(updated January 2024)
My last molar was extracted… Do I need a dental implant? I have received this comment/question so many times that I decided to write a quick post about it!
Last Molars Are Not Always Needed
To be clear, typically our last molar that shows in the mouth is our second molar. This is under the assumption that your wisdom tooth or “third molar” was extracted or is still under the gums.
The second molars are directly in line with our main chewing muscle called the masseter. These molar teeth tend to break because it is in an area of high power. I even had my own second molar break a few years ago!
So do you need to replace this tooth? If it is the bottom molar and you still have the upper opposing molar then I would typically say yes. The reason for it is if you do not replace the bottom molar, the upper opposing second molar will begin to over erupt out of its socket, trying to reach its old partner that got extracted.
Teeth need contact with one another.
Without contact with another tooth, our teeth tend to drift. It will drift enough to where you will end up biting your cheek and gum, and this can also become an interference in your bite, which may cause “TMJ”…temporomandibular jaw joint problems (TMD.)
If it is the upper molar that got removed, the rules are a little bit different. Some people can get away without replacing the upper second molar. This is because most people have a class I bite and the molar that is left behind on the bottom usually still has something to bite against. This is because the upper and lower molars do not align perfectly on top of each other; they tend to be a half tooth off. So some teeth are only biting on half of the tooth…. which is often all we need.
The lower molars do not over erupt as commonly as the upper molars do when the opposing tooth is removed. Sometimes the bone over-erupts as well causing a much more serious problem.
Upper Vs. Lower Molar Implants
Upper Vs. Lower Molar ImplantsPlease keep in mind that not all molars need a socket bone graft and then the implant a few months later. A more advanced procedure is to have an implant, bone graft and extraction on the same day.
This particular patient is missing a second molar on the bottom jaw. You can see from the side view that nothing supports the upper molar. If he does not replace it, the upper tooth will eventually be lost. He elected to have me place a dental implant .
Please note that in the United States versus internationally, we number teeth differently.
In the United States the second molars are numbered: 2, 15, 18, 31
These correspond to the international numbers of 18, 28, 38 and 48.
It often becomes confusing to answer questions about specific tooth numbers unless you are very specific as to where you live!
Ideally, most second molars should be replaced. Nature gave you 8 molars in total. Make sure you are assessed carefully for your bite to see if you really need them or not. Most of my full mouth FULL implant reconstructions do not have second molar replacement. Why? Even though these are important teeth as long as we have the molar just in front of it… The first molar… You can have a stable healthy mouth for a very long time. But remember this is carefully planned this way.
Ramsey A. Amin, D.D.S.
Diplomate of the American Board of Oral Implantology /Implant Dentistry
Fellow-American Academy of Implant Dentistry
Burbank, California
Hi! I suppose to have #17 removed and I dont have #18 since I was little. Dentist recommended inplants on 17 & 18. can I just do graft and inplant on 18? I am 50 years young 🙂
18 only! 17 is a wisdom tooth unless your jaw is shorter.
Hi! Had a failed root canal on #19 and now needs to be extracted. Was also informed that #17 has major bone loss and I should get it extracted as well and get a bone graph in both those areas after extraction. I plan to get an implant to replace #19 but do you think I need an implant for #17 which is my last bottom molar?
NO! 17 is a wisdom tooth!
Hello Dr Ramsey,
I did a root canal on #31 – which I took my time on showing up for my follow up appointment and the tooth cracked. I now need a implant on it. I had no idea my #18 is gone as well (im guessing from many years ago since i completely forgot about it.)
I’m hoping to just extract #31 and let it be since my #18 was fine this whole. Horrible idea?
Not a bad idea. How old are you ?
43
I was hoping you were 70 😉
Your upper teeth are likely to come down at your young age. But this depends on your bite as described in the article. Your dentist should be able to help you determine this.
Hello Dr Ramsey
Do you place the abutment and the final crown at the same time? I have seen some doctors place them at the same time while some don’t. Any reason for that?
Unless it is this type of abutment called a multi unit typically the above and final crown will go on at the same time.
https://burbankdentalimplants.com/what-are-multi-unit-abutments-for-dental-implants-insight-by-ramsey-amin-dds/
tooth becomes impacted because there is a lack of space in the dental arch, causing the tooth to grow on an angle towards the other molars and their roots. This impaction can cause pain, lead to infection, or cause other pathologic conditions (See Figure 1). I have pain and I have my 3rd molars impacted but I thought my molars where gonna be spare ones now I think there coming out like the amalgam they removed wow those where the blown out tire now my spares are burn out now I think how my dumb ass is gonna get what I want for my dental work
Hello Dr. Ramsey,
I am a 51 year old male. My upper left back molar and lower left back molar have been declared dead by my dentist. I have had two failed root canals on both teeth. I have been living with these teeth. No pain whatsoever. I am going on at least 5 years since the last root canal. My dentist tells me at every checkup I should have them extracted, but if they are not bothering me, why should I? So my question to you, should I have them extracted? If so, why? If I do, do I need implants since they bite into each other. They are the last molar on each side.
Steve
You probably have chronic bone infections in both. As long as the black spot on the x-ray stays the same size and it does not break through the gums with a pimple. X-ray every year and re-eval!
74 YEAR OLD MAN, HAD #18 AND #19 EXTRACTED FAILED ROOT CANAL AND ROOTS INFECTED.
DO I NEED TO GET IMPLANTS? REST OF TEETH OK, ALOT OF CAPS BUT NO OTHER PROBLEMS
REALLY DON’T HAVE MONEY AT THIS TIME FOR IMPLANTS CAN I LIVE AND EAT LIKE THIS?
You can stay as you are but you have lost significant amount of chewing surface since 19 is gone. You could replace just 19 and leave 18 as an empty spot.
If the opposing teeth are in good condition, I would replace both of them.
Once these teeth are gone for a while, your other teeth will begin to shift and the phone will shrink.
This is all elective treatment, but certainly provides better quality of life. The combination of number 18 and 19 is common to replace.
Hello Dr Ramsey
I am F 56 years old and live in the UK. No bottom wisdom teeth as removed when I was a teen. About 20 years ago I cracked my lower left second molar #31 (as per American number chart). Had a root canal and have gone through a couple onlays over the years. I have repeatedly been told the tooth is in bad shape and will at some point need to be extracted. About a week ago, the top of the tooth broke off, exposing its roots below the gumline. I am able to refit the top of the tooth as it will slot back in to place but any sticky, chewy food will dislodge it. I have an appt with my dentist next week where I am sure she will want to do the extraction. When I saw her about a month ago for a checkup, she mentioned extraction but did not make any suggestions for an implant. Do you recommend I have one done? The tooth above, #2 is in reasonable condition with an old amalgam filling. Do you think an implant for 31 would be the right thing to do? It is an expense I don’t like, but I want what’s best for my health and appearance for the long run. I am not sure what to do. Thank you for being so helpful to those of us with questions.
This is a good indication for an implant, especially if 31 has a bad prognosis
I’m in my early 50s had a root canal done on upper second molar tooth #2. Endondist told me it was 50/50 based on x-ray and then during the procedure told me it’s better to extract it since the decay in the distal part of the tooth reached the furcation point. Since extraction is always an option, I asked her to complete the root canal.
My general dentist told me they can put a crown, but it would be less stable than a typical root canal tooth due lacking tooth structure in the back. If the crown can last 5 years, then I’m willing to go with the crown. If I were to extract it and wear a customized night guard, can I get away without replacing it with an implant?
Extract and don’t replace with an implant. Save your money!!💰
Thank you for replying. It’s very helpful. I prefer to hang onto the tooth as long as possible before extracting. If a crown can last 5 years, I’d go with that option for sure. If I email X-Ray of this tooth to [email protected], would you be able to provide an assesment of whether to just extract this tooth now or crown it and get few more years out of it?
Unfortunately that is not part of this forum. Years ago, I allowed people to upload images and you could imagine what happened between inappropriate images and potential viruses 🦠
Trust your dentist if they are competent or get a formal 2nd opinion beyond just looking at an xray
Hello! I found your website after doing some research. Very interesting! My situation is this: I had RCT + crown on #2 (US) about 20+ years ago. I now live in Switzerland and my dentist says, after 20+ years, that tooth has a chronic infection in one of the roots. So far, I have no pain, no sensitivity. My dentist says to wait and observe as the infection is still pretty minimal and not causing any damage to neighbouring teeth. He does recommend extraction at some point down the road. He says I could do an implant…or not…it is not necessary and would only be for aesthetic and “chewing” issues (like if I missed my tooth’s ability to chew, etc). I would prefer not to do an implant as I don’t want another foreign object in my mouth, not to mention the expense of it all. Could I continue to have healthy teeth without an implant? For reference, I am a 48yo female, non-smoker and my dentist says I have good oral/dental health. Thanks in advance!
Thank you for the detailed information. This helps me help you. More than likely you do not need to replace the tooth and just leave it in place until it becomes a problem. Many root canals have these dark spots at the apex and do okay for many years. Sometimes they wake up and cause an abscess which requires extraction or retreatment.
Thank you for your reply!! Interesting that you say that as this is my fourth year with this recurring situation. A tingling sensation always begins around Sept/Oct then continues until April. Come May, it has completely resolved itself. I’ve made repeated trips to my dentist and each time he says it’s fine to just leave it. Occasionally I do get an ear ache on that same side as the problem tooth but nothing more than that. Is it possible that my “sleeper infection” is activated by a change in seasons? Then once it warms up again, it resolves itself?
I wish that were the case. If I were you, I would get a CBCT also known as a 3-D scan. Likely if the tooth has a root canal, it has a small fracture or a missed canal and has a small infection that goes away and comes back and the cycle repeats. You should have this retreated or looked at by an endodontist using imaging before you end up having to lose the tooth.
Hi Dr. Ramesy, I recently had tooth #2 (second upper molar) crowed as I had an old (like 40 years old) amalgam filling that was failing. I had quite a bit of pain w/the temporary crown, my dentist put me on antibiotics and 800mg ibuprofen and replaced the temp crown, this worked well, it was uncomfortable but the pain subsided. I recently had my permanent crown put on however 2 days after the placement I’ve started to have throbbing pain that comes and goes and extreme heat sensitivity. If I attempt to drink coffee, the pain is not isolated to tooth #2 but radiates to the whole upper R side. I am thinking of having the whole #2 molar extracted and be done with it bc this pain and back and forth to the dentist, waiting in the lobby etc is a lot for me. Is it ok to have a #2 molar extracted and not have an implant or bridge? I do wear retainers at night from prior ortho work. Thanks
If it were made and the tooth was predictably savable I would have a root canal done by an expert endodontist.
My upper back molar has been gone for several years. Now my lower back molar is loose. Since the molar above has been gone for so long, would I need an implant on the lower molar or could I be okay just extracting it since the tooth above is gone?
I would just remove it and not replace it. It does sound like you have some bigger issues, possibly periodontal disease because teeth don’t just get loose without a reason. Smoking and hygiene are huge reasons for disease that leads to bone loss.
Thank you so much for your reply, Dr. Amin. I have had periodontal disease for some time now and go in every 4 months for cleaning/maintenance.
Hello Dr Ramsey. I am 23 years old and need a root canal and cap on my bottom right second to last molar but I can’t afford it. What would you suggest I do instead?
It is often possible to do the crown without the root canal. in my opinion, many root canals are overdiagnosed.
Ask your dentist again.
It might end up needing a root canal in the future, but maybe for now the crown could be made and the tooth can be saved.
Dr. Amin,
I am having trouble deciding what to do. Dentist wants me to save the tooth if possible. My top second molar needs a root canal/crown or extraction. I have no opposing bottom second molar as it was extracted 10 years ago. Should I save the top second molar? I do have TMJ and am a grinder and clenched.
It depends on your bite as it states in the article. If you have a standard class one bite, then most patients do not need this. Sometimes there is an exception when somebody had orthodontics having bicuspid extractions to make room. These people have less teeth in general as four of them were already extracted. 😊
Hello,
I had to extract tooth 37 (bottom left 2nd molar) recently. I still have stitches. There’s still a molar above the extraction spot and it doesn’t connect with anything below, so it’ll continue to extrude slowly with time. I’ve read a paper stating that wearing a retainer while sleeping is a viable way to prevent the process. Unfortunately, a bone graft wasn’t available during the extraction. I’d definitely want to get an implant + bone graft in the future, but it might take a bit more time. Ideally, I don’t want to lose my upper molar due to extrusion, so do you believe that wearing a retainer every single night could be a good solution to prevent that from happening? Is it possible to place a permanent retainer connecting upper molars like in the case of front teeth after an orthodontic treatment to stop them from shifting?
I understand your concern about the upper molar extruding after the extraction of your lower left second molar (tooth 37). Wearing a removable retainer might help, but it’s unlikely to be a long-term solution. Splinting the molars is also not recommended as it can create a hygiene nightmare. Instead, I suggest trying a thicker retainer and getting it done within a year. Not everyone experiences supereruption at the same rate, so this might give you enough time to plan for your implant and bone graft.
Hello Dr. Ramsey,
I am 39 years old. I recently had my top 2nd molars extracted due to 2nd molars missing on the bottom. I did it to avoid supra extraction as I did not want implants on the bottom. Will I be fine just having my 1st molars?
Hello Dr. Ramsey,
I am a 39 years old and just recently had my two upper second molars extracted (US 2 and 15) leaving me with my first molars. I was missing my bottom 2nd molars for a while now and did it to prevent supra eruption over time. I do not want implants. Will I be ok now without my second top molars?
This is not a problem whatsoever. The upper second molars are probably the least important for having dental implants. Thank you for being so specific about the proper tooth numbers 2 and 15! ☺️
I had to get 29,30,and 31 extracted due to cracked teeth after root canals. Should I get 3 separate implants or and implant post on 29 and 31 with a 3 tooth crown bridge to cover the gap. I have all upper teeth on right (except no wisdom teeth).
Do I need to get bone graft too?
You likely will need bone grafting but as for the question of two or three implants, either one is OK. Two implants in a bridge work quite well in the lower jaw as opposed to the upper jaw. This is because the lower jaw is much harder, so the implants are quite stable.
Hi Dr. Amin,
I’m hoping you can help me with a decision I need to make. I need to have teeth 14,15 and 16 extracted. I will be doing a bone graft,implant and extraction the same day on number 14. The decision I need to make is whether I should bother with an implant on tooth number 15. I would have to do the bone graft and then wait a few months in order to do the implant because there’s not enough bone. My bottom teeth on the same side are fine and I have them all. Do I need to do the implant on number 15? I’m very Dental phobic!
Also, Due to lots of other conditions like SIBO, I am a daily medical marijuana smoker because it’s the only thing that helps my nausea and I know that I’m not going to be able to smoke for a little bit after the bone graft and I’m terrified because I have not been without it daily for years. I obviously want the bone graft to take and do not want dry socket, but I’m not sure how long I can go without the medical marijuana. I would really appreciate your advice on both. Thank you.!
The decision to replace #15 is optional. Depending on your age, bite and other factors it can be eliminated. But it is always better to share the load between #14 and 15. I generally do not replace 15 just by itself but if 14 is gone I tend to replace 15 at the same time. Keep in mind #16 is a wisdom tooth.
As for marijuana use-click on this blog and you can learn more about it –
Hi Dr. Ramsey, I just had all 4 wisdom teeth along with #15,18,30 ( US. all second molars on right side. first molar on left bottom ) i’m about 9 days post op. i have to get a root canal on my lower left 2nd molar and a bridge to cover the gap of 30. would you recommend getting an implant on #18? i am going to an ortho and i’m just fearing that i’m not going to be able to chew properly after i’m healed. thank you
Yes on 18 but ideally don’t use a root canaled tooth as a bridge anchor
I had both third molar maxillarty removed.after 3 Weeks why still I feel pain while chewing on 2nd molar
You need to be looked at for a follow-up visit. This would not be uncommon after three weeks.
Some wisdom teeth are much more complex than others requiring several weeks of healing.
Greetings, Dr. Ramsey,
I’ve (45years) just had my lower right second molar removed (an old root canal & recent root fracture). Wisdom teeth were all extracted long back. All the other teeth are fairly healthy. I wouldn’t want the pain of the implant, as I am sensitive. Can I manage without it, and will it have any cosmetic changes to my jaw or face?
YES -Can I manage without it
But likely #15 will shift out of place
Hey Dr Ramsey. I am a 23 year old female and have 4 molars extracted due to severe cavities(depression got me there). Three first molars and one second molar on lower jaw . I want to get them replaced but need bone grafts first. I am thinking of visiting you for the same. My issue is I need to fix by overbite and crowding first to get the implants. Can you tell me how long after bone grafts (In the upper jaw I might need sinus lifts) can I get braces so I can talk to my orthodontist about the same. Will really appreciate your response.
I’m sorry to hear about the challenges you’ve faced with your dental health. It’s great that you’re taking steps to address these issues. In your case, it would be ideal to see you before beginning any bone grafts or orthodontic treatment. Typically, the healing time for bone grafts is around 4-6 months. This period allows for proper integration of the graft material with your natural bone. Once the grafts have healed, you can then discuss the timing for orthodontic treatment with your orthodontist. Every case is unique, so the exact timeline can vary, but planning these treatments in a coordinated way is key to achieving the best outcome. Your proactive approach to your dental health is commendable, and I look forward to assisting you on this journey.
I have extensive damage to both my #15 and #18. My dentist has said we could either extract both, or root canal/crown both. I’m torn as to what would be the best long term solution – since they’re corresponding teeth on top and bottom, would extraction of both mean inplants would be absolutely necessary later, or could I do without since both upper and lower will be gone? Or would my teeth shift quite a bit with both those molars missing?
I understand your concern about the potential outcomes of extracting both #15 and #18 teeth. Here’s a more concise perspective:
Extraction of Both Teeth: If both teeth are extensively damaged, extraction can be a straightforward solution, preventing further issues.
Implants Necessity: After extraction, implants are not immediately necessary, especially since both corresponding upper and lower teeth are being removed. The urgency for implants decreases as there won’t be opposing teeth.
Risk of Teeth Shifting: The risk of teeth shifting is present, but unlikely
My #15 tooth was badly damaged and then crowned 10 years but is now causing me intense pain. I am trying to figure out whether to extract or root canal. I am leaning toward extraction, but do not want to get an implant. Is this a bad idea? I am 40y/o.
Generally not a problem to lose your upper left, last molar.
I have learned that I have an infection surrounding the root of tooth 18 (US). Endodontist says it will need to be extracted by the periodontist. They have suggested having bine graft at the time of extraction, then return for implant 6 mos later. I am uncomfortable with cadaver bone graft and have read about autologous dentin graft. What are your thoughts? (I like the idea of a dentin graft from my own tooth or no grafting at all rather than cadaver graft).
I do this! It works great as long as there is a HEALTHY tooth to use as the donor!
This is so helpful. I am having tooth #2 removed next week (old root canal/crown, tooth fractured and there is an infection now). My dentist said she didn’t think an implant was necessary, but that the oral surgeon might tell me otherwise (?). I haven’t seen him yet. I’d prefer to just have the extraction, unless there is a valid reason why I need an implant (I’m 44/F in the US). Could my face look different without that molar?
NO – Could my face look different without that molar?
Hi Dr. Amin,
I had my 2nd molar extracted about 10 years ago (no bone graft) and it has caused facial changes. Specifically, that same area of my face that got the extraction looks skinnier/sunken compared to the other side. Can a dental implant be able to build up enough bone to reverse this and/or prevent further bone loss?
