Dental implant vs missing back tooth WWYD?

[Tap]

I have an old cap that gets infected at the root every couple of years. The oral surgeon says it is the root going bad and creating an infection. We treat it when it gets bad, but he says the infection will never really go away and I need to have it pulled. 😞  He says I can get an implant if I want, but it isn't necessary. He doesn't feel like it is needed and will not cause any problems to be without it. It is the tooth next to the last one on the top. It doesn't show when I smile.  An implant will probably cost me $3-5k. I have good insurance but haven't priced them post COVID. I have a decent amount of money in savings, so I can technically afford it, but my savings is at a fixed point. Spending the money won't touch my 6month emergency savings, or house project fund with has $10,000 in it. With the economy, I can no longer add to my long term savings. I have enough to live and save for things like tires on my car. But I haven't added to my long term savings in a year. I am a single mom with a special needs teen ager and I own my own home. It is inevitable that more expenses will come up over the next few years, so I don't feel like I will ever be contributing to my long term savings again. 

My BF has a great job and 2 retirements. He is saying to get it fixed because he knows the idea of it being missing really bothers me. He is determined that we will be together forever and money won't be an issue in the future. I am much more pragmatic. LOL 

WWYD?

[Starr]

Will your other teeth move if there is a space there? 

[Tap]

26 minutes ago, Starr said:

Will your other teeth move if there is a space there? 

Oral surgeon says if they move at all, it will be so slight, it won't be a problem. 

[Bnogo24]

Can you have it pulled & see if it bothers you & decide about implant down the road?

[Kassia]

12 minutes ago, Bnogo24 said:

Can you have it pulled & see if it bothers you & decide about implant down the road?

This is what I recommend if possible.

DH had three teeth extracted last year and had two implants.  The third tooth is way in the back where no one can see it.  The implants are a lot of money, a lot of appointments, a lot of time in the chair.  As of now, he's not planning on having the third one done (the extractions were all done at separate times so all the work was/is staggered).  But it's an option for him if he decides later to do it.

If you think it's really going to bother you and the money isn't a big issue, then I'd recommend getting it done but I like the idea of having the extraction done and waiting a bit to see how you feel if you think you can wait.  

[Eos]

I've had one pulled with no implant for years and it's fine.  The others have not moved a noticeable amount.  The longer I wait, the more bone is there to do an implant into, but I probably won't ever do it at this point.  I'm careful about flossing and brushing the area, it's never given me any trouble.  I don't have dental insurance and had no money when I had the one pulled.  I could probably afford to do it now but don't feel the need.

[Storygirl]

DH had one back tooth that was still a baby tooth, because there was no permanent tooth there to grow in. Maybe 10 years ago, the baby tooth fell out and left a gap, which cannot be seen by others. I assumed that he should have an implant to keep his teeth from moving around, but he didn't, and he has had no problems.

I understand struggling with the idea of not replacing the tooth, because I would probably feel that way, too. But I would also hate to spend the money. I think that pulling the tooth, then waiting to see if the gap bothers you, is a good idea, as long as it would be possible to replace the tooth later on, if you decide to.

[Pawz4me]

I lost both of my second to the last teeth on top a couple of years apart. After the first one I put off having an implant because I really didn't want to spend the money and the tooth being gone didn't bother me. But after I lost the second one my ability to chew well was really affected. So I had that one replaced with an implant. It was the right thing to do. I can chew much better and it feels exactly like a natural tooth. My decision was complicated by the fact that I'm on an immune suppressing medication and probably always will be and I think that at least contributed to the abscesses that lead to the tooth losses. It's probably likely that I'll have more abscesses, even with excellent dental hygiene. I didn't want to get into a position where I needed multiple tooth implants all at once. In hindsight I think for me waiting on the first one but going ahead and having an implant after losing the second one was the right thing to do.  

[carriede]

I'm listening in...

Finally got back to the dentist in 2018 after years of not. Had lots of work done which included pulling an unsalvagable tooth - in the back, next to last on the bottom.

Then I got some much needed Invisalign (highly recommended if you need it!!) And JUST had jaw surgery to correct my bite.

So my teeth will be amazing very soon, but I'll still be missing that one and just don't wanna anymore.

[TechWife]

I had a back tooth pulled about ten years ago & my surgeon recommended not doing an implant for all the reasons you mentioned. I have never missed that tooth. I do have an implant to replace a tooth that sits between other teeth. I think that was the right call. You could try it without the implant and if it’s bothersome, have the implant done at a later time. 

[pinball]

If your boyfriend is offering to pay for it, I’d let him.

Even if you break up down the road, it’s not like you’d need to give him the tooth back.

 

[elegantlion]

I have two missing back molars- one upper left, one lower right (long term effects of radiation tx). One was a failed root canal. I did not have implants. I don't think about on most days. It doesn't affect my smile or how I eat. 

