Treatment
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When teeth need moving as well as restoring, a specialist orthodontist and a specialist in restorative dentistry plan your care together, so each stage sets up the next.
Overview
Some treatment plans need more than one kind of dentistry. A tooth may need moving before it can be restored well, or a gap may need to be made the right size before an implant, bridge or veneer can fill it. Multidisciplinary care means the clinicians responsible for each part plan the whole sequence together, before anything starts.
At Eastdale, that usually means Dr Amal Abu Maizar, a specialist orthodontist, and Dr Ahmed Jebril, a specialist in restorative dentistry. They agree what the finished teeth should look like and how they should bite, then work back to the order of treatment. The orthodontics leaves each tooth where the restorations need it, and the restorations help keep what the orthodontics achieved.
Some people are born without one or more adult teeth, most often a lower second premolar or an upper lateral incisor (the narrower tooth beside the two front teeth). There are two broad routes. The space can be closed, moving the neighbouring teeth into it and reshaping them to look like the missing tooth. Or it can be opened to the right width for an implant, a bonded bridge or a denture tooth.
Which suits you depends on your bite, your smile and gum line, the size, shape and colour of the teeth next to the gap, and your age. Implants are usually delayed until the jaws have finished growing, so a younger patient may need a temporary tooth for some years after their braces come off.
When a tooth has been missing for a while, the teeth beside the gap can tip or drift into it, and the tooth opposite can grow into the space. What is left may be too narrow, or the roots too close together, for an implant. A short course of orthodontics can upright the neighbouring teeth and set the space up for the replacement that is planned, so the new tooth can be shaped like a natural one rather than squeezed in.
Veneers and crowns placed over crowded, rotated or tilted teeth may need much more tooth trimmed away to look straight, and can still look bulky. Aligning the teeth first can mean less trimming of healthy tooth, and sometimes no restorations at all. Uneven gaps around small or peg-shaped teeth can be shared out so that composite bonding or veneers give teeth of natural proportions.
As front teeth wear, the teeth and jaw often adapt so the bite still meets, leaving no room to add back what has been lost. Sometimes the new restorations can create that room themselves, as the bite settles around them over a few months. Where teeth are also out of position, or the bite needs correcting, orthodontics can create the room in a more controlled way first.
A tooth broken at or below the gum may be impossible to restore where it sits. Orthodontics can slowly bring the root up, a technique called forced eruption, so that a crown can be fitted to sound tooth above the gum. If the tooth cannot be saved, the same movement can bring bone and gum with it, giving a better foundation for an implant.
Gum disease can loosen teeth and let the front teeth fan out or gaps open. Once the gums are healthy and stable, orthodontics with gentle forces can bring the teeth back together, and a bonded retainer or restorations can then help hold them. Orthodontic treatment is not started while gum disease is active.
Dr Abu Maizar plans and carries out the orthodontic stage, and Dr Jebril the restorative stage. If a dentist referred you, they stay responsible for your routine care, and both specialists keep them informed. If you only want straighter teeth, with no restorations planned, Guildford Orthodontics, our parent practice at the same address, provides orthodontic treatment on its own.
Process
You talk through what you would like to change with both specialists, at the same visit or one after the other, and they examine your teeth, gums and bite.
Photographs, digital scans and any X-rays needed, so both specialists plan from the same information.
A digital set-up or wax mock-up of the finished teeth shows how far teeth need to move and where restorations will go; where it helps, you can try a temporary mock-up in your mouth.
The order of treatment, the options and alternatives, the fee for each stage and a likely timescale, before you commit to anything.
Any decay or gum disease is treated first, because teeth should be healthy before they are moved or restored.
Fixed braces or clear aligners move the teeth into the planned positions; a temporary tooth can fill a gap along the way.
Implants, bridges, crowns, veneers or bonding are completed once the teeth are in position and the gums have settled, sometimes while the braces are still on.
Retainers hold the teeth in their new positions, and both specialists review the result before you return to routine check-ups.
Suitability
Choices
There is rarely only one right answer. Depending on your aims and your mouth, the team may also discuss:
FAQs
It means specialists from different fields plan your treatment together. Here that is usually a specialist orthodontist and a specialist in restorative dentistry, who agree the end result and the order of treatment before anything starts.
Restorations are only as good as the space and tooth positions they are built on. Moving teeth first can create a gap of the right size, keep more of your natural tooth and give a more natural shape and gum line.
Usually either closing the gap with orthodontics and reshaping the neighbouring teeth, or opening it to the right size for an implant, bonded bridge or denture tooth. The joint assessment looks at your bite, smile and the teeth involved before advising which suits you.
Not until the jaws have finished growing, often in the late teens or early twenties. An implant placed earlier can end up out of line with the teeth beside it as they keep growing, so a temporary tooth is used in the meantime.
Not always. If your teeth are reasonably straight, veneers or bonding alone may be enough. If they are crowded or tilted, straightening first can mean less trimming of healthy tooth.
Yes. Teeth tend to move throughout life, so retainers are usually needed long term to hold the result.
No. You can contact the practice directly, or your dentist can refer you.
Yes. If another clinician is already treating you, the team can share records and plan alongside them, and keep your dentist informed throughout.
It depends on which stages you need. After the joint assessment you receive a written plan with the fee for each stage before treatment starts.
Clinically reviewed by Dr Ahmed Jebril on 9 October 2026.
Next step
Share what you are hoping to improve and the practice will help identify a sensible next step.