Hi there,
Generally, the extraction of a single second molar shouldn’t cause noticeable changes to your facial structure. The sunken appearance you’re noticing could be due to natural changes over time or other factors. While a dental implant can help prevent further bone loss by stimulating the jawbone, whether it can build up enough bone to reverse the changes you’re seeing depends on the individual case.
Best wishes,
Dr. Amin
At age 26 i recently had tooth number 18 extracted, and i am also missing 19. But with numbers 14 and 15 still healthy, which bottom molar would you suggest needs an implant most? im am also missing all wisdom teeth do to them being impacted
BOTH 18 and 19 would be your way to go.
My partner never got his 48 and 38 wisdom teeth and has had his 46 and 36 extracted.He is worried what we need to do now. Will he lose the shape of his jaw and does he need them to be replaced what would you suggest?
Wisdom teeth do not need to be replaced.
My #31 was removed a while back 3 days ago I got hit and my 32 was knocked loose. My face is still swollen and i can feel the cracking of the tooth shifting.
My question is. Without the 31 how are they going to be able to stabilize my 32 (I.e I can’t get a bridge without a tooth on either side and I can splint the 32 without the 31 present yes?
Are you speaking in European tooth numbers making this your lower front teeth? Or are these your wisdom teeth in the American numbering system? If they are wisdom teeth you need to be evaluated for possible broken jaw
It’s been determined that tooth #31 (US) is a failed root canal, has infected root and decay under crown. I was referred to a specialist to determine if the tooth can be saved. It’s been giving me problems lately and pain is pretty bad. Tooth #30 is needing root canal and crown. If I extract rather than determine if it can be saved (and do another root canal on it) do I need to get an implant for #31? Tooth #2 is good and no issues with it.
If you are keeping #2, then #31 is a good idea for most cases.
I recently had teeth #1, #31 and #32 extracted. The oral surgeon said that because tooth #2 is partially hitting with #30 when I bite, that I won’t need an implant for #31. Does this sound plausible to you?
Thank you Dr. Ramsey!
YES! Good advice!
dear dr. amin,
Iam a 63 year old female that is getting ready to have tooth #31 extracted( root canaled tooth) suspected fractured root(s)based on CBCT scan. A lot of bone loss.! I have tooth #2 (deep filling with onlay) #32,#30. is it possible that tooth # 2 can hit tooth #32? Does this scenario mean i have an option of whether or not to have an implant? I am doing a bone graft to keep my options open.What happens to the bone graft if no implants?
I am very afraid of doing an implant.,however i want to do what is best in the long term.
MANY thanks
P.S. i understand you lost this tooth, did you do an implant?
If 2 touches 32 you can avoid the implant. You would not want to have #31 implant with #32 present anyway as it will likely cause food impaction!
#12 & #28
How important are implants?
American numbers or European? I am assuming you are referencing the American numbering system and they would be very important.
Hi Dr Amin,
if #31 is removed and #32 is present but does not touch #2, can you clarify whether or not you advise having an implant?
also can you please say more about food impaction in the case where #32 present and #31 is pulled or has an implant – I could not understand the scenario you were sharing.
thank you.
32 usually should go. Especially if you decide to have implant #31. That scenario often impacts food badly.
Hi, Dr. Amin,
I am 58 years old. I had my wisdom teeth removed and braces as a teenager. My teeth have pushed forward and overlapped as I have aged, and it has really begun to cause pain.
My right second lower molar has a crown and my dentist said it needs revision. The teeth on that side are also pushing forward more than the left. If I just had the tooth removed, would it help my teeth drift in that direction? Could it eventually compensate for not having a molar there to meet its top partner?
Thank you so much! I can’t find good information on this anywhere.
I’m sorry. I should have specified that only my lower teeth are crowding.
Thank you for your question. The teeth can only drift forward not to drift backwards. At your young age 😉 it is not likely to happen. Depending on teeth to drift is usually something only possible in the young teenage years.
Hi um, im an 18yo female who had my upper 2nd molars extracted (2 & 15 i think) and ive never had my wisdom teeth removed, and they havent grown in yet- I wasn’t sure if my teeth would shift- and if thats a possibility would it be possible to use my wisdom teeth to replace them?
This might happen but it is not likely. Only time will tell. It may take until you are 27 to see this. A panoramic x-ray would help.
Hey doc. 29YO female here. When I had braces as a young teen, I believe they removed 4, 13, 20, and 29 to create space. My wisdom teeth were removed a couple of years before that. I’ve had an awful time with my back molars.. cavities, cracking, infections, root canals, gum issues, etc. despite having good oral hygiene and otherwise healthy teeth and gums. I’ve been told it’s still pretty tight in there. Unfortunately, I have to get 18 extracted (root canal when young, crown kept popping off as tooth was too short, had them place a filling in to buy me some time, now its infected and has to happen ASAP. We had to buy time as there was some concern on there not being enough space between the top and bottom teeth for an implant. Bringing it down to basically two options (unless you have a third!)..extract and implant 18, try to get a crown on 15, ideally it all measures up. Then crowns on 19 and 30 as they are weak/cracking/too many fillings. OR just extract 18, but then there’s some concern about 19 and 15 not being supported. So what if I just extracted 18 and 31? And would I also just want to extract 15 and 2 to even it out? I plan to get invisaline to fix some minor shifting after all is said and done, so wondering if less teeth = more room = easier to care for and set correctly with invisaline. Really looking for a long term solution here. Thank you so much!! I appreciate any comments you might have. -Leah
Hi!
My dentist said that there is not enough room for my wisdom teeth to grow, and that i should remove all four. because i dont want the wisdom teeth to push my other teeth and cause them to be crooked, i am considering it.
however reading about it online, i hear many people reporting facial changes after removing wisdom teeth, the worst being saggy and wrinkled skin. is this possible? can i avoid it? (im 19 years old)
can i use some sort of braces to help the wisdom teeth grow without moving my other teeth?
thanks!
Hello Dr. Amin, so grateful for this post as you are giving genuine unbiased opinions.
I am 47 years old and have been advised to have second back molar (#31) removed (root canal, screw, crown, infection at the root). All wisdom teeth are removed. I really don’t want to get an implant, but worried about my other teeth shifting, supraeruption. Upper molar #2 is not a healthy tooth (has a root canal and a crown). What would you recommend?
Did you ever get an answer? I’m in same situation but not sure I want/need implant on 31, crown on 2
22 yrs old had the #14 removed at 18yrs old. The dentist at the time said that my bottom wisdom tooth would shift the teeth foward so nothing would need to be done after that. The dentist I went to after that said nothing of it but my new dentist is insisting on an implant of $3,000. My wisdom teeth on top are already growing in and the bottom ones are sure to follow. Can my wisdom teeth be shifted foward to make up for my missing molar or do i really need the implant.
At your age of 22 the teeth are not going to move that much to make up for missing molar #14. This only happens in very young patients approximately 12-14 years old. You will probably need the implants and/or orthodontics along with it. #14 is a very important tooth to replace
Tooth 30 and 31 bottom teeth. I had them removed. Do I need to get two implants. My gums are healing right now from the extraction. Any advice? Don’t want my teeth to shift.
Yes – both
did you get implants
I was age 25 when my wisdom tooth moved into place of a back tooth I had pulled. SO happy I didn’t remove my wisdom teeth. They sure do come in handy. Here I am 36 years old and using my wisdom tooth as a normal back molar. Glad I didn’t do an implant etc
Hello – my previous post somehow disappeared. I am just trying to understand two things:
1. If extract tooth #2 due to an infection is it absolutely necessary to have a bone graft (I am not replacing it under any circumstance with a fake tooth.
2. Is there any validity to the rumor that because I had an infection (which has cleared by the way with Clinidymacin for a week) I HAVE to do something with the tooth (extract or root canal) or can I just leave it alone unless it comes back?
I am having a hard time believing that without any symptoms the same infection could spread to my brain or jaw. And if that is a concern, how much time do I have? It has been 2 weeks since I had the pain issue. Thank you.
I think I replied you already. Is not necessary to have a bone graft if you are not going to replace the tooth with an implant.
The term “infection” can be used loosely in dentistry. My guess is that you have a root canal that is not looking good but your body is holding it back from spreading into your brain or adjacent teeth. Most of these types of infections have no symptoms and rarely can they get really really bad but they are better to remove than they are to keep as they create chronic inflammation for your immune system and destroy bone internally
Once removed the bad tooth, does bone grow back from stopping the infection?
Usually the tooth is the source of the infection.
Hi – I love that you are answering questions as I can’t get a straight answer. Tooth #2 needs to come out due to failed root canal, infection and crown. The dentist is insisting that I have a bone graft even though I have zero intention of getting an implant. The tooth on the bottom that opposes it has a root canal and crown. Any reason I can’t just leave it alone? Will my top teeth shift dramatically (I am 53 years old). Tooth number 18 was removed last year no bone graft. (different dentist) no issues. The upper tooth above that also has a root canal and crown. The tooth next #19 is an implant. Thank you!
NO need!
Hi Dr. Ramsey Amin,
Thank you for such informative content. It help patients like me understand the situation better, which in turns help us to take better course of action. I have had such awful experience with dentist. Last year I had my wisdom tooth extracted and the dentist left a metal tip, root, tooth parts, etc inside my mouth. But that was taken care of by different wonderful dentist but unfortunately that wonderful dentist moved away.
I had my two upper teeth extracted when I was a teenager for braces. 1 (#32 )of my lower wisdom tooth got extracted before and the other (#17) last year. My new dentist was pushing me to get upper wisdom teeth (#1 and #17) removed too stating all wisdom teeth end my causing problem down the line. I stupidly got my upper right wisdom tooth (#1 )extracted. Now there is no corresponding upper teeth to my lower 2nd moral. I have Type 2 bite ( overbite). It feels awkward and a bit difficult to chew . I am attaching Xray of the same. What should I do ? Should I get an implant? or would it get better with time .
https://drive.google.com/file/d/1bi4JcRgH5iEaZZ3X9TS9o15GxNMBy77l/view?usp=sharing
It will get better with time. Wisdom teeth should not be replaced with dental implants unless it is a special implants used for full arch replacement called a pterygoid dental implant.
#17 is broken, infected and DDS is looking to do root canal. I have a fairly small mouth and is pretty far back. Wisdom teeth removed years ago. He is open to, but not recommending, an extraction. I am leaning towards extraction for finincal reasons. This would allow me to get another extraction and needed bridge at #13. Will I be ok with extraction? Will my face / facial structure change?
EXTRACT the wisdom tooth!
Hello,
I am having complications with my second molar on top due to infection to the nerve. They gave me the options to with remove it or do a root canal but the seems to be decaying all around. I am 24 so I’m trying to find the best option I’m not having no further infection or problems with my mouth in the future due to my choices.
Save it if it is predictable to do so! See an expert DDS!
Which option u selected , did u extracted the tooth or
Mine also the same case with 17 th decayed , and a wisdom tooth behind
Hi Dr Ramsey
I am a 32 y.o female who has had 4 premolars extracted for braces ( gaps closed). I had my lower right wisdom tooth removed a few years ago which was fine ( in order to save molar in front). Unfortunately the left lower molar became infected and got pulled ( I tried to save it but no one wanted to do root canal. Now I feel that my bite feels weak. The right molar was half way in the gum but the chewing surface was fully exposed and in good alignment with the upper. The upper wisdom tooth has already supraerupted but I don’t want to remove any more.
Should I get implants for the two lowers? Or what should I do?
Many thanks
Because you had 4 premolars extracted for braces I would suggest you replace those teeth.
Hi, I’m a 20 year old and need help making a decision. My tooth (#18) is very bad I have two options to either get a root canal or extract it. I would rather extract it this tooth has a bad cavity and has been causing problems for quite some time now. But my fear is that my teeth will shift, I still have my wisdom teeth they haven’t really grown in yet fully. I just really need help with an option I don’t want my teeth to shift. Do I need an implant?
Save it if you can.
The same thing happens with me but I couldn’t get a root canal so they had to extract it . What should I do now ? Is it possible for my wisdom tooth to be pushed forward and replace that tooth I’m too broke for implants 😢
not likely ;-(
November 13, 2022
Burbank Dental Implants
Dear Dr. Amin,
Thank you for providing this very informative community dental forum.
About ten days ago I lost #31 molar in my sleep. I woke up to find it in my mouth complete with roots and years-old crown intact. No blood and no pain.
This deserves some explanation. As long ago as 2002 this tooth was identified by my periodontist as endangered after root planing and scaling. Again, in 2014 and in 2016 my general dentist said that the outlook for #31 was poor and he recommended four quadrant osseous surgery. At the time (and now), I have no pain or swelling in my teeth or gums and no blood when I brush or floss. Some deep pockets were identified. I have three wisdom teeth with no pain or bleeding; #17 is missing, possibly years ago.
Two months ago, #31 became loose. A dental blog I read recommended daily salt water rinses to tighten periodontal pockets and possibly save an endangered tooth. After two and a half months of salt water rinses, the pockets may have tightened to the ironic degree that they forced #31 out!!?? I don’t use alcohol or tobacco.
I’m now 85, in good health but very reluctant to risk surgery and its possible consequences. I know that bone loss at #31 probably contributed to the loss of the tooth’s anchor and that bone loss may make me a poor candidate for an implant without grafting. I recently came across information that mini implants are not appropriate for molars. And it’s not clear to me whether a partial is a good solution.
I read your very interesting comments above about losing a second molar and would be grateful to have your opinion on my options.
Thank you,
Jacques Levy
I investigated salt water rinse. They can make your teeth dentin break down faster.
Only for keeping bacteria at bay after an extraction.
Salt water will not break down dentin faster.
https://drive.google.com/file/d/1_Qc0L8VPLKTuR2HezcvVvIeXFyMsMxjA/view?usp=drivesdk
Sir My 2nd molar extracted on 24 th October.
Already have a wisdom tooth , i can see some crown portion inside the tooth socket after 2nd molar extraction.
Dr. Told me both the socket and visible part of the 90° horizontal wisdom tooth will gradually covered by the gum
And no need to remove the wisdom tooth.
1.sir Is it possible that the gum tissue grow over the small visible portion of wisdom teeth and combain with the healing gum of the socket .?
2.Is this healing satisfactory Doctor.?
Photo attached in the links🙏😊
I did answer 😉
https://drive.google.com/file/d/1_Qc0L8VPLKTuR2HezcvVvIeXFyMsMxjA/view?usp=drivesdk
Sir My 2nd molar extracted on 24 th October.
Already have a wisdom tooth , i can see some crown portion inside the tooth socket after 2nd molar extraction.
Dr. Told me both the socket and visible part of the 90° horizontal wisdom tooth will gradually covered by the gum
And no need to remove the wisdom tooth.
1.sir Is it possible that the gum tissue grow over the small visible portion of wisdom teeth and combain with the healing gum of the socket .?
2.Is this healing satisfactory Doctor.?
Photo attached in the links🙏😊
This might work! Nice pics!
Sir My 2nd molar extracted on 24 th October.
Already have a wisdom tooth , i can see some crown portion inside the tooth socket after 2nd molar extraction.
Dr. Told me both the socket and visible part of the 90° horizontal wisdom tooth will gradually covered by the gum
And no need to remove the wisdom tooth.
1.sir Is it possible that the gum tissue grow over the small visible portion of wisdom teeth and combain with the healing gum of the socket .?
2.Is this healing satisfactory Doctor.?
Photo attached in the links🙏😊
Hi dr. , Iam 27 years old ( right side 2 wisdom tooth a already removed )
Iam suffering from a Fully bony impacted wisdom ( 90° horizontal) left side lower 7 th teeth
Also Abcesses due to this wisdom tooth resulted in swelling and pain .
After antibiotics treatment
my doctor suggested to remove the second molar teeth ( which already has a deep filling ) rather than going for the surgical extraction of wisdom 🦷.
But i doubt will this gap caused by. The removal of 2nd molar create any future issues?
My dr. Suggestion is to put a dummy theeth in the place of 2nd molar with the help of 6 th theeth with a cap. ( Candliver bridge)
So that the wisdom tooth area will be gradually covered under gum
If this is a good decision doctor? ,( there is a financial issue also for wisdom tooth + root canal + crown)
hmm…. consider coronectomy if your wisdom tooth is really high risk. That way you can still get an implant for the second molar.
Wisdom tooth is 90° horizontal in position , but no infection in its surroundings
Only issue is the gum and the gap between the 2md molar and wisdom creates a gap and food liquid get trapped under the 2nd molar roots
Without seeing you I can’t make the final call. See somebody with a great reputation.
Hi dr. , Iam 27 years old ( right side 2 wisdom tooth a already removed )
Iam suffering from a Fully bony impacted wisdom ( 90° horizontal) left side lower 7 th teeth
Also Abcesses due to this wisdom tooth resulted in swelling and pain .
After antibiotics treatment
my doctor suggested to remove the second molar teeth ( which already has a deep filling ) rather than going for the surgical extraction of wisdom 🦷.
But i doubt will this gap caused by. The removal of 2nd molar create any future issues?
My dr. Suggestion is to put a dummy theeth in the place of 2nd molar with the help of 6 th theeth with a cap. ( Candliver bridge)
So that the wisdom tooth area will be gradually covered under gum
If this is a good decision doctor? ,( there is a financial issue also for wisdom tooth + root canal + crown)
Thank you for taking the time to answer these questions! I need to make a decision. My #`18 molor has had a root canal many years ago and the root canal has failed. I have a infection in the bottom tip of the root and some bone erosion. . The endo says he can do a second root canal, but it will be tricky because there is a broken dental drill inside one of the roots. He says the second root canal has a 70% success rate. I am 67 I think if I spend 900 dollars on a root canal and another 500 on a crown the cost would be about the same for an implant. However if there is some bone erosion from the infection, will that bone grow back? Will it grow back after an extraction? I need to make a decision and am not sure about redoing this root canal or should it extracted and I get an implant. Do I really need an implant at all? Trying to keep my teeth.
I think I just replied to you on a different post?
I was advised to extract #31 ( right bottom second molar )(age early 40s ) .. Do I need to get a bone graft and an implant? I have been told that implants are difficult to take care of. I didn’t take good care of my teeth during my teens and both sides the bottom 2nd molars are root canal and crown with the warning that they would need to be eventually extracted. The upper molars are fine but have had a filling a few years ago… So I do need bone graft or implants( external things added to the body ) or leave it as is and extract the top molar if it starts coming down?
They are both good options. The condition of the opposing #2 would be the biggest deciding factor for me. If it is perfect then implant the lower
This is my exact situation. So you recommend getting implant for #31, is implanted tooth compatible with MRI machines? That’s my fear. What if you have to do MRI in future for diagnosis?
MRI is a non-issue with an implant
Hi! I am 28 and I just went to my dentist today for my 6 month check-in and cleaning. My dentist discovered a cavity in #2 and it’s between #2 and #3. He said the cavity is growing and it needs to be filled. He said the cavity is very close to the nerve of #2 and it would take 90 minutes or so to get it filled. My other option is to get #2 removed because it’s not hitting against the opposite tooth. According to my dentist, #2 is hard for me to clean and food will continue to get trapped. He said the cavity may come back again in the future if I get it filled and that in the long run it could complicate it with potential root canal and a crown. His suggestion is removing it, which I want to really not sure if I want to. But I want to explore other opinions and see what your thoughts are before I make my decision.