I also broke my front teeth out as a kid and had crowns redone recently. They had to post one. I don't know if they do molar implants differently but at certain times  - especially if I'm having allergy or sinus issues, the gum line above that tooth aches. So, you might ask about side effects of implants. 

 

[knitgrl]

I must have weird genetics because I had 3 baby teeth, with no adult tooth underneath. One fell out maybe six years ago. It's a molar, third from the back. I was going to get an implant, and then I turned up pregnant and ended up not having it done. Nobody but my dentist sees it. It is a little bit annoying in that peanuts especially like to get stuck in that space, and the gap between the two molars behind it has opened up a little bit so that if I eat wakame salad, I know I am gonna have some seaweed stuck between them. So, some extra flossing and peanut annoyance.

Unfortunately, one of my other baby teeth is directly under the missing one and I can tell it is not long for this world. I am going to need to get something there - either a bridge or an implant. I think I will see how a bridge goes.

[alisoncooks]

Following. My last tooth on the top has had issues for years (sensitivity after a filling).  I’m leaning towards having it pulled (vs $3k for root canal and crown). 

[MercyA]

For me personally, it would not be worth the money if it didn't affect my chewing and couldn't be seen when I smile. If the oral surgeon thinks you'll be fine without an implant, I see no reason not to just wait and see if it bothers you. 

I've had a back molar pulled and have had no problems at all.

[Elizabeth86]

I have one missing back tooth and it has caused no problems.

[Corraleno]

If you just want to have the extraction done now but keep your options open for a possible implant in the future, you can have them pack the socket with bone graft material. That ensures that the bone will heal up strong and solid, which is good even if you ultimately decide not to get an implant. Sometimes the socket will heal fine on its own, but sometimes the bone can deteriorate and lead to additional problems down the road. Many years ago I had a molar pulled at a time when I couldn't afford an implant, so I had the socket packed with graft material and it healed up perfectly. When I eventually had the implant, the bone was strong and solid.

[stephanier.1765]

I have one missing right now - next to the last tooth on the bottom. I had the bone graft done at the time it was extracted in the fall but, as of right now, I'm waiting to get caught up on other dental bills before I decide if I want to get it replaced. I do notice that I eat on the opposite side more. I recently needed a crown on the second to last tooth on the other side of the bottom. The first temporary fell out and it was a couple of days before I could get in to get it replaced and I really noticed then how much I use that side vs the one with the missing tooth to eat. I don't know if that will affect me down the road but it's something I'm keeping in mind.

[Halftime Hope]

I am missing both of my rear top molars. When I was a college student, they both had large cavities.  Several crowns later on each one, there was finally a choice: pull, or pull and implant. The oral surgeons (two opinions) said that implants don't take nearly as well on the top jaw, the other teeth would not move laterally, there was no need for them for chewing in my unique bite pattern--unlike the lower molars--and so I had them pulled and haven't looked back.

The hardest thing about it was my own feeling of stigma at having missing teeth.  Sigh. My dentist was bemused at my take on it, but that's how it felt.  In practice, it's actually quite nice to be relieved of the chore of flossing behind/around those last two teeth in very tight quarters.

Finally, yes, I think having an ongoing infection is dangerous for your health. My father lost the sight in one eye due to an undiagnosed tooth infection that was finally discovered due to an abcess, but after his eyesight was damaged.  (I don't know any further details.)

One other question for your caregivers: it's been 10 years or so since mine were pulled. It could be that technology has changed. You could ask about upper jaw implants, how those fare. 

 

Edited February 24, 2023 by Halftime Hope

[LucyStoner]

I am missing my second to last molar on one side of my lower jaw.  I initially put off the implant due to money.  Then I was putting it off because an implant freaks me out.  Now, I keep meaning to do it but i haven’t.  No issues with it being gone in 15 years but I will say that I think it’s caused my teeth on the other side to wear down more since I tend to chew more on that side.  I kinda wish I’d done it years ago but clearly not enough to actually get my shizznit together and do it.  

[prairiewindmomma]

In your shoes, I would call around and really price it out. I would probably have it pulled and have the bone building material put in at minimum, and maybe the post but not the tooth. If you don’t maintain enough bone material in the jaw, an implant won’t be an option in the future. 

[Ausmumof3]

I had orthodontic treatment to close up the gap and fix other teeth at the same time when in a similar situation. It was around the same cost as an implant and I got other issues fixed as well.

Just mentioning it in case that’s something that you could do. Eventually I suspect I will have the same problem again as I have one filling in the same spot on the opposite side that keeps having to be redone. I doubt I’ll get the implant unless they get a lot cheaper but I probably would if it wouldn’t affect us financially.

[Amethyst]

Personally, I'd do the implant

[easypeasy]

I had the same choice a few years ago and opted to have the tooth pulled. All my teeth stayed put & I don’t regret the choice. (It was a very back tooth in my case)
 

In my case, I’ve known one person with a bad implant story (her body rejected the implants) and it honestly just sounded more painful than having the tooth pulled and I was tired of being in pain!

