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I think it depends on how visible it was, or how different it made me feel. I've got small teeth - many of them are actually baby teeth - and I've always been super sensitive about my smile. But hell if I'm paying $7000+ for orthodontics and implants! And ever since I decided that my smile is fine the way it is, I've gotten tons of complements on it, small teeth or not.
I guess if I had a birthmark or a scar or something on my face that was really distracting and made me feel super self-conscious, I'd probably get it taken care of, though. If it's easily fixable and will make me more self-confident, why not? I think there's a difference between "fixing" things that aren't aesthetically perfect but aren't really hindrances, and taking care of something that causes you serious embarassment or self-consciousness.
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"If ten million people believe a foolish thing, it is still a foolish thing."
- Anatole France
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