If it just needs a filling I would KEEP it!
Hi Doctor
Two weeks ago I got #18 removed. I am scared of the effects of having this tooth missing (supereruption). This is the only missing tooth I have. I am 27. I am scared of implant because it is so far back and close to the nerve and the bundle of veins/artery. I also have anxiety which makes me nervous even to think about having an implant done. Do I really need to have this tooth replaced? Please help 😢
It would be good to replace it. You can be sedated for the treatment. With the right dentist or team, this should be an EASY procedure for you. You got this!
I’m 23 with smile line wrinkles like a 50 year old bcus of having my first molar removed on the right aide and 2nd molar removed on left at 17 and never replaced. My mouth/jaw is beginning to feel tight, avoid tooth removal unless you’re going to die without it literally and if you have to, you must get a replacement tooth or your life will be ruined by it. 👍
thank you for this
Hello! I am 26 and just had #15 extracted. I had a crack in the tooth on the surface that was filled by my dentist and still had pain so was referred to a root canal specialist. He did a partial root canal and was unable to confirm or not confirm if there was a fracture in the tooth. He said there was a 50/50 chance. Couple days later after the partial, I had horrible pain so much so I made the decision to have it removed to get some relief. He said he would like for me to come back to discuss an implant in 4 months. Would you recommend that an implant is needed? https://www.canva.com/design/DAFMbg1SWwU/c2x6kmxxegR_WCNxdn892Q/view?utm_content=DAFMbg1SWwU&utm_campaign=designshare&utm_medium=link2&utm_source=sharebutton
Just saw this part!
I don’t think you really need the implant. Extract it and reassess in 6 months. You can always do it later!
My tooth 19 is a baby tooth with no permanent tooth underneath. I am 51 years old and the tooth has started to crack. My dentist said I would need an extraction. Is it necessary to get an implant when that tooth is extracted? Would it be OK to be left without replacing it
#19 is a critically important tooth. #19 and #30 are the most common dental implants on the planet!
Hello! I am 26 and I had to have #15 extracted and my oral surgeon is recommending an implant. After reading through this thread I am unsure if it is needed or not. I would greatly appreciate if your opinion! Link it so my X-rays. https://www.canva.com/design/DAFMbg1SWwU/c2x6kmxxegR_WCNxdn892Q/view?utm_content=DAFMbg1SWwU&utm_campaign=designshare&utm_medium=link2&utm_source=sharebutton
Hmm…why was it extracted?
I am a 59 year old male. I had my right 2nd upper molar (#2) extracted in 2017 and did not have an implant placed. That seemed to work well and fixed the pain issues. However I now periodically bite my tongue on the right side. Many years earlier I had #14 extracted due to a failed root canal and an implant placed.
I am now having pain which I believe is my left 2nd upper molar (#15). The tooth sensitivity seems to be primarily from #15 and #14 (an implant). Sometimes #13 even feels sensitive. My dentist can not see any issues on an xray and after some months of the pain coming and going he suggested I go to an endodontist to check #12, 13 14, and 15 and treat if needed. I am pretty much anti-root canal because I have had 5 done in my lifetime and 4 failed requiring extraction. That was in January. Since then the pain would subside and then return periodically. Now however I am getting pain everyday and this has been going on for a month. The pain is tooth pain but also in cheek bones, temples, and top of head. Recommendation? Should I get #15 extracted? If so, should I again skip replacing it with an implant?
I talked to my family doctor via a phone consult and was prescribed antibiotics for a possible sinus infection that might cause this situation (I have had multiple occurrences of upper molar pain in years past that was caused by sinus issues). I finished the antibiotic course yesterday and the pain remains. My doctor also mentioned that TMJ could cause issues but decided to go with antibiotics first. Many years ago I was diagnosed with a bit of grinding my teeth at night and was given a night guard but I could not sleep. Could I have TMJ? If so, what type of specialist should I see?
If it is confirmed that #15 is the problem then extracting it would be the best idea. It is possible that you are just grinding very heavily and cracking the teeth internally. Consider wearing a dentist fabricated night guard and/or Botox to regulate the strength of the jaw muscles. These are both things that a dentist can do for you to manage possible TMJ or just heavy grinding.
Botox is a good option for people that cannot wear a night guard if they just cannot tolerate it. It is placed into the masseter muscle which is the primary biting muscle in your cheeks.
It is difficult to get unbiased second options so I appreciate your article and taking the time to respond. I was just informed that I should have #14 and #15 extracted. Do you recommend an implant to replace #14? Or both? My four wisdom teeth have been gone for decades, if that makes a difference.
It really depends on your bite. Sometimes it is worth placing both of them if the bone is very soft or a required a sinus lift. This would distribute the load of a heavy biting area over to implants that are sometimes even connected. Dental implants are not permanent but if they are designed well you can get many years out of them. The upper back teeth tend to be the most difficult because the bone is hollow often necessitating a sinus lift.
https://burbankdentalimplants.com/dental-implants-are-not-permanent-redos-revisions-the-truth/
In some other cases, if enough healthy jawbone is present, it may be possible to place a dental implant the same day a tooth is taken out. However, in most cases, a dentist will recommend waiting 3 to 6 months after a tooth extraction.
Hi Doctor
Thank you for your very insightful article and all of your responses. I am in need of advice. I just had #30 extracted as apparently it couldn’t be saved. It was 3 days ago. I have no other fillings or removals apart from my top right wisdom. The gap can’t be noticed when I smoke but I’m concerned about eating normally and about the possibility of the opposing tooth having issues. I really don’t want more teeth extracted. Do i need to replace this tooth. Financially this will be hard but I can save for it. How important is this tooth? I have over some crowding, front bottom teeth overlap a little. Having this gap, would this give them more room? What would you advise? I am 47 and devastated with this extraction. Many thanks in advance for your advice.
Apologies for the typo. Smoke should be smile! I don’t smoke.
#30 is a critical tooth worth replacing 95% of the time
Thank you Dr Amin. How long do I have after extraction to replace this tooth?
I also suffer with Abfraction. I tend to over brush and clench. What would you recommend?
Thank you for your time. Amanda
Try to replace it within 6 months.
Maybe orthodontics to correct your bite, a night guard and/or Botox to relax the jaw muscular system.
Hi Dr,
I had to extract my 2nd lower molar (tooth 37). I still have a healthy 3rd molar (tooth 38) and all my other teeth. I am 35 years old. My dentist says that if I am not bothered by the gap, I don’t need an implant to replace it. What do you think, could it be like that. Does tooth 38 prevent supraeruption of tooth 27 and does tooth 27 prevent mesial drifting of tooth 38?
Thank you for your opinion!
I am much more likely to replace a lower second molar over an upper second molar for exactly the reasons you describe.
Thank you for the article. I had my bottom right 2nd molar extracted a couple years ago, 5 month after extraction the adjacent molar (1st molar) started hurting and giving me temple headaches daily, I am living on advil. I’ve seen the dentist, endodontist, ortho, and doctor – had a ct scan, xrays, test for nerve issue, night guard and am being told it might be TMD. I’m not convinced since this started after the 3rd molar was removed. When I do wear my nightguard 24/7 it does help but the appliance is large, uncomfortable, and I am not biting on all my teeth when it’s in. Could all this be from having the 3rd molar removed which is causing pressure on the 1st molar? I’m wondering if an implant would fix it. Thank you for any advice, I’m tired of this pain.
An implant will it fix this. I would suggest against this until your jaw is better.
It is rare for a wisdom tooth extraction to cause this without preexisting disease.
Don’t wear nightguard 24/7! That will cause BIG problems.
You should see a TMJ specialist before anything else is done
👍🏻😊good luck!🍀
Hi, I had upper molar #15 removed after internal resorption was discovered.
My dentist is recommending an implant.
I am in my 60’s; should I get the implant?
If I don’t will the bottom molar have to be removed? Will any other teeth move?
Thank you!
Not needed in most cases. The article discusses this a lot and depends on your bite.
It’s been years since I’ve had my wisdom teeth removed and now I just had my second molar on my right upper side removed. After two weeks it feels as if I tongue is all over the next tooth in succession. Even when I’m talking it fee like I’m almost bitting my tongue. I’m thinking that would be #30. If i’m seeing it correctly I had #31 removed and now #30 is the last tooth on my upper right side. Is this some type of ghosting affect because the tooth is gone. It really causing me some anxiety and mouth fatigue. I guess my question is should I get an implant there. Also would this tooth being extracted have changed my bite. I resisted my dentist and said my brain still hasn’t gotten conditioned to the extraction.
It is likely not needed but you really need to be seen for a proper diagnosis and treatment plan 😊
Hello doctor my left side jaw the third molar and second molar is without support from the lower molar (exactly the same picture of the upper vs lower implant). Should i remove them? it is causing pain at the moment. I have an x-ray if you would like to see it
Without a clinical exam and x-rays I cannot make that type of recommendation. Have a very skilled dentist look at you before making permanent decisions. If you would like to upload an x-ray you can uploaded to a public google drive that anybody with the link can view
https://drive.google.com/file/d/1rSCUbmgVxuLYu9Q3QAl8xcsE6xsAxvrQ/view?usp=sharing
Heres the link doc as you can see from the right side xray (which is my left jaw) lower wisdom tooth has been removed and the upper got no support. So do i need to make implants? i went to a clinic but they said it couldn’t be done due to theres no room..
No need and no room
the xray was in 2019 i just went to a dentist specialist, they advise me to remove the last molar for the upper left, so i agree with that, but do i need to remove the second last molar since its going down? i dont want to make a braces since its they say i need to remove 4 teeth
Yes remove it due to supraeruption.
Will I have a speech problem later on if I remove those last two molar at the top jaw.
unlikely
Hello Dr. Ramsey,
I am 26 years old I had my 2nd molar and 3rd molar on my left side removed last year. My 3rd molar on the right side is impacted. Can braces move help and save my 3rd molar and move my teeth to cover the space created by the removal of my 2nd and 3rd molar on the left side? Thank you in advance doctor.
Are you talking about your upper or your lower teeth? In order to use a third molar in the place of a second molar you have to be pretty young with partial root formation of third molar also known as the wisdom tooth
He’ll doctor, thank you for this great article.
I had my upper left last wisdom tooth removed today.
My dentist suggested that we might have to think of extracting the lower left last tooth also. (I think its the molar?) But it’s perfectly good and has no issues. He said something about needing to be careful when removing it because of a nerve that is running close by. Also he said all my teeth are formed now.
I cannot remember all the details now. But any idea why he said that? And also he said that its not something we have to do but can keep monitoring..
Yes that nerve is under or lower molars.
These articles may help you understand its relevance for lower extractions/implants
Hi,
I extracted my bottom right molar (second last) few years ago. Now the tooth right above it is coming down (erupts). Any advice ?
HI Dr. Amin.
I have been having terrible tooth/jaw pain on my lower right side for a few weeks. Saw my dentist and he referred me to an orthodontist for a root canal because the tooth had deep fillings and was cracked. Endo said tooth was not a good candidate for a root canal and needs to be extracted. The both made it seem like it needed done asap…like within days, but I cannot get an appointment for two weeks with an oral surgeon. (Not sure if this is something that a regular dentist can do or not. It may get complicated because of the crack. They did say that there was no active infection or abcess. I am on antibiotics. There is some swelling in my chin but it’s going down. I am still in intermittent pain and can only eat soft foods.) Would you reccomend waiting the two weeks for an oral surgeon or going to a regular dentist? Also, they wanted to know if I wanted an implant. It’s tooth #31. The wisdom teeth have been extracted on that side. I know from reading this blog and from what the endo told me that the upper molar can drop down and have to be pulled anyway since it can’t meet the bottom one. I had the same tooth (last bottom molar but on right side) removed about 15 years ago due to a failed root canal and have not had any issues at all. I do have the wisdom teeth on that side still, though they are only partially erupted. I am reluctant to get an implant for the cost, and for my fear that it will bother me since I have metal allergies. Would it be ok to leave it open and get the upper molar pulled later if it starts to drop down? I also read on this blog that tooth #31 is hard to implant because of the nerve endings being fragile. The endo said the nerves in the tooth were dead but the ligaments were still alive. Thank you for any advice with this
It is definitely worth waiting to see somebody that has skill, experience and a good reputation. The antibiotics are going to provide a Band-Aid for a while. And these decisions should not be rushed
It sounds like you need an implant for tooth number 30 and number 31. The nerve endings are not fragile but it just takes more skill. It’s a very common implant for me to do.
Once you lose one tooth than another it can be a domino effect. Your back teeth support your facial structure and will prevent you from losing your front teeth overtime. Find a dentist that you trust to make a good treatment plan and best to have it all done at once rather than in a piecemeal fashion.
I hope this helps. Please let me know that you got this reply. You have to subscribe to replies to be able to receive notification. 😇
Thank you
Thank you Dr. Ramsey
What a fantastic series of questions and careful responses! I had #31 extracted ten weeks ago. Recovery was much slower and more unpleasant than I expected. I returned three times for a persistent moderate (but noticable) bad taste in my (otherwise completely healthy mouth). Dismissed as “everything looks fine” so I feel that I’m left to resolve this on my own. The wound has not completely healed. There is still a small cavern enough to hold a grain of rice lengthwise. I had thought it would heal to smooth gum. Still undecided about implant after weeks of nausea and bad taste after extraction — hard to consider starting over. I have tried every hygienic approach I can think of. Any thoughts about the healing? Will it ever be smooth, or always a hole at this point?
It sounds like you had an underlying instruction causing the bad smell. The whole will have actually smooth L but it might take six months to a year. Most patients eventually get everything smooth again but it does take time as we get older.
Dr. Ramsey, first off I thank you for these articles, they gave me a lot of insight. I have had dental anxiety as long as i can remember and now being an adult I hesitate asking important questions in person.
I am having my OS #2 extracted surgically. It had a root canal and eventually was lost due to decay. It gives me no pain and I keep it clean.
I read that depending on the person I may not need anything to replace it after extraction but my question is down the road is there need for a bone graft?
Also do I have to worry about teeth shifting or any other complications after the extraction?
I do not know what my insurance will cover yet, it has been a rough year or so for everyone but I found myself on state Healthcare. I just want to get further insight, this surgery has given me a lot of stress about the future outcome of the state of my teeth. So much I just may opt to do nothing until I can cover everything out of pocket.
Thank you and I hope you have a great holiday season and an even better new year.
No to both questions 😉
I read that depending on the person I may not need anything to replace it after extraction but my question is down the road is there need for a bone graft?
Also do I have to worry about teeth shifting or any other complications after the extraction?
Hi Dr. Amin!
I am a 28 year old male with a damaged secondary molar (#31) that needs to be extracted. However I also have a slightly erupted, impacted premolar right next to it. I am trying not to remove anymore teeth if need be, but if I want to open the door for dental implants within the next 8 months I was wondering if I should also remove that premolar as well. Thank you doctor!
I would need to see you and your x-ray to answer that. I don’t want to lead you in the wrong direction.
No. 3 was extracted normally about three months ago. 2 and 4 remain and are in healthy condition. No other extractions except lower wisdoms in my 20’s. Upper wisdoms are below gums and have never given me trouble. I’m 72 and have had prediabetes for several years, but it hasn’t ever progressed to actual diabetes. Would you recommend replacement of 3 with an implant or a bridge? Is it inappropriate to simply leave the tooth missing? I have had no difficulty eating or chewing. Thank you.
#3 is a really important tooth. I would replace it with an implant. One day you will be 92! The bridge won’t last!
I am 62 years old and have been advised to have back molars 18 and 15 removed. They are loose and I have deep pockets. (Wisdom teeth removed in my 20s).
Would rather not deal with an implant or bridge, but I’m concerned about my other teeth shifting due to the open spaces. Thoughts/advice? Thanks.
That would be the perfect combination to do nothing. Just go ahead and extract molars #18 a #15. No need to replace anything!
Hi dr!
I just spent a really long time reading through all these and am hoping you can give me some kind of words of encouragement. I had a good decade (my twenties) of making poor decisions and seeing dentists that were slightly questionable. 3 years ago I set out to finally start fixing all the things wrong. Because of finances I ended up having to pull quite a bit .
I have my top molars (minus 1)
My bottom right had both molars pulled
Last week I had my second to last molar pulled on my left. I did get a bone graft done for that tho.
I’m struggling to eat and it’s making my anxiety go through the roof as I try to save money for an implant on the left side where that bone graft is. Any advice? Did I really screw up? Lol . I’m trying so hard to fix all the mistakes I’ve made with my dental health but it’s been a long 3 years and emotionally I’m really struggling. This tooth I pulled last week (which was beyond saving and was a failed root canal) was the breaking point for me.
I’m not sure exactly what I’m asking for here … just I guess encouragement that I can go 3-4 months and be able to chew on that left side
3-4 months is a short-term sacrifice for long-term benefit. Do it the right way, the first time. This will save you a lot of grief, money and time 😉
62 with a cracked #14. To be extracted. #15 in place. Deep roots. Would it be better to allow #15 to shift into the space for #14 rather than a bone graft opr expensive implant? Molars have been removed. Jaw intact with all teeth. Thanks
15 Will not move that far forward. You need to have the implant done
Thanks. How long can I leave the cracked 14 in until extraction?
If it has a root canal it is less likely to hurt. The sooner the better to avoid more silent now destruction.
Again…thank you.
Dr Ramsey,
This is so amazing. Thank you so much for the info.
I’m 48 female and both of my 2nd molars top and bottom have to be extracted due to infection and tooth decay.
Dr told me I don’t need to have implants but I wonder… (maybe because it’s expensive?)
Should I still ask for implants?
Thank you so much for sharing your knowledge 🙏🏼
Probably not needed 😀
I’m 17 years old, all my teeth are healthy except tooth 31(my 2nd molar) I had a cavity filled, and about 6 months later came back because of pain in the same spot, the cavity was just so deep that it hurts still, so I was given the option of a route canal, or a tooth removal, and I chose removal which I’m getting on the 6th. My dentist never mentioned a thing about an implant, does this mean I won’t need one
I would root canal it if it can be saved! I hope it is not gone already!
What a terrific post, informative and concise. Amazing, your willingness to share and respond to posts, thank you. I have a fractured upper 2nd molar right (2) that my dentist recommends pulling; the lower 2nd molar (31) is intact and has the 3rd molar (32) intact as well, the only wisdom tooth left in my mouth. I’m 65 in generally good health and was curious about your opinion regarding post extraction options for that tooth. My dentist said implants for that molar are quite challenging, Again my thanks Dr. Amin.
Thank you for your very kind words. I would probably just extracted tooth number two and leave everything alone on the bottom. See what you think in a few months and if you really miss the tooth you can have the implant put there. It’s not that big of a deal. I did two of them today in that very same area!
Hi Dr Amin,
I am in much distress and anxiety. I had a swollen gum 3 weaks ago over tooth 37. My wisdom tooth 38 was extracted when i was a teen (now i’m 39). Now the dentist has strongly recommended for me to extract tooth 37 as there is no bone supporting it even though the gum has got firmer(no more abcess). I can’t really chew with it as it feels slightly painful. I would have pulled it if i could do dental implant later but was told that the possibility is low due to my bone loss. Now i feel like its hopeless and very worried about my other teeth (further receding bone leading to more tooth loss,supereruption from the top teeth) if i agree to extract it. Is successful dental implant really impossible for me?