Edited February 24, 2023 by easypeasy

[prairiewindmomma]

How do you feel about flying to Mexico for dental treatment?

[Amethyst]

54 minutes ago, easypeasy said:

 

In my case, I’ve known one person with a bad implant story (her body rejected the implants) and it honestly just sounded more painful than having the tooth pulled and I was tired of being in pain!

There are many many people with positive implant stories too. Implants have a very high success rate. 

[Amethyst]

15 hours ago, Tap said:

 

He is saying to get it fixed because he knows the idea of it being missing really bothers me. 

Is he right? Does the idea of it being missing bother you? It would bother me. A lot. But clearly not everyone here feels the same way. So, how about you? Would it bother you? 

[easypeasy]

2 hours ago, Amethyst said:

There are many many people with positive implant stories too. Implants have a very high success rate. 

Oh, yes. I know this. But a hundred good stories don’t hold the weight of going through the one bad experience in person.  😄 So, for me personally, i erred on the side of getting it over with as fast and as pain free as possible. 
 

If it hadn't been the very back tooth in my head, or visible in any way, i wouldn’t have opted for the fastest option. 🙂

[QueenCat]

I would get the implant. 

[Sunshine State Sue]

On 2/24/2023 at 6:21 AM, Storygirl said:

DH had one back tooth that was still a baby tooth, because there was no permanent tooth there to grow in.

I had a baby tooth without an adult tooth that was crowned when I was a teenager but eventually disintegrated.  This was back around 1990 before implants were invented I think. I had a bridge put in.  Is that a possibility? It may or may not make sense depending on the health of the teeth on both sides.

On 2/24/2023 at 1:17 PM, Halftime Hope said:

 The oral surgeons (two opinions) said that implants don't take nearly as well on the top jaw, the other teeth would not move laterally

I broke my 2nd to last tooth on the top a few years ago and decided to get an implant. It is true that implants don't work as well on the top. I remember the oral surgeon talking about some issue with the nasal cavity. It's a long process. It's an expensive process. A few months after I was finally done, the implant fell out. 🙁 So, another very long process (2nd time was free though). I think that my teeth did shift a bit and I had a lot of trouble with food getting caught between the 2 teeth just in front of the missing tooth. My dentist was able to make me a retainer that filled in the missing space while I waited for the long process to end.

I don't know if I would get another implant if the missing tooth wasn't visible and didn't affect chewing.

[Tap]

Well you have all given me more confidence in just getting it pulled~ Yes, I will be bothered by missing a tooth, but honestly, in the grand scheme of things, this tooth is a already crown, so honestly, my tooth has been MIA for years.🤣 LOL 

Edited February 26, 2023 by Tap

[Amethyst]

43 minutes ago, Tap said:

Well you have all given me more confidence in just getting it pulled~ Yes, I will be bothered by missing a tooth, but honestly, in the grand scheme of things, this tooth is a already crown, so honestly, so really my tooth has been MIA for years.🤣 LOL 

Not really. The root of your tooth is still there. That is what is sustaining the bone. When you  remove the tooth, the bone that was supporting the too remodels and you have less bone in that area. 
 

Have you considered a bridge instead of an implant?

[Tap]

4 minutes ago, Amethyst said:

Not really. The root of your tooth is still there. That is what is sustaining the bone. When you  remove the tooth, the bone that was supporting the too remodels and you have less bone in that area. 
 

Have you considered a bridge instead of an implant?

Ah, yes, that is important too. He didn't recommend a bridge, I can't remember why. Maybe because the adjacent tooth s a crown too?? Really don't remember. 

[katilac]

19 minutes ago, Tap said:

Ah, yes, that is important too. He didn't recommend a bridge, I can't remember why. Maybe because the adjacent tooth s a crown too?? Really don't remember. 

I would ask about the bridge, they are traditionally supported by a crown on each end. 

[math teacher]

I have a missing tooth-bottom right, next to last tooth. It's been missing for years, and I really need to get it fixed. I rarely chew on that side. 

Not sure if this has been mentioned, but my insurance has a missing tooth clause-dentist has told me that the majority of insurance companies also have this clause. You might want to check, because if you decide later to have an implant, insurance might not cover it.

[Amethyst]

18 hours ago, Tap said:

Ah, yes, that is important too. He didn't recommend a bridge, I can't remember why. Maybe because the adjacent tooth s a crown too?? Really don't remember. 

This explains why a bridge was not recommended. In order to do a bridge, they would need to remove the crown on the adjacent tooth. If it’s a perfectly good crown, I wouldn’t suggest a bridge either. In that situation, an implant would be the ideal choice. Unfortunately, many of my patients can’t afford them. 

[Splash1]

I had the implant done.  For me I wouldn't have enough chewing space without it.  I have a small mouth with four teeth pulled before braces for space.  It's a pretty long process for an implant so you have time to decide.  I'd recommend it.

Kimberly

[J-rap]

My dh chose not to have an implant in the area of back molar about 11 years ago and hasn't found it to be any problem at all.