks up stains from coffee, tea, red wine and smoking more readily than ceramic, and its surface polish dulls over time. A dental hygienist can often polish it back, and small chips can usually be repaired by adding more composite. Many people end up having bonding refreshed at some point, which is the trade-off for so little drilling.
Ceramic veneers keep their colour well, but they can chip or come loose, and repairing ceramic is harder than repairing composite. Biting hard objects with the front teeth, such as opening packets or biting nails, is a common cause of chips on both materials. If you grind your teeth at night, a night guard protects the new edges.
Gums matter too. A lateral that has been widened has new edges near the gum on each side. Cleaning between the teeth with floss or small brushes keeps the gum healthy around those edges, which helps the tooth look natural for longer.
Finally, think about whitening before any of this. Composite and ceramic do not whiten, so if you want lighter teeth, it is best done first and the new lateral matched to the whitened shade.
Questions to ask your dentist
- Is the space either side of my peg lateral even, and would orthodontics give a better shape?
- Can the tooth be built up without drilling?
- If you suggest a veneer, how much preparation would it need on this tooth?
- If you suggest a crown, why is it better than bonding or a veneer here?
- Is the lateral on the other side present and healthy?
At Precious Dental we prefer to protect a healthy tooth rather than crown it, and a peg lateral is a good example of a tooth that usually needs adding to, not cutting down. We publish composite bonding at £125 per tooth and E-max laminate veneers at £300 per tooth; for other options see crown prices. If you send photos of your smile and side teeth through our contact page, we will reply with a free written plan that says which option we would suggest for each tooth.
Common questions
Are peg-shaped teeth unhealthy?
No. They are a variation in how the tooth formed. The root and nerve are usually normal. Treatment is for appearance and sometimes to close gaps.
Is bonding or a veneer better for a peg lateral?
Bonding needs little or no drilling, costs less and can be repaired, but may chip or stain over time. A ceramic veneer keeps its colour and polish longer but is more costly and may need slight preparation. Both are reasonable; the space available and your bite help decide.
Do I need braces before fixing a peg lateral?
Not always. If the space around the tooth is about right, it can be built up directly. If the gaps are uneven, or the tooth is too close to its neighbours, orthodontics first gives a better shape.
Why not just crown it?
A peg lateral is already small. A crown would mean reducing an already small tooth all the way round, which the tooth does not need. Adding material usually gives the same look with far less harm.
What if the other lateral is missing?
This is fairly common with peg laterals. The gap may be closed with orthodontics, or replaced with a bonded bridge or implant. Your plan should look at both sides together.
Sources
- Hua F et al. (2013). Prevalence of peg-shaped maxillary permanent lateral incisors: A meta-analysis. Am J Orthod Dentofacial Orthop
- Counihan D (2000). The orthodontic restorative management of the peg-lateral. Dent Update
- Demarco FF et al. (2015). Anterior composite restorations: A systematic review on long-term survival and reasons for failure. Dent Mater
- Edelhoff D, Sorensen JA (2002). Tooth structure removal associated with various preparation designs for anterior teeth. J Prosthet Dent
- Oral Health Foundation. Veneers
Checked October 2026. Where we give our own view as a clinic, we say so.
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