I thinks you should get a second opinion with a dentist with an exceptional reputation. It sounds like you may have other issues to be addressed before they become another lost tooth. That’s what I would do 😊
Dr Ramsey: I had my second maxillary molar removed four years ago. It has not been replaced with an implant. The extraction was traumatic and seems to have caused residual nerve damage as it is highly sensitive to heat. In light of this, is it a good idea to look into getting an implant or will that only exacerbate the nerve damage? I am also concerned that after several years post-extraction the alveolar bone is no longer strong enough to sustain an implant.
If you are sensitive to heat it is likely the tooth in front or behind it. Sometimes when you extracted tooth it exposes a bit of the root of the adjacent tooth. Sensitivity to heat is a classic sign of pulpal necrosis. This means the tooth is likely dying and needs a root canal. Sorry for the bad news but this is the most likely scenario. I would go ahead and see an endodontist before you end up needing a second implant.
https://drive.google.com/file/d/1JGUdXzlAgsddrHQQf4uhXroAHIPYFbwE/view?usp=drivesdk
Help i am a female, 29, in the United States. They want to remove #32 impacted and #31. I want to save #31 to avoid upper tooth from dropping down. I included a recent July 2021 pano photo. #31 has decay…is it really beyond repair? Or can it be saved?
Please resubmit your Google Drive so that it can be publicly clicked on.
I cannot see your x-ray.
Be sure to reply back with the link so I can click it when you upload
Hi and thank you for the amazing education and support. I am 57 years old and need to have tooth #3 extracted. I realise that you say that this is one of the most important teeth! However, given my age and the fact that I have always had a lopsided face due to hemifacial microsomia and extraction of tooth #11 as a teenager, is it vital to have an implant? Thank you
Sorry. Please delete. Double post.
Your age…lol! You are YOUNG!❤ Even with the condition you mentioned this is a critical tooth to replace.
😉
😊 Thank you!
I will get an implant asap.
Hello Dr Ramsey,
A year ago I had root canal done on the second molar lower jaw. A year later I returned to the dentist as the tooth was still hurting. I was sent to another dentist who recommended re-root canal saying that the artificial roots of the first root canal did not go deep enough. The did the re-root canal 2 months ago and still the pain is there.
I was told that it is not advisable to simply get the tooth extracted and leave the space empty. The dentists don’t seem to understand why I have pain and what to do.
Have you experienced anything similar with any of your patients?
Thanks for your guidance.
Some teeth have extra nerve canals that can not be removed. This leads to failure of the root canal. Sorry 😞
Thanks for your response. Do you recommend extraction of the tooth or not?
Yes. Extraction 😞
Thank you. And do I need to get an implant or can I just leave that space empty?
it would be a good choice
I got my tooth 18 extracted due to fracture and also bone graft done, is this enough and not go for implant?
Hi Dr Amin,
First, I would like to thank you for the informative article and willingness to devote your time to answer the various inquiries of others. For me in particular, I am 17, about to turn 18 in September, and have to get 31 extracted due to tooth decay and a sector (about a quarter) being “chipped” off. I am unsure whether I should have a dental implant.
You are too young still. Wait until you are 21 due to jaw growth.
I’m 35 and just had my bottom wisdom teeth removed in April. Since then my second molar on one side has become wiggly and a bit sore. I went back and was given no options. It doesn’t seem to be tightening back up and my experience with having them removed was horrible. Do you have any suggestions on saving the second molar? I was told that according to the X-ray it is a healthy tooth. I do not want to do an implant. I do have my top 2nd molar and a microdant upper wisdom tooth, but not an upper first molar.
It is possible that your bite is too high. Have them look for fremitus on your tooth. Google what that means. A simple adjustment if the bite is bad it will save this tooth. It can only be saved if the bone is perfect.
Hi Dr. Ramsey,
I just had #18(US)extracted due to decay. I had bone graft done. A week later I got black triangles in my front 3 teeth out of no where. Is there a correlation? How can those be fixed for cosmetic reasons? Thank you!!
hmm,,,, I am guessing you probably have some sort of gum disease? May be you had a deep cleaning done at the same time? I would research periodontal disease and speak to dentist about that. Black triangles do not show up for any other reason besides bone loss.
I did have a routine cleaning 2 weeks prior to the extraction and that’s when my tooth hurt really bad that it was determined to be infected. Not sure if the cleaning did something or the infection was ready there. My dentist simply told me to massage the gums and the gums did fill the holes a little better but it’s still there. I’m getting an implant on #18.
If there was infection dentist sometimes us an antibiotic from a brown bottle which can stain teeth. I only know this from personal experiences of having gum disease treated with this antibiotic.
https://www.uofmhealth.org/health-library/d01231a1
Dear Dr. Amin,
My daughter has a small mouth, and when she was young her dentist said to extract all of the 2nd molars and let the wisdom teeth replace them. I trusted my dentist and we had this done. My daughter is 18 now, and the wisdom teeth are not in yet. I am regretting having her healthy teeth taken out to be replaced by the smaller wisdom teeth. I want to know if there is still hope, and I would like you to comment on this for any other parents who are being told to extract all the 2nd molars at a young age for the wisdom teeth to come in. I recognize that having all the wisdom teeth come in will allow for a good bite because the teeth ‘match’, but now I am worried there might be many other problems that arise.
Thank you for your help
This is a case by case scenario so I cannot comment either way. What I can say is that most females do not really get their wisdom teeth coming in until between age 19 and 30. Some people erupt very quickly and some are very slow like my oldest daughter! The human body can be unpredictable at times. Best thing to do would be to take a panoramic x-ray and see where they are positioned. Sometimes they can be forced erupted into place. This is like giving them a nudge to “wake up!” 😁
Hello Dr. Ramsey, I appreciate the knowledge that you share with us. I have a dead second molar tooth on the upper side of my mouth. It will cost me around 6000 for an implant in the U.S. If I were to do an extraction and clean the infection. Since it is near my sinus, I will need bone graft also and it will be costly. Would I see any negative long term affects? I do have the money but if it’s not absolutely necessary. I would prefer to do just an extraction.
As I have stated in the article, the upper second molar sometimes it is not critical to replace. It depends on your bite
Is it normal for a small hole to be near the extracted site 5-6 days after ?& if so when would that hole close ?
this is normal. It will take about 30 days
Hello Dr. Ramsey,
I am in a bit of bind. Went to a new dentist after 1.5 yr (didn’t go for regular check ups during COVID).
1. The dentist found cavity on tooth no 2, said caused by wisdom tooth 1. She said she wouldn’t try to save 2 (cavity is deep) so extract tooth 1&2.
2. On upper left, I am feeling cold sensitivity. Tooth 15 had root canal several years ago. Dentist recommends extract tooth 15 & 16.
3. Also recommends remove 32 & 17 as they may cause future problems and are impacted. So essentially all 4 wisdom teeth and 2, 15.
From your article, I realized that extracting 2& 15 can cause issue with lower molar (with no support from too)
I am attaching my x-ray. Can you help give your opinion (please) if I should extract all as asked? any Implant will be needed or 2, 15 space can be empty? How soon should I get this done?
https://docs.google.com/document/d/10B9LSToZq_T0rWgXvCHFI4OJhVX_1Ygt_yqIbto3LHg/edit
Please advice.
Jyotsna
(Wish you were in IL)
Hello Dr. Amin,
Adding another question on my front tooth #8 – it’s a dead tooth (been like that for a long time) I got a root canal down on it 6.5 years ago. There is no movement or pain. But dentist recommended to get the implant done.
1. Do I need an implant? A crown is not advisable? Will implant last long enough
2. Also, this tooth 8 is crooked (slender) due to one next to it. Will I need to get braces to straighten the two teeth so implant can gone properly? Or can the dentist place implant in the same titled manner as how current tooth sits?
Will really appreciate your advice.
Thanks,
Jyotsna
I would need to see you in person rather than just x-rays to make such a decision.
Sorry
Of course I have not seen you but, this is a good plan! No implants needed! Thanks for posting your x-rays the right way! 😊😊😊😊
Thanks for your response doctor. The oral surgeon also mentioned that 32 & 17- bottom wisdom teeth in either side- are very close to the nerve and probably will consider leaving slight tooth in there to not expose the nerve. Will leaving some tooth in there this cause any future issue?
I had also asked question regarding my front #8 tooth above same x-ray). Let me know if I should repost the question.
Sorry, I know it’s long weekend and you probably will get to it.
Thanks for your help!
Jyotsna V
this article should help
https://burbankdentalimplants.com/wisdom-teeth-extractioncoronectomy-with-simultaneous-baby-tooth-dental-implant-replacement-case-example/
A coronectomy allows the head of the tooth to be removed and purposely leave the roots behind. It is a procedure that is accepted in modern oral surgery but is not that common.
Hi Dr. R., I’m in a little bit of a tough situation & would be delighted if you helped ease my mind and make a decision.
I had a really deep cavity on #31 and got it filled and placed with a temp. crown 3 weeks ago, I’ve been having pain ever since and cannot chew on that side. My dentist said the root canal would be tricky considering where the cavity was and referred me to an Endodontist as well as gave me Amoxi to kill off any infection, but I just found out today how much it would cost and it’s way more than I can pay 🙁 So I called my dentist back & asked that they would email me over a quote for just pulling it because im so over all of it. She said they recommend doing a bone graft so that in the future, we can put in an implant. So here’s the situation: My teeth are super close together in the front (21-28) and overlapping, I have a very small mouth and I feel that if I got #31 removed, hopefully they would all spread out nicely and I wouldnt need to get a replacement tooth back there.
Can you give me some advice on that? I’d really appreciate it, thank you!
Sorry I forgot to mention I’m 26 years of age.
I love your way of thinking. Unfortunately removing one tooth is not going to space out the others. It sounds like your money might be better spent on orthodontics rather than an implant. Teeth that are overlapping or very likely to have gum and bone problems as you get older. Do some braces not for cosmetic reasons but for health. I hope this helps you!
Dr my question is during pandemic I attained a gum infection once I could into my periodontist I had my gums scaled. Unfortunately my bottom right molar #32 became week my gum is not holding on to it I tried to save it but at this point I will be removing it my concern is will my mouth feel crocked due to empty hole I was told I cannot get a bride due to position and and implant might hit a nerve by jaw if not done properly please help. NJ Bergen county. Thank you Sir
32 is a wisdom tooth. You are better off removing it. Poor prognosis to save
I have my upper wisdom teeth extracted as recommended by my dentist to avoid impacting #2. A couple months later I started having start having pain in the area. Went back and was told the root is exposed and lots of bone loss causing an infection. The dentist recommended extracting, bone graft and implant. Went to a Periodontist he perform laser therapy to stimulate the bone and said a root canal is an option as well, however every other dentist says to go with the extraction and implant. The pain a 10 sometimes… Thoughts?
Hello I am 22 years old and 31 was chipped and then recently taken out. It’s been a couple days still in pain how long is the healing process and would you recommend a replacement for 31? Thanks.
My 12 year old daughter’s tooth #31 took over 6 months to fully erupt and when it finally did the part that was covered eventually chipped badly. I’m torn between having it pulled and hoping her wisdom tooth will erupt and replace it and having multiple procedures to save it because they want to do a partial root canal to give her tooth time to fully mature before doing a full root canal and crown. Is it foolish to assume her wisdom tooth will be able to take the place of #31?
The wisdom tooth “might” work. She is a good age for that! See an orthodontist asap!
Hello, 4 years ago #31 was extracted also the wisdom tooth #32 and now #2 is starting to drop in it’s socket. It’s not bothering me at the moment but I’m worried it will soon and effect my bite. Is it okay to extract? Will my teeth shift or cause problems? Do I need that tooth? My dentist also recommends dental implant but due to financial issues I’m not sure but willing to go that route if I have to. Just want to get another opinion. Thanks!
Removed tooth #2 and do not bother replacing 31. Just take care to make sure you do not lose molar #30 or molar #3!!
Good luck 😊
My wife got 2 ND tooth lower molar extracted 2 months back when is the ideal time to replace it? Which r best implants now I mean metal non metal? She is 30 years old
3 months is ideal.
Non metal implants for second molars is a bad idea. They break!
Zirconia Dental Implants Pros and Cons Video
Hi Doc,
I live in Jamaica and I lost number 2, 15, 18 and 31 by the time I was 16. I am now 20 yrs old and the other day I was looking at the shape of my teeth and it looked as if it was a bit twisted. Is it possible that my teeth restructured themselves to support my bite? Also I have notice bite marks on the sides of my tongue in the mornings because it is pressed against the spaces between my teeth when I sleep. Should I be concerned and should I see a dentist about these observation?
YES your teeth moved around a bit in order to accommodate the missing teeth.
The bite mark on the sides of your tongue is referred to as a scalloped tongue. This means that you are likely grinding her teeth because you are pressing your tongue up against her teeth. You could also have a slight version of sleep apnea. You should see a very smart dentist to discuss these things.
I found this on google because my 12-year old went for a root canal on tooth #31 and we were told we could do partial or have it pulled and he recommended having it pulled. Her appointment is for next Tuesday. He says she won’t need a replacement tooth. But after reading this, it sounds like she may. Will discuss with her dentist.
When I night down I have a small over bight… and when my second molar is pushed back what does that mean?
I don’t understand what you are saying 🤷♂️
Hey there,
I recently had my second molar on the upper left side extracted at the recommendation of my dentist. I think I made an awful decision. I suffer from extreme dental anxiety so at that moment I just agreed to what he said, but now I’m having issues with my speech and it has affected me mentally to the point that I feel like I’ll never talk or smile again. Are speech issues common after molar extraction? It’s been a week and one day since extraction. Thank you for any help you are able to provide.
I am really sorry about your situation. What you are experiencing is not common after removal of an upper second molar. This is the one tooth that I would say can be optional in many people depending on your bite. What your dentist told you is correct. I hope you feel better.
Maybe consider getting an implant for the areas that things feel more normal again. 😊💕
Hi Dr. Ramsey,
Maybe you can help me. I recently had my upper left 2nd molar extracted by recommendation of the dentist. He never recommended root canal or anything. Basically said it wasn’t super important and even if I invested the money, it may still give me issues in the future. Thinking it would be no big deal, I had it done. Now I’m worried!! It hasn’t been very long, but I feel like everything about my mouth has changed. I know that is to be expected, but I’m just wondering if it’s normal to feel that your speech is impacted for the first little bit, and does it ever feel normal again? At this rate, I can’t imagine not getting an implant! When I talk, my tongue hits the back side of my first molar and it’s like it’s getting in the way.
I had my last molar on the upper right side crack, now I am in severe pain. I was told I could do a root canal and crown or have it extracted. Due to finances I am leaning toward extraction. Will I have consequences later for having this pulled? I do not have an overbite or anything. Have had pretty normal teeth up until this incident. Thank you!
You will likely be just fine without it. That’s the best tooth to lose. It’s probably tooth number two or number 15 in the USA numbering system
I just had the last molar on the upper left side removed,I am 75 should I get an implant.
What tooth number was at Stephan?
Hello i need a root canal on tooth 30 but 15 but my insurance will not cover a root canal and i am in pain. tooth 15 i dont feel any pain but tooth 30 aches badly im thinking of extracting it will extracting tooth 30 damage any other tooth ?
It is 1 of the most important teeth in the entire mouth… Tooth #30
Thank you for responding.
Hi doctor!
31 32 are decayed. I have only spoken with an oral surgeon. He said to extract but a dentist could save with root canal, gum surgery and a crown. Do you think I should save them?
I do not know without a lot more information in looking at you and your x-ray carefully. I am sorry
Hi Sir, I had a pretty bad decay on my right bottom last molar ( wisdom already removed), did root canal and crown. Was only told by the dentist after crown was made that my tooth was too short and crown will highly likely dislodge again. I have clenching to add on. Six months in my crown dislodged while chewing.Please advice what will be a more cost effective solution in the long term.
It sounds like there was not enough tooth to hold a crown. You would be best off extracting and placing an implant. Have a consult done and make sure to have a 3-D scan. There is a nerve directly underneath this tooth so it is considered a more difficult implant
Hi i had my #2 tooth removed,now it feels like the rest of my has drop. I can feel them touching too much when i close my mouth. Is that normal? Also u have my other second molar for extraction. It broke while eating ice. My dentist told me the root is in my sinus. How bad is that? Im having problem chewing with my molar.
I’m not really understanding your question.
Most all of us have molars that touch the sinus. You might need a sinus lift in order to have an implant.
Getting conflicting info/recommendations between a dentist and an oral surgeon. My lower left 2nd molar cracked a piece off of it (I think due to a filling) and I’ve got a temporary crown on it. Furthermore, the dentist that did the emergency work says I need to have my wisdom tooth on bottom left removed before she can fit the permanent crown and I need to get botox and invisalign to fix my bite and stop severe teeth grinding/clenching. She sent me to an oral surgeon who highly recommended no wisdom tooth removal, get a permanent crown, don’t bother with invisalign and get a mouth guard for the teeth grinding. In his opinion a heavy grinder will grind no matter what, especially since I don’t have any of the typical indicators of heavy grinders (not overweight, don’t drink, don’t smoke, no pain, don’t keep my partner awake) – just teeth that are ground down :/ (stupid bruxism). I don’t like questioning my medical providers as I understand they are well trained experts, but I am a scientist myself and like to make evidence-based decisions. I can read the literature which supports the oral surgeons suggestions. I can’t find a good evidence base for botox and invisalign as a bruxism treatment. I’m thinking I need a third opinion now to figure out: 1) do i need the impacted wisdom tooth removed before the permanent crown 2) will invisalign be needed/will it help my bite and prevent future damage 3) do I need botox for the rest of my life for bruxism or can I get a mouthguard (from a dentist!) and simply replace that if/when it breaks?
https://drive.google.com/file/d/1uX0ZeE1V0L5892qyDgwzQ19imBS3Q5Xv/view?usp=sharing
I looked at your x-ray. That was in tooth does not need to be removed in order to fix the second molar. I would tend to agree with the surgeon on this one. Botox is useful for the very severe grinders and I use it myself but most patients will be just fine without invisible line and without Botox and just a mouth guard. Be sure that you are not a daytime clencher in addition to a nighttime grinder!
Hi Dr Ramsey,
I had a filling done on lower left last molar # 37 . Upon X-ray, it showed a hole and caries not been fully cleaned according to the dentist(she is a young dentist serving her government bond) I would be extracting the upper last molar #27 as it was dead (irreversible pulpits with symptomatic AP). Her recommendation was to not redo the fillings as 1. Another dentist may not do a better job. 2. I wont have the upper molar soon, and could extract this lower molar #37 if it is in pain later since the caries are still there with a hole.
Could you kindly advice if what the dentist said is good for me, or I should get re do the filling. (Dentist said it’s close to the nerve).
Thank you very much. I really hope to hear from you.
HI Jane – this block is intended for people looking for dental implant advice not general dentistry. Maybe I did not understand your question correctly?
Hi Dr Ramsey,
I just had a filling done on my lower left molar. The dentist took an x-ray and told me, she didn’t manage to clear up all the caries and didn’t managed to cover up the cavities. Is it advisable to redo the fillings by another dentist? The current dentist said the caries is close to the nerve, n someone else may not do a better job.
Yes –See a more skilled DDS!
Thank you very much Dr Ramsey! I just did it yesterday– an x-ray was taken and the hole was covered up now!
Hello Dr, I have a question. I was to told that I need a extraction on upper left 15 my last molar. Dentist told me he couldn’t save it because it’s to decayed and he won’t have ground for a crown. Do you think I should get a second option? With a root canal Dr? I am petrified of going to the dentist this took a lot out me.
It is probably pretty bad then. 😢 The last thing you want to do is spend the money for a crown only for it to fail soon.
My son is 18 and was diagnosed with macrodontia. He had wisdom teeth removed and now the recommendation from dentist, orthodontist and oral surgeon is to remove all 4 2nd molars. I was told his jaw is normal but teeth are large. He is a large person (over 6’8” and still growing). I’m a little nervous about the long term impact of extraction. Is it true his jaw is done growing even if he isn’t? Should I get another opinion? There isn’t a lot of information available on macrodontia. His molars seem to be what’s affected. His front teeth and smile are ideal. I don’t want to mess it up or cause problems later by acting too soon or not acting soon enough.
Can you post his panoramic x-ray as a public google drive on this thread?
Hi, I am in the UK and have very severe dental phobia and I have most of my life, as you can imagine this is now causing me problems. Problems that I have buried my head about for longer than I can remember.
I have lost all of my upper back right hand side teeth, this is not easily noticeable due to them being the back but I am worried what will happen next.
What are my options? Could they just replace 1 or 2 or would they insist on a bridge or dentures? And what happens if I don’t do anything what can I expect to happen?
I really am so annoyed at myself for not dealing with this sooner but even now I feel sick at the thought of even trying to book an appointment.
Any help would be appreciated. Thank you x
Thanks for reaching out. I have treated so many patients just like you. So fearful that it paralyzed them from having proper dental work done
In my office we routinely sedate patient daily using intravenous sedation. Basically you sleep through the whole thing. 💤
All of the teeth can be replaced or implanted on a single day with minimal to no pain.
This week alone I treated to patients for full mouth implants in a matter of hours.
Find someone you trust and that can sedate you with intravenous sedation not oral medication.
Thoughts??
Hello, I was told by my dentist last week that I need #15 (US) pulled it has a crown with decay around the margins and near root. I went to an see a endodontist for a second opinion because I’m trying to keep my teeth and he said he could save it with a root canal. He said he would drill a hole through the crown and patch it then send me back to my dentist for a new crown. I did ask the endodontist if they could see through the crown to see if I had decay. He did tell me x-ray cannot see through metal and he would not take crown off that my dentist has to do that. So my question is should I have root canal done first and hope everything is fine under crown? I don’t want to waste my money if the tooth has extensive decay under crown or should I ask dentist to take crown off first and look to see if I would even have enough tooth left for a crown.
You can take off the crown and make a temporary crown. That might give you and the dentist “closure” to really be certain the tooth is not savable. Make sure that it’s savable in a predictable manner and not just heroic Dentistry that’s going to fail
Greetings, firstly I appreciate this article; very informative. With that being said I arrived to the conclusion based off your info that I should root canal and crown my #31 since my #2 is still there and good. I’m currently (today makes 7days taking it) on clindamycin and ibu 800 and now codeine (2 left of 12) bc the pain was so severe before they can do my procedure. The pain is still there even with this addition. Do you recommend anything else to take or even natural remedies. I don’t know if I can make it another week and half before my procedure without just pulling it? Also, I had my #14 extracted do you recommend anything for that and my #18 is shifting sideways? Any help would be greatly appreciated. I have X-ray but don’t see an attachment section on comments.
https://photos.app.goo.gl/tjtMxZ28mfULeUA8A
Based on your x-ray:
Remove 1, 16 (wisdom teeth)
Root canal/crown 31
Implant 14
Leave 18 as is unless you can correct it with braces
😊
Thanks for replying and so swiftly. Ditto to all of that. Do you have any recommendations for the pain? I have 5 clindamycin’s left, 1 ibu 800 and no more Tylenol 3’s, and the pain is just as severe as before. It’s like. Shooting throbbing pain coming from 31
You can do the start of a root canal on the tooth to at least remove the nerve. That will take away all pain while you make final decisions. That’s generally a very quick procedure. It’s not a full root canal… Only an access to remove nerve
Hi doctor I had a root canal done on 15,31,18 and all 3 halve broken in half I feel like my dentist over drilled and left them too weak what do you recommend I had an X-ray done and the said I do not need bone graft work done but do I have to have implants can I just remove all three I have over crowding any ways ?
just remove them
Maybe #2 should go as well for balance
After removal is it possible to get braces so they migrate as I stated I have over crowding and extreme over bite
yes
Hi Dr. Ramsey,
I am scheduled to have #18 tooth extracted and both the dentist I’ve seen and the implant specialist I was referred to say I don’t need an implant because I wear a mouthguard which will prevent the upper tooth from drifting. I would love your expert opinion on this recommendation as I would prefer not to get an implant but want to make sure I make the best decision for my teeth and my jaw.
Thank you!
Michelle
The mouthguard you are mentioning must be on the lower. It must also be a very hard, inflexible type if it’s going to hold the space. You may still have drifting overtime regardless of a retainer or night guard
Hi Doctor Ramsey,
I’ll like your advice about implants. I had tooth 30 and 3 on the right side extracted 2 years ago. I am not a candidate to have an implant on tooth 3 because of my very low sinuses. Is it worthwhile just getting an implant for tooth 30 if it doesn’t have an opposing tooth for chewing.
Lift the sinus to place #3! Very common! Then place 30 as well!
Hello Doctor Ramsey I need your help, I have had a root canal done to my #30 molar tooth bottom right and crown put on. The xray immediately after said the infection was still there. The doctor prescribed antibiotics and wanted to wait. I had no pain and 5 years later the infection has made my jaw very painful and throwing. The devoleped cyst in my root cause facial swelling and pain. I went to see an endodontist and he said to either retreat the root canal or extract. What is your opinion? My appointment to retreat is not up for 20 days and I’m in pain and taking clyndamicin in the meantime. He is going to perform the retreatmemt with the crown and I’ve heard that it is not advisable.
Thank you for your answers doctor.
I’m 27 years old if that matters.
If the tooth can be saved with a great prognosis then it should be KEPT!!!
Hello! Thank you for this wonderful article! I had tooth #3 extracted as it had decay on a pre-existing root canal and caused me excruciating pain. I still have tooth #2 and #4. Is grafting absolutely necessary?
Hi Sam,
This tooth almost always needs some type of socket bone graft and or internal or lateral sinus lift bone graft.
thank you! Is this something that can be delayed? I had the tooth extracted about a month ago now. What happens if I do nothing?
If you do nothing your teeth will shift and you will lose more bone. Try to get this done in the next few months.
I think i should get love inked on my skin. Maybe that’s the only way i am destined to keep it.
I am trying some home remedies.
Can my wisdom tooth erupting cause locking of jaw , I realize I clench in my sleep and recently I’ve been getting this clicking everytime I open my mouth wide but I also took a tooth out a few years back but had no jaw issues so I’m assuming it’s my wisdom tooth
Not usually you probably have a bad bite. Braces often help. Some people have jaw joint issues that are more complex though. Clenching is VERY damaging.
Hi Dr, Ramsey I am having my lower left second molar extracted as my wisdom tooth is impacted and not growing straight. This has led my dentist to saying getting the second molar extracted as it is causing me discomfort they did mention a root canal but they were against the idea as it is very hard to do on that tooth and there is no guarantee that it won’t occur again in a couple of years just leading me to pay more and more. What would u recommend I do?
Also if the lower second molar was extracted would I have any difficulty eating given that all my other teeth are still fine?
Most people do not notice any media change with this particular tooth but I would suggest replacing the the lower left second molar with an implant. You also need to remove your wisdom tooth as well.
If the tooth has very sound structure a root canal and crown can last many years. But if it is questionable then the prognosis is likely poor. Without seeing you and your x-rays I cannot give you a definitive answer but the lower tooth is often better to replace
Hi Dr, thanks for the reply. I can email you my x ray if that’s okay with you?
You are welcome to post it onto a Google Drive that anyone can see on this post.
Dr Ramsey, thank you for this very helpful article and for answering all the questions. I really hope you can have the chance to answer mine.
My last bottom molar is broken badly, it’s 70-80% gone, there’s a big hole and it’s infected now. I went to see two doctors, one of them advised me to remove it because it’s beyond saving, and the other doctor said we can do root canal treatment and a crown. I’m not sure if the crown will have enough support or if it will cause me any pain or problems later on, but my upper molar has already drifted down and i’m scared it will drift even further if I remove the bottom molar.
What would you advise me to do?
Thank you very much!
The success of a crown will completely be determined on how much of your own good tooth remains. Sure you can build up and put posts into anything and it will work for a while but if it is really broken down the crown will not likely last. Of course without seeing you and an x-ray I cannot give you perfect advice. Every dentist has a very different skill set. Perhaps a second opinion? If not a single tooth dental implant would be an excellent replacement.
I am 21 and my dentist thinks that I will not have 3/4 of my back molars (both bottom and one top) within the next few years. Are these ones that I will need to replace? I also recently got my wisdom teeth removed
I am not sure I understand. Are you saying you will be missing 3 of the 8 molars?
Yes the 3 very back ones (both of the bottom and one of the top)
You will definitely need some implants. The molar 🦷 teeth are so important
Hi Dr Ramsey,
I have a filling in my #2 molar. I broke it while flossing and now I have a hole and some of the tooth and filling is missing. I do not want a root canal because I have heard even after the procedure the tooth still holds infection and bacteria so I am considering just pulling the tooth. Do you think I would need to get an implant for this? I would also prefer to not do that but also do not want to risk the teeth shifting (I have naturally perfectly straight teeth on top) or any bone/jaw damage due to the missing tooth.
A well done root canal will not harm you. Go to an endodontist specialist and save your tooth!
Should I have an implant after loosing the molar that the wisdom tooth was invading? I am 46 years old.
file:///var/mobile/Library/SMS/Attachments/1f/15/7D70868E-F6C0-4955-86DF-A1C32E2FF8D3/View%20recent%20photos.png
I believe you in California and I am willing to travel to see you. Are you able to do a phone consultation. I have seen probably 5 different dentist and my issue is easy to fix I think but complicated and needs a dentist that will take the time to help me. I have suffered in misery and the only dentist that can help I am not trusting as they want thousands of dollars
Would you please consider a phone consultation (I will pay of course). Just want to see if it’s something you can help me with
It would be best to call my staff. They can help set up a virtual consultation. 😁
818-846-3203
sorry I dont have my wisdom teeth anymore, I meant I had #30 extracted years ago, and #31 is crowned with possible crack under crown. I want an implant for #30 but have little to no bone left it looks like..also worried about possible extraction of #31 if it is a crack or break.
See other reply
Hello Dr. Amin,
I have extracted my wisdom tooth # 18 in the upper left jaw a couple of days ago . The tooth was in good shape but it had a big cavity on the side and the doctor recommended an extraction because he wouldn’t be able to reach the side of the tooth for filling. Now that I have the place of this tooth empty should I consider implanting ? And if yes . Should it be done now or later implantion is possible as well.
Thank you.
Noha
Is this the upper right wisdom tooth or lower left? #17 is the lower left wisdom that does not need to be replaced. Can you clarify? Wisdom teeth should not get replaced with implants
Hello Dr Amin,
It is the the upper left wisdom tooth.
Thank you
Noha
No need to replace a wisdom tooth! 😄
Hello doctor Amin,
Thanks doctor. Would this lead to bone recession or face asymmetry as I have read in some pages? If yes . What are the post procedures to be taken to avoid this.
Noha
Not for just this one tooth
Hi Dr, please give your advice!!
I’m a 23 y/o female in Canada who has had a life of dental problems. 5 years ago i had molar #31 removed, ever since then no implant has been discussed, so I recently realized the bone has shrunk dramatically where the tooth has been removed. Last year, #32 had a crack in the filling so I got that fixed and then later crowned…The crown has only been on this tooth for 3 months and it hurts to chew on it in the last few weeks, it feels like the same pain that I had last year when I originally got the tooth filling fixed. I am at a loss for words with my dental problems. It is hard enough to chew with a missing middle molar but now the stand alone tooth (#32) is giving me pain after a pricey crown procedure. I really do not know what to do, the dentist said they would adjust my bite but I know deep down that it is a larger problem since I can feel a pain that goes below the crown (tooth has had root canal so it has no nerves). Also- I really want an implant where #32 was extracted but worried about the lack of bone now as it has shrunk extremely. What do you think for all of this?
Hi Melissa! I saw your other correction comment as well. If #31 with a crown is hurting and the tooth has substantial structure left then it would be best to have a root canal done to save it if it has a good prognosis. If not you may want to consider having an implant for #30 and #31. The bone can easily be corrected by a skilled provider. Keep in mind you might need a gum graft in addition to a bone graft to make the implants last as long as possible.
Although dental implants are the best way to replace missing teeth implants are not permanent. At your young age of 23 you will likely need to do some sort of implant repair 20 years from now. That being said be sure you see a very skilled implant dentist that has a great reputation for long-term results.
Hi Dr. Amin! Thanks for fielding questions!
I’m a 37 year-old male, with an extracted #15 tooth due to failed root canal. All wisdom teeth have already been extracted. Should I get an implant for #15? I wear a plastic retainer once a week to keep my teeth aligned. My dentist warned me of TMJ and potential cracked teeth without the implant. See panoramic:
https://drive.google.com/file/d/14B6bjynvxCvNgNhez2vDvcj4xg1yAYcf/view?usp=sharing
Cheers!
Great image! I would call it totally elective. It depends on your bite. If your bite is “class 1” then likely no need. If you are “class 2” overbite then would be a great idea!
Hello my name is Mya, I am 19 years old and I was told that I needed to have #15 molar removed because it’s has mostly chipped away. Will I need to get a replacement?
Not always-read the article closely and it will discuss this particular tooth.
Hello Dr. Amin,
I got molar #3 and tooth #4 extracted in summer 2019 – one and a half years ago. A bone graft was performed back then. I’m planing to have implants put in at one point. Out of financial reasons I’m not ready yet. How much longer can I wait before I risk the possibility of getting future implants.
Thanks a lot,
Vivia
Vivia – It depends on the so many factors such as genetics and the type of bone and method that was used. Does the bone still look ‘full’ or is there a dent? If there is a dent then the bone is likely shrinking rapidly. Try to get it done sooner. 1.5 years is already a long time!
Watch the bone grafting video on this link. I think it will help
I have very very bad cavities in tooth #2 and #18. The dentist recommends extraction. I have all my other teeth. Will this impact my chewing or my smile? They told me it’s unlikely my teeth will shift backwards, is that accurate? All of my wisdom teeth are already out. Do i eventually need implants or should i be okay?
#18 is more important than #2 in most mouths
😉
Thank you for writing this article.
I’m 52yo. I had teeth 30 and 31 extracted many years ago. Now teeth 2 and 3 need work. Tooth 2 needs to be extracted but tooth 3 needs a root canal and crown.
Since I have no opposing teeth on the bottom, can I just have both 2 and 3 extracted or should I have #3 fixed?
Thank you.
Fix #3 and Implant #30. That way you have one molar that opposes the other! BEST PLAN!
Stay safe and get the vaccine 😉
Hello!
I have extracted my #17 tooth.And now my #18 tooth have partially deacyed which was previously done simple tooth filling.Is it a good option to go for nerve filling or no harm in extracting it?
Thank you!😊
I had dental implants on upper #4 and #5 3 years ago with excruciating pain caused in #3 while healing, especially with the abutment causing pain in #3 and #2 have both had several root canals each. At this point the pain in #2 and #3 are unbearable so I’m scheduled for implant on #3 bc I can’t stand the pain. He wants me to go to the endo Dr. again, but with each root canal I get no relief. So I’m opposed to the idea, I’m 62 years old. Have never been out of pain since the implants, just varying degrees of pain. I have an overbite, he has recently drilled down the #3 crown just to see if it made a difference and it took away a lot of pain but shifted it to #2, the last upper tooth. He used a sensor last week showing the bite pressure and it’s helped. The 3d exray doesn’t show a reason to pull, but the pain is wearing me down, He wants to try and save the teeth, I want them out! Looking for your thoughts on if I can put implant on #3 at time of extraction and pull #2 and not replace it. I have all bottom teeth with a crown on last bottom molar opposite #2.
YES –Looking for your thoughts on if I can put implant on #3 at time of extraction and pull #2 and not replace it. I have all bottom teeth with a crown on last bottom molar opposite #2.
How is it now?
Hello,
My #3 is over erupted because I don’t have the mate #30. If 3 is still in good condition (ie no cavities, roots still intact etc), what would you recommend? Should I just take out 3 altogether or should I try to have it surgical (if possible) pushed back in/shaved and get an #30 implant? How much more expensive do you think the latter would be compared to the former?
Also my wisdom teeth are out on the top and bottom so my right jaw starts with #3 and #29.
Intrude it with ortho
https://www.semanticscholar.org/paper/The-use-of-temporary-anchorage-devices-for-molar-Kravitz-Kusnoto/4789ce4133fef79d9207d5a9a9124e3e96e200fc
Hi there, I have just recently lost #3 & #2 teeth,
Over the last 10 years I have lost #18,# 31,#14,
I’m committed to taking better care of my teeth. Looking at implants what would you suggest please? Do I need any implants on my bottom jaw? As I was looking at doing my upper.
Kind regards
Hannah
Only replace 3 and 14
Hi there, my #3 needs to be extracted and my #2 needs a crown. All my wisdom teeth have been extracted.
Should I get an implant for #3 or would it be fine just to extract?
implant for #3 is a really important replacement. #3 is a part of what supports the base of your cheekbone (the zygoma)
Is an implant for #3 critical at 75 yrs?
I had it pulled 3 months ago? 12/11/24. #1 and #2 are gone. Have all bottom teeth including molars. #30 had a root canal about 6 yrs ago. Until that time, I had perfect teeth, according to my dentist. Only had 3 cavities in my lifetime.Also missing #14 . All extracted teeth were ones that had cavity fillings 40 years ago.
Hi Maureen-you are about my mom’s age and I would definitely replace her #3. If it was just #1 or #2 you could leave those alone but #3 is the maxillary first molar which is critical for maintaining your bone structure and bite. Without this tooth the eventual collapse occurs leading to the loss or damage of other teeth. Keep in mind that #3 oftentimes needs a small sinus lift done at the same time of implant placement.
Hi Dr. Amin,
Great article and informative comments.
I’m 33 years old. 19 was extracted in my teens and I’ve recently had 18 removed.
I’m worried how this will affect my bite and facial structure. Would you recommend I receive an implant. My dentist advised me against a bridge because it could damage healthy teeth’s nerves. I’m 33 and the idea of a denture is horrifying. I really care for my teeth as an adult but my teenage years are catching up with me.
Since the extraction, I’ve suffered from terrible sinus pressure. I’m not sure if this is related.
Also, my dentist informed me that there is residual root from 19’s extraction within my gum but it might cause me no harm.
I appreciate any advice. Thanks.
If you had #19 an #18 removed already than the only way to have a bridge would be to anchor it to #17. #17 is a wisdom tooth and I would rarely ever advised the bridge anchored to a wisdom tooth.
I am assuming you are speaking in the American tooth numbering system rather than the International tooth numbering system
If #18 a #19 are removed and nothing is done over time it will certainly affect your bite and facial structure. Dental implants would be the best option.
Since these are lower teeth they will not affect the sinus
Hi,
I’m 32, I have really bad teeth, I have root canals on 37, 36 root & crown, 47, 26, 11. Waiting extraction of 17 which is root canal that had a crown which failed and it’s not possible to put another crown. Currently in a lot of pain for 28, seems that filling has a crack which reaches the nerve, teeth is very wormed out and dentist says a root canal would fail, advices to put local antibiotics and amalgam filling multiple times or alternatively extraction. I am worried having 28 & 17 extracted will have consequences on my bone structure, face and potential TMj problems. So much pain they also refer me for trigeminal neuralgia
As long as you have first molars #16, 26, 36 and 46 all will be good. (International Numbers)
These can be implants OR teeth!
I’m 15 at the moment and both my top and have to be removed as they have collided during growth they are saying that my wisdom teeth could come and replace the molar I need advice on what’s going on
It is possible that the wisdom teeth could grow in their place. Usually this happens if you are younger than 15.
You are too young for dental implants
Hi
I am getting my top left 3rd molar extracted, my upper teeth are a little crowded. I’m 41 years old. Should I get an implant done? My 1st molar will also be extracted as it is crooked and has a big cavity. I have a root canal and capping on molar #2.
I wanted to know if I’ll be fine without an implant. I feel the area around #3 that is to be extracted is already crowded enough.
Need your expert opinion.
Thanks
Only replace the 1st molar that is #14.
Do not replace #16
Hi! I have 2 very bad root canals in tooth 2 & 18. They recommend I extract, which I’m okay with due to root canal and extraction cost difference. I have all my other teeth. Is this a good idea to do? Will my teeth shift or will I still be able to eat okay?
Your left side will likely shift but the right should be ok. It varies in each person though.
Hi
I’m 21 , I lost my first molar around 2 to 3 years ago. At first I was worried that people would notice my missing tooth and my dentist told me that I can get an implant however do I need the implant ? My wisdom teeth is erupting but I’m worried about the space
The first molar is a REALLY important tooth to replace. The sooner the better! The wisdom tooth will not close the space properly causing shifting of your teeth.
Good morning dr.,
I went to the dentist to have tooth 18 and 19 extracted as they cannot be saved. I thought he would extract them right there and then because they’re infected instead he asked me to come back tomorrow and keeps pressuring me in getting a bone graft. Do you think this is necessary?
Socket bone grafting can preserve your jawbone from shrinking. Read this article.
I think I can say for all of us, we really appreciate you answering all our questions.
Which brings me to mine. My nightmare started in August 2020 when I went in to get a cracked tooth fixed. #30, had the temp put in and then a filing done #29. 2 weeks later I went in to get the permanent put in and mentioned to my Dentist #29 was sensitive to floss in between #30. Crown went in and my bite has been off every since. Actually went in 5 times for bite adjustments and second opinions and nothing has helped.
3 weeks ago I was in excruciating pain with #29 and had a root canal done. Last week my Dentist agreed to redo the crown and thank goodness I got it taken out and was feeling better until 2 days ago when I started to experience swelling on my gums. I just contacted my dentist this morning so he could call in a prescription for me. I might mention also that my bite is still off and feels like I’m hitting #31. Could this be the cause of the gum swelling? Looks like it’s concentrated around 30,31.
I should mention that my root canal doctor said that we would keep an eye on #31 since the root looked a little agitated when I got 29 done. I was hoping to hold out until next year but I don’t think I’m going to make it. 🙁
I’m afraid I will probably have to get another root canal done. I guess my question is will I be ok with having the tooth #31 extracted? If I choose that? I probably won’t do it but wanted to ask. I’m 52, never had this much problem with any of my teeth before and it really has been a stressful time during all of this not to mention the anxiety.
It’s been awful! I hope this ends soon.
Yes –ok to extract 31! Have they found the real problem now? Maybe you have pockets and periodontal disease?
Hi, my husband was referred to have an extraction and implant of tooth #18 which is very expensive. He had a crown which didn’t work and now tooth #18 is broken so he is hesitant on this referral. He is thinking about just leaving extracted since but i am worried for his bite and teeth shifting. Would he be ok if he just extracted? tx
If he has the upper molar #15 then it is a good option. See an expert for sure. 2nd molars are considered difficult to do.
I’m missing tooth number directly under number 3. I went for a root canal on number 3 but it was unable to be done because he could reach the end of the root. He told me to pull it and have an implant. Can I just get an implant on number 3 with the bottom tooth umber it missing or do I have to get two implants?
I’m missing tooth number directly under number 3. I went for a root canal on number 3 but it was unable to be done because he could reach the end of the root. He told me to pull it and have an implant. Can I just get an implant on number 3 with the bottom tooth umber it missing or do I have to get two implants?
I am 45 years old. I’ve never had straight teeth, or healthy teeth. Several root canals and crowns as an adult.
I had a root canal in #18 two decades ago, and now I have a cavity. Dentist wants to remove the old crown, handle the cavity, and replace the crown. Because of the age of the crown, he can’t predict the extent of the cavity.
I think I want to have it extracted instead. Opinions?
If your tooth is predictably savable and it is best to keep it. Ask your dentist what would he or she due in their own mouth in your particular situation. That might help clarify the best option.
I am 45 years old. I’ve never had straight teeth, or healthy teeth. Several root canals and crowns as an adult.
I had a root canal in #18 two decades ago, and now I have a cavity. Dentist wants to remove the old crown, handle the cavity, and replace the crown. Because of the age of the crown, he can’t predict the extent of the cavity.
I think I want to have it extracted instead. Opinions?
If your tooth is predictably savable and it is best to keep it. Ask your dentist what would he or she due in their own mouth in your particular situation. That might help clarify the best option.
Hello Docter,
Thanks a million for your expert advice.
My wisdom teeth are in the sleeping position. It’s affected the tooth #31 next to it. Should I get both of them extracted or is there any chance to save #31 with a crown? Should I opt for root canal or implant if #31 will affect my chewing?
Thanks in advance
can you post an x-ray to your google drive and show me?
Hello Docter,
Thanks a million for your expert advice.
My wisdom teeth are in the sleeping position. It’s affected the tooth #31 next to it. Should I get both of them extracted or is there any chance to save #31 with a crown? Should I opt for root canal or implant if #31 will affect my chewing?
Thanks in advance
can you post an x-ray to your google drive and show me?
Hi Doctor. So #31 is decayed and being removed next Monday with a bone graft, and I still have #18. An implant is way out of my price range. So it’s either a partial or nothing. Which option would be best?
If you are not going to have an implant, not sure doing a graft is really needed. I would pass on it. Most of the time I place the implant AT THE SAME time as the extraction.
Hi Doctor. So #31 is decayed and being removed next Monday with a bone graft, and I still have #18. An implant is way out of my price range. So it’s either a partial or nothing. Which option would be best?
If you are not going to have an implant, not sure doing a graft is really needed. I would pass on it. Most of the time I place the implant AT THE SAME time as the extraction.
Hello!
Had TMJ surgery for symmetry back in 1995. I’m 41 now and molar #2 with an old filling has begun to ache. Was sent to endo who recommended root canal. I got second opinion from biological dentist and she said root canal there may have high chance to fail because of condition of tooth. Recommended extraction. I do not want a change in symmetry. My bite is not perfect. I guess my question is do I root canal or extract and does my precious surgery make any impact on outcomes. Stressed a bit over the decision. Also, is extraction/implanting painful? I have developed a great bit of anxiety with all the work I’ve had.
Hello!
Had TMJ surgery for symmetry back in 1995. I’m 41 now and molar #2 with an old filling has begun to ache. Was sent to endo who recommended root canal. I got second opinion from biological dentist and she said root canal there may have high chance to fail because of condition of tooth. Recommended extraction. I do not want a change in symmetry. My bite is not perfect. I guess my question is do I root canal or extract and does my precious surgery make any impact on outcomes. Stressed a bit over the decision. Also, is extraction/implanting painful? I have developed a great bit of anxiety with all the work I’ve had.
Hi Doctor,
I had a question I am getting my tooth#31 removed Oct 20 because it got infected badly. So It can’t be saved. I wanted to ask first for a tooth#31 removal is it painful?
Second Question: Will I need a implant ? Will I need it right away after my tooth removal? What happens if I don’t do a implant? Is it dangerous?
Thank you
Hi Doctor,
I had a question I am getting my tooth#31 removed Oct 20 because it got infected badly. So It can’t be saved. I wanted to ask first for a tooth#31 removal is it painful?
Second Question: Will I need a implant ? Will I need it right away after my tooth removal? What happens if I don’t do a implant? Is it dangerous?
Thank you
Hi Doc, I had to get my 31 extracted due to infection, surprisingly though the dentist never prescribed any antibiotic treatment ever. Following extraction i was advised to have an implant with bone graft and membrane etc etc. Following placement of implant i could never bite without pain and could never use that side for chewing & eating food (managed with one side). Now suddenly after 1 yr of literal no usage the implanted teeth is wiggly and in lots of pain. Since i could not chew any more had no option but to extract the implant out. I dont want to go through the unnecessary cost, time and pain of having to implant again, do i really need to put a bone graft? I am happy to leave without this second molar.
Antibiotics are not always necessary.
It sounds like your bite was never ideal and perfect on the implant. If the bite is too heavy especially on a last molar, the implant will fail miserably. You were not the first 1 I have consulted about this. If you are not going to have another implant that you do not need a bone graft. You can leave the second molar as an empty space but keep in mind that once 31 is gone the upper molar #2 is going to start moving downwards. Maybe the space was too small to begin with for implant.
Dental implants are a very specialized procedure and I find way too many dentist without a lot of experience placing in restoring implants. If you do decide to do another one, due to your due diligence and find a very experienced implant specialist.
Sorry that dentistry has that you down ;-( Most people that have an implant will have it for a very long time with a very high success rate
Thanks Doc for your valuable and objective guidance. 😃 I sure will do some diligence once I decide to go for second round.
Hi Doc, I had to get my 31 extracted due to infection, surprisingly though the dentist never prescribed any antibiotic treatment ever. Following extraction i was advised to have an implant with bone graft and membrane etc etc. Following placement of implant i could never bite without pain and could never use that side for chewing & eating food (managed with one side). Now suddenly after 1 yr of literal no usage the implanted teeth is wiggly and in lots of pain. Since i could not chew any more had no option but to extract the implant out. I dont want to go through the unnecessary cost, time and pain of having to implant again, do i really need to put a bone graft? I am happy to leave without this second molar.
Antibiotics are not always necessary.
It sounds like your bite was never ideal and perfect on the implant. If the bite is too heavy especially on a last molar, the implant will fail miserably. You were not the first 1 I have consulted about this. If you are not going to have another implant that you do not need a bone graft. You can leave the second molar as an empty space but keep in mind that once 31 is gone the upper molar #2 is going to start moving downwards. Maybe the space was too small to begin with for implant.
Dental implants are a very specialized procedure and I find way too many dentist without a lot of experience placing in restoring implants. If you do decide to do another one, due to your due diligence and find a very experienced implant specialist.
Sorry that dentistry has that you down ;-( Most people that have an implant will have it for a very long time with a very high success rate
Thanks Doc for your valuable and objective guidance. 😃 I sure will do some diligence once I decide to go for second round.
Hi Dr,
First I want to say thank you for this article and for after all this time still replying to the comments.
I’m 33 years old and I hadn’t been to the dentist in several years due to phobia, depression & alcoholism. I finally got the nerve & went to the dentist to try to get my life back on track. Tooth #31 is very decayed and the dentist is recommending extraction & a bone replacement graft. I asked him if I needed an implant, he said we could talk about it in the future but he thought it was best to remove the tooth/ infection & let it heal first before doing the implant. Is there any issue with this ?
#30 also has an infection and the dentist said we may be able to save it with a root canal & crown lengthing. Are crown lengthing a long term solution or am I just buying time?
No issue with not having any immediate implant for a molar. It is more important for front tooth to have immediate replacement although it does save some money and time to have the molar replaced at the same time it is extracted. Probably 80% of the molars I treat are immediate placement
#30 may be eventually an implant but without seeing you and your x-ray would be hard to tell. This is also very technique based. Many teeth do quite well as long as you do your part at home. It sounds like you got a handle on alcoholism which really causes a lot of dental disease as well.
Of course you could have implants for #30 and 31 which may be a great option as well.
Still have 1 wisdom tooth – 32 – but need to have 31 taken out due to a very deep large cavity – will this cause a problem…. without having an implant. I do have crowding in the front lower – would love if this gave me extra room
It will not really give you extra room in the upper molar #2 is likely going to over erupted. I am assuming that you are 30 years of age or under.
Hi Dr.
I am someone who still has one wisdom tooth #32 , but needs to have 31 removed.
I am 82 years old , and had heart surgery 7 years ago. Is it reasonable to consider not having an implant?
Thank you
At your young age I think you will be ok!
😉
In the past few months, my upper molars (US 2 and 15) have both been broken and there is not much of the tooth remaining. It occasionally hurts after eating and/or brushing my teeth but it’s never been really painful. All of my other teeth are perfectly in tact. If I end up getting the upper molars extracted, is an implant necessary? I’m 37 years old.
From a gender standpoint some females show all the way back to #2 and 15 when they smile. Dental implants are elective so you do not have to do anything.
Please keep in mind that although dental implants are the very best tooth replacement they are not permanent. Nothing is really permanent including fillings, crowns, bridges etc. They do last a long time though especially when done right the first time!
Hello Dr.
I am 53, and just had #15 extracted due to deep crack in tooth, and underneath infection. (Upper left last molar)
My wisdom tooth next to it was already extracted last year due to cavity.
Now I need to decide soon if I need an implant to replace #15 or not.
Can you please tell what is the life of an implant?
(Would I need to do another replacement down the road)
Please keep in mind that although dental implants are the very best tooth replacement they are not permanent. Nothing is really permanent including fillings, crowns, bridges etc. They do last a long time though especially when done right the first time!
Ramsey A. Amin, D.D.S.
Diplomate of the American Board of Oral Implantology /Implant Dentistry
Fellow-American Academy of Implant Dentistry
Burbank, California
My #2 has root canal fracture and I’m getting it pulled out in a few days, at recommendation of endodontist. What are my options after that (should I get implant)?
Hi.
I need to have #14 extracted. I’m missing #19 and #31 and #15 has a crown. If I have #14 extracted will I need to get an implant or will it be fine without one. My extractions are over 10 years old.
You should! The most important molar numbers are #3, #14, #19 and #30! Even though you will be fine in the short-term, as you age your jaw will collapse and change. Nature gives us many molars for reason!
😉
Stay safe during COVID 19
Hello,
My #32 (US) cracked and from the message above I understand I should get an implant otherwise the upper molar might shift. How long can I wait before extracting the tooth? I’m currently not eating with my R side.
32 is a wisdom tooth that DOES NOT NEED to be replaced
Hello,
I have had teeth 18 and 30 extracted due to damage. I am 22 years old. Tooth 18 has been gone now for quite a few years and hasn’t bothered me at all, but I am noticing the teeth behind it are slowly shifting forward ( I have both my bottom wisdom teeth). I just recently had tooth 30 removed a few days ago. I was wondering, in your opinion, what the best replacement option would be? I am wondering if there are less invasive options than an implant, maybe a partial denture or flipper tooth? I just really do not want to go through an extensive surgery. Thanks for the help!
Your procedure is not likely an “extensive surgery.” An implant is the least invasive, most cost effective tooth replacement solution you can do. Everything else is much more aggressive like a bridge where your teeth are ground down. The sooner the better especially at your young age your teeth will shift very quickly!
would a flipper tooth be an option in my case?
Very uncomfortable to wear for a very last molar!
Hello,
I have been referred to have 18,31,29, 14 & 12 removed. I wanted to know which ones I can get away with not having an implant done on. Thank you!
In your situation I would do implants for all of them. If I ‘had’ to chose then 29, 14 & 12 would be my first choice 😉
Stay safe, take the vaccine!
Hello, I recently had #14 extracted. It was a root canal that went bad and got infected after several years. I’m 40 years old and that’s the only tooth I’m missing. I just had a nice mouth guard made and will wear that every night. Can I live without #14? I’d rather not have an implant placed. I don’t miss the tooth at all. Thanks!
#14 is a really important tooth! It supports the base of the zygomatic bone which is your cheekbone. It also engages your sinus.
Hi Dr. Ramsey,
I appreciated your article! I’m curious what you would say to my situation. I currently have an infection in a root tio of molar #3 (upper right, back). This is the same molar where I had a root canal and crown placed about 7 years ago. My Dentist says the endodontist did not fill all of the three roots, and in the curvy end of one of them infection is showing on the x ray (and I feel it!). He recommends apioectomy and root canal re-treatment. I’ve read apioectomies can take out too much bone such as to make future implants not viable. At 36 years of age and hoping for many years of a healthy bite, what should I do?
Apicos on upper molars are not that successful. Hmm. Can you post an X-ray to a public google images?
Hello! I am 44 and I had #15 recently extracted and decided not to do bone grafting/socket restoration for an implant. I’m having a hard time adjusting to the missing tooth – feels like the adjacent tooth (#14) is poking in my cheek or tongue at times and I catch myself “sucking on it” a lot? Sorry, sounds gross – is this just something my mouth will get used to or is there anything outside of an implant I can get to replace the tooth? I understand that a flipper is not an option for that tooth. Thanks!
Not too many options in this situation except for an implant. You can still have it done even though you did not do the graft! Stay safe!
This is an amazing service you offer us. Thank you from my heart.
I’m 58 years old. My #14 fell off. My dentist put an implant to replace it and that fell off after 3 months. The gums were not ready. He said that it in general, was not necessary to replace #14 (true?) and we decided not to put one. A year later, it seems that #15 has shifted diagonally and is taking some of the previous space of #14. FYI, I had braces when I was a kid and 4 teeth were extracted. Thank you
#14 is a critical tooth! First molar we get when we are six years old! It is way more important than #15!
Hi Dr. – I so appreciate your willingness to answer questions.
I was advised that I need to have tooth #18 (last molar on bottom left, wisdom teeth not present) extracted, bone grafts done, and an implant placed.
I had a root canal done on this same tooth 2.5 years ago which went badly wrong – I ended up with an abscess and Ludwig’s Angina, and spent two days hospitalized (away from my newborn). Once it healed, the crown was placed – but within a year there was a cavity underneath the crown and they did the filling by drilling through the crown (told this is common practice).
I went in today because that tooth felt sharp and I figured either the crown had chipped or the filling was loose. While getting that checked, dentist says he believes (but cannot be entirely sure without a CT) that the tooth beneath the crown is cracked, and that there is continued loss of (pulp? bone? I wasn’t entirely clear) beneath the crown. Said a second root canal could be tried, but probably easier/better to just extract, do bone graft, and replace w/ implant- and pushed to do it TOMORROW, then handed me a credit card application at the reception desk to make that possible, since my insurance company considers implants cosmetic.
I am fine with extracting – sort of wish I’d done that from the getgo honestly! – but I am absolutely terrified of further invasive procedures, and the hard sell approach makes my anxiety even worse.
Ludwig’s Angina!!!!!! That tooth should have been extracted if it caused that type of an infection. That is SERIOUS! Implant would be a much better option in your case! Stay safe!
Dr., I am looking for your opinion. I just had #15 extracted due to an infection and bone decay around the tooth. Dentist put a collagen graft there right after the extraction. Two days later and I feel #14 has a tiny bit of movement.
Will the collagen be absorbed and harden to maybe allow an implant if i choose and will #14 now lack support and eventually also be a loss? Or should there have been a different route?
I appreciate any feedback.
Great Question! Sometimes the adjacent tooth may get a little sore in the healing process. This should be gone in 10 days. #14 should be fine!
Dear Dr,
I have crowns on the second molars both upper and bottom. The upper tooth also has root canal and can’t really hold a crown. It needs to be extracted at some point because there’s not so much tooth left. The bottom one is doing ok. My question is will the bottom one grow out of socket if it has a crown on? Thanks
NO —the crown is not what holds it in place
Have deep crack through bicuspid on upper right. Dentist said cracked through cannot do a root canal. Needs to be extracted. He said I should get an implant. Do I need to get implant? Said it will be around $4,000. I don’t have insurance and am 70 years old. Can I just have the tooth extracted? Do I need to get an implant? My teeth are healthy, never had any removed only 4 fillings. Please let me know. Thank you for your time and help. It is greatly appreciated!
Implants are elective procedures. Of course you can go without a tooth but your oral health is better with that tooth. The bicuspids are very important teeth. You may end up cracking other teeth because you do not replace this one. Your bite will be out of balance.
Hi Dr. Amin,
Thank you so much for your insightful article. My tooth 27 (international numbering) was extracted last year due to decay, and a root canal was done to tooth 26 right before pandemic. Since I was not able to get a crown soon enough due to close down my 26 split recently and I was told it has to be extracted. I am 24. Do I have to get an implant for it or is it too risky to just leave it empty? Thank you very much in advance!
Have two implants done at the same time for 27 and 26. You are very young!
Will having a top molar extracted change my appearance? I need my last top right molar extracted. Do you advise an implant?
Thank you so much!!!
not likely —Will having a top molar extracted change my appearance?
This is such an informative forum. I would love to know your opinion on getting an implant (or not) after extraction of tooth 15. I have had all 4 of my wisdom teeth removed, so it is the last tooth on that top side. I have an x-ray of the top and bottom teeth on that side of my mouth and how they meet. I have the photo here:
https://photos.google.com/album/AF1QipNhvDFgkBPUyuZI_S7JVa5LGbbc3n-6JG00jpCS
It is the tooth behind the implant. Do you see the decay? I have been told it will either need root canal + crown lengthening + crown or extraction and the of course extraction + implant. Advice?
Thanks in advance!
dead link
I apologize, this link should work and I look forward to your advice:
https://photos.app.goo.gl/8vfGHjQVK53zZKQC9
Looks like internal resorbtion. See a root canal specialist first. It is possible this tooth can be saved. The x-rays are little bit grainy though
https://photos.app.goo.gl/8vfGHjQVK53zZKQC9
Looking at the lineup of the teeth, if #15 were to be extracted, is it necessary to replace it with an implant? If it is a choice, what would you do if it were your mouth and why?
Thanks again for your helpful advice!
I would replace that one!
Hello, Doctor Ramsey! I’m 28 years old and only have my #31 molar left. And my #32 molar is up for extraction. Do I need implants for #28, #29 and #30? But it would need bone grafting since it has been a decade since they were extracted. I am afraid of possible late implant problems. I was wondering if you would also recommend dentures instead? Thank you
You would probably be better off extracting the wisdom tooth #32. Then you could have two implants. 1 for #28 and 1 for #30. You can make a 3 tooth bridge from #28-30 making 29 a pontic. This will work great. It will save you some money and still have a very good long lasting result. You will probably need some form of bone widening. This is a great procedure to quickly add bone at a low cost that will last for a long time since it is all your own!
Hello, Doctor! First of all, this has been a very informative thread. I was hoping you could answer a query which I hope would also be beneficial to others.
I am 29 years old. On the right side, all of my teeth are intact except for #19 (lower right)
On the left, all upper teeth are intact, BUT as for the LOWER LEFT, #30, #29 and #28 have long been extracted (about a decade ago).
#32 is up for extraction. Should I get implants or bone graft for #32 to prevent (and please correct me if i am wrong) super eruption of #1 and to prevent future problems from loss of #32?
Bone graft and implant was also suggested for #30, #29 and #28 (extracted about a decade ago). Should I get the bone graft and implant for the three molars or would dentures do? I can feel my left cheek caving in in the place of the three absent molars and was told that my lip would droop eventually because of the non-use and non-development of muscles on one side, especially considering that my sole remaining molar is #31.
I have been in a constant state of anxiety over this and would really appreciate your input. Thank you and more power!
You would probably be better off extracting the wisdom tooth #1 and the wisdom tooth #32. Then you could have two implants. 1 for #28 and 1 for #30. You can make a 3 tooth bridge from #28-30 making 29 a pontic. This will work great. It will save you some money and still have a very good long lasting result. You will probably need some form of bone widening. This is a great procedure to quickly add bone at a low cost that will last for a long time since it is all your own!
Hello Doctor. Im wondering what is the timeframe for a dental implant after extraction? I only have two molars on the left side of mouth. 14 was removed due to decay/inability to afford a root canal in 2018, 16 was removed due to impaction in 2017. 17 and 18 were removed due to 17 being untreateable and full bony impaction of 18 very recently. Ive disscused implantation in the socket of 14 with a specialist. I just don’t have 4000 to spend on that right now. What is the risk in waiting longer? The margins of socket 14 have maintained their margins quite nicely over the past 2.5 years and teeth haven t moved Would waiting for another 2 years do irreversible damage. Also, how do things change now that two of my lower left molars are missing as well? PS the specialist mentioned something about a sinus lift but he’s not sure if they’ll need to do one.
Things are likely already moving you just can not see it. Typically I would extract/implant and internal sinus lift all at the SAME time. This is a more advanced method but saves time and money. Waiting 2 years will result in some issues such as more extensive bone loss
Dr. Amin, your blog is so straightforward, direct, and helpful. Thank you. So, I can’t make a decision about whether to go the root canal-crown route or extraction on my second upper right molar and part of difficulty is the trouble I had with only other root canal. I have a crowded mouth and all four wisdom teeth, so crowded that when I did invisalign about 15 years ago as nearing 40 they simply “polished” teeth to make room to straighten teeth. I was having problems five years ago with third lower right molar and my former dentist did a root canal. It did not work and she sent me to an endodentist who retreated it. I wish she had sent me initially to the endodentist because I felt quite a bit of pain while she was doing the root canal and was in terrible pain two days later. The endodentist treatment still didn’t work and he retreated it again. It still hurt and I had to have extracted. It turned out there was a fracture. The oral surgeon put bone in after extraction and I later had an implant. That developed an infection and I needed advil and codeine to manage the pain for 10 days. The implant survived and I have a nice crown, but about the easiest procedure during the ordeal was the extraction (aided by laughing gas). My new dentist who saw me two weeks ago when my gum was swollen around this molar says the bone is good and he’d save the tooth but if extracted he doesn’t think an implant is required and said that’s an OK choice too. I have a cross bit. Your blog was enlightening about how your bite impacts the decision on a replacement for upper molar. I have the money in an FSA account to cover cost that is not covered by insurance. I am so torn, but must make a decision this week as have let it go two weeks now and antibiotic runs out soon.
We all grapple with these difficult decisions. Really it comes down to long-term prognosis. Ask your dentist what they would do if this where their mother’s tooth.
You may be surprised what the answer is. Without seeing you or your x-rays are really cannot tell you exactly what to do because that decision tree is made by a clinical and x-ray exam.
Perhaps have a second opinion before you take the plunge if your grappling with what to do!
Thank you for your kind words. This blog form has been a passion of mine for over 10 years. I really enjoy the communication
Ramsey A. Amin, D.D.S.
Diplomate of the American Board of Oral Implantology /Implant Dentistry
Fellow-American Academy of Implant Dentistry
Burbank, California
My dentist said I have abscess on the gum(there is no discharge just a tiny bump) above my upper right 2nd molar. That tooth has a crown and a post. He suggested to me to have it a. extracted or b. do the entire restoration. What would be a better option. I am 49 yrs old.
If the tooth is savable with a good long-term prognosis the choice is obvious… Keep it! If it is going to be lost because it has limited tooth structure then it would be better to extract and replace it
Hi, Doctor. Thank you for this useful site! My tooth #31 was extracted two weeks ago, due to the tooth showing both internal and external resorption on 3-D xray and determination by an endodontist that it could not be saved with a root canal.
My questions are:
1. I have the type of bite such that (without an implant) the tooth directly above the area of former tooth #31 would likely drift downward over time. (My understanding is that this is due to #31 no longer being there for the upper tooth to chew against, resulting in insufficient bone stimulation in the area of the upper tooth.)
Given that I don’t want a titanium implant, I am currently testing a theory: I have purchased individually-wrapped sterile tongue depressors. I plan to regularly do an exercise where I pretend to chew, using the upper tooth and the tongue depressor. Using that exercise, I hope to cause sufficient, substitute root stimulation in the area of the upper tooth, so that the upper tooth does not start to drift downward. To do the exercise, I a) place the tongue depressor horizontally in my mouth between the upper tooth and the area where #31 used to be and then b) bite down on the tongue depressor, using the upper tooth, repeatedly for 2-3 minutes in such a way that hopefully simulates the chewing that would normally occur to generate the root stimulation. I plan to do this exercise 3x daily, after normal brushing of my teeth, for the rest of my life (or until it stops working to prevent the upper tooth from shifting downward.) I have already begun this routine.
My question is, do you have any advice for raising the odds of this tongue-depressor technique being a success in preventing downward drifting of the upper tooth? When I had mentioned it during consultation with my oral surgeon, he deemed it as having a “maybe” chance of working, but stressed that chewing isn’t the only time the teeth come together–that they also come together when we swallow, for example. (However, I don’t actually bring my teeth together when I swallow because years ago I had heard on the radio that it’s not good for a person with a history of TMJ problems to put teeth together when swallowing, and that you should train yourself to keep your tongue in the way of your teeth, when you go to swallow, to lessen the stress on the jaw. So I took some time back then and trained myself not to bring my teeth together when I swallow, and it became my normal.)
2. I have chosen not to seek a titanium implant because of multiple concerns that I have about it. However, when #31 was extracted, I did elect to have the bone graft done, in case I might decide later on to seek a zirconia (ceramic) implant as an alternative.
My question is, do you feel a zirconia (ceramic) implant has a good chance of success in a 2nd molar area like #31? (If so, I may possibly consider at some point consulting with an oral surgeon specialist out East, where there appear to be way more oral surgeons performing the zirconia implant procedure than there are here in the Chicago area.)
3. Now that #31 tooth has been extracted, my periodontist wants to check my bite in 3 months to see if I need to start wearing a retainer the rest of my life. However, I’m doubtful that a retainer would prevent shifting, in my case, because after having had braces at age 27, a retainer did not work for me to prevent shifting. (More detail: immediately after having had braces at age 27 to try and resolve my TMJ issues, I wore a tooth positioner at night for a while. Unfortunately, the tooth positioner caused jaw pain, so I asked the orthodontist if he could cut it in half, which he did, and then I just wore the upper half at night. But the upper half of the tooth positioner still caused pain in my jaw, so we gave up on that idea and he gave me a retainer to wear instead. But unlike the tooth positioner–which had been working to prevent shifting of teeth, the retainer didn’t work; my upper teeth went back to overlapping to some extent, and other teeth shifted a bit as well. Hence I’m doubtful that a retainer would work any better for me now than it did back then. Your thoughts?
More Notes:
I’m 63 years old with no current health issues. During my teens and early 20’s a total of 8 teeth–including wisdom–were extracted, to prevent crowding. I had painful TMJ issues back in the 80’s; open-joint surgery was recommended, but I managed to avoid it by having 6 months of neuromuscular therapy in 1992, which successfully eliminated my jaw pain and extreme head tension. I have been asymptomatic since that time, with the exception that whenever I have dental work, my jaw gets very tired and I so have to take breaks. I have neuromuscular massage every 1-2 months, which keeps my upper body relaxed. In short, I’ve been very fortunate.
You may want to consider not having an implant at all. It is unlikely that the tongue depressor will work long-term. Some patients do not get this over eruption but most do. Perhaps he will be lucky. I am not a fan of zirconia for implants but it is a great material for the abutments and the crown! As for the TMJ the second molar often times makes a premature contact which can exacerbate a pre-existing condition. For most patients replacing this tooth would be the right thing to do but perhaps for you given your special circumstances you may want to just skip it.
Hello. I hope you are doing quite well, Doctor.
I am a 32 year old woman. I have had extraction of the molars #3 and #14 (U.S. based) and I just had a filling on molar number 2, due to cavity. It seems that the filling didn’t work out well for my tooth because nearly 3 weeks later I have a lot of pain.
Problem is if I extract this molar, I will have no back molars on top right of my mouth. But the pain is bad. I can’t keep the molar if I will just be in constant pain. And my body seems to have rejected the filling weeks later.
What should I do?
Thank you, in advance.
Root canal and crown!
My wisdom tooth was removed a year ago but because it impacted the tooth in front #31, has a cavity. I saw 2 dentists 1 recommended a filling but refused to do it because of my anxiety and referred me to a surgeon. The second dentist recommended I do a root canal and crown or extraction but I am absolutely terrified to do any dental work without being put to sleep. I am scheduled for an extraction tomorrow but not I am second guessing my decision because I heard there will be negative long terms affects and possible #2 falling down. What should I do? And why I Am completely terrified!
Hi I am 29 years old and I just had my Left upper second molar extracted yesterday….I had a root canal 10 years ago and the tooth just broke under the crown and had to get a complete extraction …the oral surgeon said I would not need an implant but I’m not sure….I have a history of developing bone loss after my wisdom teeth were extracted so I am worried about that now… also my left bottom second molar does not have anything on top so I’m worried it’ll move? Thank you in advance for the reply
Is going to be up to you. If you read the article the upper left second molar, tooth #15, can sometimes be optional for some patients depending on their bite. It really depends on how much tooth surface/chewing surface was removed. Sometimes only 10% of #15 touches the lower tooth #18 while sometimes it is 90%. Each situation is unique. Stay safe during COVID 19
Help!!! I am 25 and I got an ice cream from Dairy Queen a few days ago there was a rock in the ice cream and when I hit down I shattered and cracked tooth 15. I am getting it extracted tomorrow along with the wisdom took behind it. I just got my braces off and I’m so scared my teeth will shift.
A rock!!!!!!! Yikes! Have your dentist evaluate your bite to see if you really need it replaced or not. It is ideal to have it replaced. That is what I would do if our at your age in your situation.
Hello Doctor.
I have had 3 infected root canals that need to be extracted as they cannot be saved.
The dentist is a implant specialist and is trying to convince me of doing implants.
I was quoted with a massive bill $13k, and I have no insurance.
He was selling me on the idea of bone loss and spacing, however from what I see on your website it looks like it may not affect me? Otherwise, my teeth are in good condition and straight.
The teeth I have affected are 15, 32,31 on this image..
https://dentalimplants-usa.com/wp-content/uploads/2015/07/toothdiaghram.jpg
Please let me know what is the best decision. I am only 28 and cannot afford this. I could maybe get implants in the future, but this serves no aesthetic purpose for me and my smile.. just functional at this point
Thank you for your thorough question. If anything I would just replace tooth #31 and not worry about 15, 32.
(I’m resubmitting this comment as I realized I did a poor editing job on the first submission. Feel free to use this one for responding.)
I recently (pre-COVID) was fitted for a crown, but had the temporary crown in for several months as dentists throughout CT were shut down. When my dentist reopened, I returned to have the final crown fitted, but I informed my dentist I was experiencing some discomfort for the past couple of weeks above the temporary crown. Another x-ray was taken and he informed me that a root canal was likely, so I was referred to an endodontics specialist, who during the process either discovered the tooth had a hairline fracture or it fractured while drilling. The root canal was not completed. Is that a common occurrence? Regardless, now I’m off to see an oral surgeon for possible tooth extraction and implant. This is the #3, upper right. My wisdom tooth was extracted years ago, so this is the second tooth in on the upper right, labeled #3. So my questions are: Is this a common/not-unusual event? And are there other options than extraction/implant? Can I have an extraction without an implant considering its location. Thanks. Just looking for additional perspective.
It sounds like you went to a good endodontist because they abandoned the root canal when they saw small crack. This is not totally uncommon. An implant would be a much better option than having a bridge. That would be your only other real option besides just leaving it alone as an empty space. Keep in mind this particular tooth is close to the sinus so sometimes the sinus needs to be lifted up a bit at the same time of the surgery or separately depending on the skill and experience of the dentist and your unique situation. Stay safe during COVID-19 🤗
Dr. Amin, thanks much for the response, as well as the additional information related to the sinuses. I have a conversation scheduled with the oral surgeon tomorrow, as well as my original referring dentist.
I recently (pre-COVID) was fitted for a crown, but have had the temporary crown in for several months as dentists throughout CT were shut down. When my dentist reopened, I returned to have the final crown fitted, but I informed my dentist I was experiencing some discomfort above the temporary crown. Another x-ray was taken and he recommended I see a Temporary put in but the final never was as dentists were shut. During the shutdown, the area above the tooth began to bother me and with a further x-ray after my dentist returned, a root canal was recommended prior to the final crown being installed. Was referred to an endodontics specialist for the root canal, who during the process either discovered the tooth was fractured or it fractured while drilling. I don’t know know how common that is, but now I’m off to see an oral surgeon for tooth extraction and implant. This is the #3, upper right. My wisdom tooth was extracted years ago, so this is the second tooth in on the upper right, labeled $3. My question is this a regular occurrence, are there other options than extraction/implant? Can I have an extraction without an implant considering it’s location. Thanks. Just looking for additional perspective.
Hi, Dr. Ramsey , my oral surgeon wants to extract teeth 2 and 15, both top second molar in order to proceed with my jaw surgery. I previously had 8 teeth extracted for braces ( 21,28, 5 , all wisdom teeth and a lower 2nd molar.) I want to know if my removal of 2 and 15 will cause facial asymmetry and bone loss or not. Will it change my appearance? Also , do I need to get these 2 teeth replaced for chewing?
Are you having “ orthognathic surgery?”
Yes sir
Hi Dr. Amin,
5 days ago I had #2 and #31 (US) extracted as they had broken, I believe due to decay. I suffer from bruxism and am on route to periodontitis. In 2014, I had 5 impacted wisdom teeth removed. I lost my dental insurance so cost is definitely an important factor at this time. I have been doing some research and am now very concerned that my facial shape may change and become asymmetrical. I am only 27 years old so this is a big concern for me. The dentist who extracted my teeth was in a rush and didn’t explain any options or anything regarding bone grafting to me. She told me I would be, “just fine” and moved on. In your opinion, what is the likelihood that my facial shape will change? Also, do you think a bone graft is necessary to prevent any asymmetry? Thank you for your help!
This is a great question Rebecca. Missing #2 and #31 is not going to lead to facial shape changes and becoming asymmetrical even though those 2 teeth are both on the same side. You have to lose more teeth especially the first molars which are numbered #3, #14, #19, #30. If you do have periodontitis this could lead to the loss of all of your teeth having severe bone loss and facial changes like this.bone loss and facial changes like this.
Hi. I am 17 years old and I have gotten number 31 removed. Do I need to replace it and if I don’t will the rest of my teeth in my mouth start moving later in life and look weird? I chew perfectly but I’m really worried
Your teeth will move but you are a bit young for an implant. You can make a special retainer that will hold your upper tooth #2 from moving for a few years hopefully. That is the tooth that bites with #31
Hi Dr. Amin,
5 days ago I had #2 and #31 (US) extracted as they had broken, I believe due to decay. I suffer from bruxism and am on route to periodontitis. In 2014, I had 5 impacted wisdom teeth removed. I lost my dental insurance so cost is definitely an important factor at this time. I have been doing some research and am now very concerned that my facial shape may change and become asymmetrical. I am only 27 years old so this is a big concern for me. The dentist who extracted my teeth was in a rush and didn’t explain any options or anything regarding bone grafting to me. She told me I would be, “just fine” and moved on. In your opinion, what is the likelihood that my facial shape will change? Also, do you think a bone graft is necessary to prevent any asymmetry? Thank you for your help!
This is a great question Rebecca. Missing #2 and #31 is not going to lead to facial shape changes and becoming asymmetrical even though those 2 teeth are both on the same side. You have to lose more teeth especially the first molars which are numbered #3, #14, #19, #30. If you do have periodontitis this could lead to the loss of all of your teeth having severe bone loss and facial changes like this.bone loss and facial changes like this.
Ramsey A. Amin, D.D.S.
Diplomate of the American Board of Oral Implantology /Implant Dentistry
Fellow-American Academy of Implant Dentistry
Burbank, California
Hi, I’m 46 and have just had my lower left second molar removed*. I still have my wisdom teeth, so now I have a gap. How long is it okay to wait to have an implant done?
*the molar was extracted after it fractured 10 weeks ago. Due to the covid crisis my dentist was closed and I had to go on a waiting list for an emergency consultation. When I eventually saw the emergency dentist he told my it could be saved with another root canal treatment and then crowned, but, that service is not available until Jan 2021 ‘apparently’. I had already taken three courses of antibiotics to help with infection which kept coming back and honestly, after 10 weeks of utter misery, I said rip it out. Plus Jan 2021 is six months away, there’s no way I was prepared to wait that long, and risk the infection getting worse.
Thank you kindly for your time if you reply!
Aaron
Hi Aaron,
It sounds like you need a new dentist! January 2021! That is ridiculous! This would be a great area to have an implant especially at your age. This exactly describes the problem in the article about missing the last molar. It is more critical went on the bottom than on the top. Stay safe during COVID 19
Ramsey A. Amin, D.D.S.
Diplomate of the American Board of Oral Implantology /Implant Dentistry
Fellow-American Academy of Implant Dentistry
Burbank, California
hello dr i just got first molar on the lower left side (#30?) removed today and i want an implant so i dont fully mess up the others and when should i get it done? my doctor didn’t talk about it at all during our appointment he was rather dismissive just pull n go attitude really
btw im 26
Gosh… It is certainly better to plan this out. Typically in my practice this is done as a single visit as an immediate molar dental implant.immediate molar dental implant. That means the implant is placed on the same day of the extraction along with a small bone graft. This saves a lot of time and money. If this was not done you should be looked at soon as this is a very important tooth to replace
Hi Dr. I have had A molar extraction number 31 using the United States labeling is a tooth replacement needed ? I was also told I would need to lose number 19 any advice ? 🙁
Per the article, replacing BOTH would be awesome
Hi,
I had my upper 2nd molar removed 1 year ago. I noticed the lower 2nd molar below it is a bit higher than the adjacent teeth. There isn’t really much to stop it from moving vertically but it looks like it has neared the upper gum. Is this a cause for concern? Would something like a night guard help to stop it from moving? I don’t feel pain or sensitivity, Just noticed it randomly.
A guard will not stop it. It will likely keep moving and will create a periodontal pocket.
Hi Dr.,
I must commend how you handle dental related issues on this platform and I wish I had discovered earlier, I wouldn’t have been in the current situation I find myself. I am an African and will be 40 this year, over the years, I’ve had causes to extract tooth numbers 5,18, 19, 30, and 31 (using the United states labelling system). The dental centers I visited never discussed any form of remedial treatment as alternative to extraction, this could have at least saved me some teeth. As we speak, number 32 is affected and may possibly be extracted also. I also noticed recently that I frequently have itchy ears, could it be that my ears have been affected?
Please doctor, I do not have the finances for now to travel abroad for any form of treatment even when all the Covid-19 issues are all over, but I need your advice on what to do regarding treatments, implants, or whatever I need to know when next I visit any dentist in a standard hospital.
Thank you.
Thank you for your kind words. I am sorry that you had some issues. The itchy ears are not related. You may want to see a dermatologist for that question. As for tooth #32 generally provides no value and is a source of periodontal disease.
As long as you have molars #3, 14, 19 and 30 you will be in good shape long-term for most patients bite types. If you are missing any of those teeth I would suggest replacing them. The second molars are numbered 2, 15, 18, 31 and are not as important if you are missing multiple teeth.
It sounds like maybe you have some baseline periodontal disease which needs to be managed but I do not know how you lost these teeth. People loose teeth due to decay or due to periodontal disease. Both are preventable so please connect herself up with a very good dentist that can give you a comprehensive treatment plan and then do regular maintenance procedures and home care so that you can keep the teeth that you have. Replacing tooth #5 can be straightforward as long as there is no bone or tissue lost requiring a bone and/or gum graft.
Thanks Dr. Ramsey for your prompt response to my enquiries in spite of your busy schedule.
I will want to send you some images for you to further advise. Can I reach you via email, please?
Thank you.
It would be best to see me in person. I wish I had the time to personally look x-rays at the 100s of messages I receive daily. Feel free to call the office to make an appointment. Respectfully, Dr. Amin
Hello I am 21 years old. I have a cracked molar on number 15 I’m in so much pain the dentist recommended me to an endo to try to save it but he doesn’t know if they can save it and because of corona virus I have to wait to see an endo. Or I can have it extracted which I’m leaning towards. Can I get an implant in the future if they just fully extract it I don’t think the OS does any pre implant stuff. I have an over bite and my bottom molar is still in place how long do I have before it shifts? I also already had my wisdom teeth removed
Can I get an implant in the future if they just fully extract it? YES!
At age 21 your teeth are likely to shift FASTER than if you were 41. The sooner the better.
Does endodontic treatment last forever.? I heard there were a lot of well-known dental professional claiming it impossible to sterilize the tubules fully as there are millions of it in a compromised tooth, which can harbor bacteria and potentially harm a person’s health. Even it the canals are sealed up with gutta percha filling, it’s edotoxin can leak out in matter of time. Do you practice holistic dentistry that assess every aspects of your patient before proceeding with such a major dental work?
I’m 41 years old and my molar on bottom right needs an implant. I want to know if it would be safe to just extract and will I have future pain from upper molar? Thank You
Read the article a second time. If it is the bottom molar it is likely a better candidate to replace than to leave it as an empty space. Your upper tooth will over erupt causing future issues if you have a normal bite pattern. Stay safe during COVID 19!!!!
i’m 30 years old and i had to get both my lower left side last 2 molars removed, as i didn’t have money to get it fix. and the last tooth left on my lower left side needs a root canal. i’m so scared as to what will happen to my smile since i don’t have money to fix my teeth.
It should be ok but keep an eye on the upper last two molars.
Thank you for replying to myself and everyone else 🙂
I’m 41 years old and my molar on bottom right needs an implant. I want to know if it would be safe to just extract and will I have future pain from upper molar?
I am 67 and most of my teeth are in decent shape. But the rearward most molar on my upper right side (I think that is #2) is dead and breaking apart. Both an endodontist and an oral surgeon have said it needs to be removed, it cannot be saved. I have the procedure scheduled. But I need to decide if I want an implant or not, because if I just want to be able to have an implant later on, the surgeon says I need a “Sinus alignment vertical” and a “Platelet rich fibrin.” Neither are covered by insurance. Then if I decide on the implant sometime later, that is really expensive and only 50% covered by insurance. But if I am sure I don’t want an implant, it is just an extraction. What is the downside of just doing the extraction?
In this article I specifically discussed the upper molars. You may be okay without it but this really depends on your bite.
Thank you so much for your guidance in the article. As it turned out, my appointment to have the molar removed was delayed a month due to the COVID thing. But then the molar started to break apart and I had to get an emergency appointment with the oral surgeon to have it removed. I told him to skip the pre-implant procedures and just get the tooth out of there. It went well but he said that what he encountered with the position of the molar relative to my sinus would have made an implant more difficult that he originally thought, so it was just as well that I chose not to have one. I’m all healed up now and everything is fine. I can’t do hard chewing on the missing molar side, but other than that, I don’t miss it.
Thanks for the follow up 🤗
Hello,
I got my 2nd molar in the lower jaw removed when I was 10. I recently noticed that my wisdom tooth is starting to grow now. Is it possible that it will grow in the place of my 2nd molar and it completely fills up that gap?
It is possible because of the age that you had your second molar removed. It can also orthodontically be pulled into place. This is because of the timing of your extraction. See an orthodontist ASAP. I am assuming you are between 17 and 25 years of age.
My 14 year old daughter has been very delayed in losing her baby teeth and adult teeth forming. Most adult teeth are in now with a couple of exceptions. #29 is a baby tooth that does have an adult tooth that has been slow to form but dentist said it is looking like it will with a little more time. #20 has no adult tooth formed at all under it. She has no wisdom teeth per x-ray but her bottom 2nd molars are trying to come in. Dentist said there isn’t a lot of room for them. They have offered a couple of options: #1-Let #29 come in, file the sides of #20 down just a little to give more room, then put on braces to pull teeth together (her teeth seem to be shifted a little off center from center of face and she has an overbite anyway so she needs them). They hope that it gives #18 & #31 room to come in with no problems. If so great, if not pull them both. Said she would also most likely need an implant in her early 20’s for #20 OR #2 option-pull both #20 & #29 and use “T.A.D” anchor system in that area along with braces to pull the two molars inward to give them more room. Said keeping molars would be best option because molars are stronger teeth than the others but the concern was that molars take longer to move with orthodontia and my daughter had a really big issue in her first phase of braces with decalcification and battling her with proper cleaning,. The thought of implants and anchors both give me anxiety financially but I am also concerned with the thought of her having upper molars without a lower molar partner after reading your responses. I do not want to cause major dental problems down the road by making an uniformed poor choice now. What are your recommendations and what are the potential problems with either option?
Keeping molars would be best option… She is too young for dental implants. She needs to be coached on her oral hygiene every day using an electric toothbrush. Baby teeth can be maintained for many many years. Make sure she does not drink any soda of any kind.
Hi Dr Ramsey,
I am going to have the teeth #15 to be removed next week. I don’t plan to do the implant of this teeth in the future. My dentist suggests me to do the bone graft at the same time of extraction of this this teeth because this teeth gets infection and has a deep hole.
Do you think I should do the bone graft if I don’t plant to get an implant of this teeth?
Thx,
Florence
If not Implant there’s no need
I had #18 extracted and I an thinking about getting an implant even though I don’t have any chewing difficulty. . Several dentists have told me that I grind my teeth but I am not aware of it. Would a molar implant be able to withstand the force of moderate teeth grinding or would it likely fail. Also can an implant cause periodontal disease or bone loss in adjacent teeth?
Thanks
A type of implant that should be selected for somebody with your bite strength should specifically be grade 5 or 23 titanium. The second molar has a high bite force and a thin walled implant may break. I have done 100’s of these with great success
An “bad” implant can case bone loss but unlikely. You would know there was a problem before it got that bad
I have Bad teeth. I have 11 teeth upper & 11 teeth bottom, the dentist wants to pull all 4 / 2nd molors. That leaves me with 9 upper & 9 Lower. Not much to chew on,& my face is already sunk in.what to do?
Not a bad plan… It is the molars that are typically the most affected by decay and periodontal disease. If you have your bicuspid teeth you may be okay as long as everything else is very solid
Dear Dr Amin,
By bicuspid teeth you are referring to the premolars. The 4th an 5th teeth before the first molar right? May I ask if all the teeth are intact, but there is a missing number 18 (lower left second molar). In this case, would the opposing still shift down if it has a little contact with the lower first molar.
Yes, I am referring to the premolars. Bicuspid then premolars are synonymous. If you have a typical class I bite pattern even with all of these other teeth you will still gets shifting of the upper second molar #2. This may cause some TMJ problems down the road and periodontal disease on #2 and #3 because of a pocket that becomes deep.
I am having trouble with upper left side molar (tooth 27). It is causing pain now and dentist says I should either get it extracted or root canal done. The tooth has already been comprised with a very large filling. I already have the last molar (wisdom tooth beside it) removed previously.
My dentist seems to feel that either option are fine with him. Just wondering what are chances if I have it extracted that I will have other problems later as a result of tooth 27 missing. I do not really want to be faced with an implant to be honest.
Thanks for any advice
On January 17th, 2020 I had my upper right wisdom tooth extracted, it was healthy, had enough space and had grown in properly. My dentist said that the upper wisdom teeth were pushing my bite forward and that’s why she extracted the tooth. Problem is that some years ago I had both of my upper premolars extracted for orthodontic treatment. My bite got messed up again due to untreated tongue habit after the removal of the braces and not caused by the wisdom tooth. The space left after the removal of the tooth is huge and I’ve trouble chewing on that side, I feel like I lost a lot of strength on that side of the mouth and I’m constantly getting the gum prickled when I’m eating. Would an implant be an option? What would you suggest? I’m also in need of orthodontic treatment to fix the bite and treat the tongue habit. I’m only 21.
braces first followed by implant second…but the implant must be PRE-PLANNED before starting the braces so the space can be managed. Do not take off the braces until the implant dds clears you to do so
Would there be any more risks to be considered compared to the implant surgery of a different tooth and not a wisdom tooth? From what I’ve researched online I’ve not been able to find much information in implants for a wisdom tooth. Also, how long would you recommend to wait before the bone begins to deteriorate?
Thank you Doctor!
Are you wanting to have an implant for your wisdom tooth? That is not recommended. There are so many anatomical restrictions in those areas and also they do not provide any sort of chewing capability.
You’ll be hard-pressed to find someone that would put an implant for wisdom tooth 🦷
There is a different type of implant that I specifically place in the wisdom tooth area called a pterygoid implant but that is very specific to full upper replacement
https://www.burbankdentalimplants.com/what-is-a-pterygoid-dental-implant/
Hello Dr. Would it be crucial for me to get both my letter A and letter j teeth replaced after extraction I just do not have the money replace them. I am 23 a female.
Why take them out!! Keep them as long as you can!! Unless they are loose or decayed do not remove!
52 years old. Yesterday had an extraction on 2.
5 years ago had a root canal and subsequent crown down on 3.
Is it imperative that I get an implant for 2?
Not necessarily based on the article but you need to have a proper bite in order for this to be relevant
You mentioned that if one has a Class I bite, they can potentially get away with having a molar on the upper arch removed. I have a minor cross bite and tooth #2 has an abscess but I can’t handle the pain for a month nor can I afford the root canal. Will I be shooting myself in the foot by getting it extracted?
Likely will be ok
Hi,
I’m 58 and had to have #18 extracted due to a large crack. I have bruxism and have for years. I only have one crown #17. So otherwise teeth are healthy. My wisdom teeth were removed in college.
I cannot afford an implant so do I have any other options? Do I have to do anything?
There is always the choice for no treatment. At your age things may be stable. You should definitely monitor this every 6 months by x-ray. The opposing tooth would be #15. That is the tooth that should be watched for drifting. Course consult with your dentist about this.
Hello Ramsey.
I hope I am not too late on the post. Discovered this article today and I find it very informative. Thank you. I have my 18,19,30,31,32 removed. Looks like i will have to also remove 15 and 17 as they now have holes. My question is, can i also remove 1,2,3, 14 and 16 and not have implants or are implants a must? Your response will be greatly appreciated.
Regards
Judith
South Africa
It would be best if you had 3, 14 , 19 and 30. That would give you one crucial molar in every quadrant. This is ideal ✅
Thank you so much. I will get implants for 19 and 30.
Kind regards
Hello Dr. Would it be crucial for me to get both my letter A and letter j teeth replaced after extraction I just do not have the money replace them. I am 23 a female.
On January 21, 2020 I got an extraction on 18. How long do I have to wait to get an implant? When do teeth start to shift? Would I need an implant? I’m only 21 years old. Are tooth implants safe to get? Is there any danger in the further?
I usually placer the implant on the same day of the extraction. If not, 4 Months is a good timeline. An implant would be suggested in this scenario
Could a single tooth denture stop 15 from shifting? Will boneless only occur on the missing tooth?
Correct as long as the tooth wear on the plastic tooth is always replaced/maintained. It will wear down
Should I worry about bone loss in the future?
Yes. It will happen if the tooth is gone. 🦷
On January 21 2020 i got a tooth extraction on 18 would I need to get implant? How long do I need to wait to get an implant? When do teeth start shifting? Will my teeth shift?
In my practice that would be a same-day extraction in same day dental implant. If you are having a delayed placement then wait about 4-6 months before doing anything
Last month I had to have #31 removed because it cracked down the root while a filling was being put in. I have a root canal in #2 that is about 25 years old. I am 52 now. I had both wisdom teeth removed when I was 22. Will I loose #2 also because it will start reaching for #31? I can’t afford a dental implant and at 52 if I have problems with #2 should I just have it pulled also?
It may be best to just remove both #2 and #31 and do not replace either one
Hello, Mr.Ramsey
I’m missing #2, 3 and 14, 15 but still have my wisdom teeth. Is this a major problem? I am 23
Sorry, I believe I’m missing #31,30 and 18,19 on the bottom jaw instead.
It’s a problem that you don’t have those molars. They are critical to you in the long term!!
Hi Dr, Amin. Thank you so much for posting about this. I had all 4 wisdom teeth removed in high school. A few years ago, I had a root canal and crown on a second molar (#18, left side, bottom, far back). The root canal failed and the tooth became infected so my DDS fully extracted it. He says the upper molar (15?) is starting to come down and suggests I get an implant in 18. He said it was not vital but worst case scenario is the upper molar will eventually come down so far it will need to be removed (and this could take anywhere from 5-10 years but it’s impossible to be sure). He also said the implant would be more dire if the tooth adjacent to 18 cracked or failed. This is a lot of money and it’s major surgery. I am 38 years old. Should I get the implant? Are there any additional concerns for an implant that far back? Nerve damage? Infection? Thank you so much for your time.
A skilled implant dds Will greatly reduce risk of nerve damage and infection. If these is enough space for a normal size crown on the implant I would have it done SOON! If it is too tight then plan on losing 15
Hello I have to have tooth 18 and possibly 17 extracted due to a cracked root and infection. I am 53 years of age. Can I get away with not getting implants to replace these teeth?
Hi Dr. Amin
I am planning to get a titanium implant for a lower 2nd molar that was recently extracted. The 1st molar has amalgam fillings and I was wondering if that would cause problems with galvanic corrosion.
Thanks.
Not a concern. Very anecdotal information on galvanic interactions.
I’m 32 and had my last molar lower left side removed , do I need bone graft and implant?
Hi,
I got all four of my wisdom teeth pulled as well as a bottom second molar. They pulled the molar because it was decayed and cracked, and my bottom row are overcrowded anyway. I’m now realizing from reading your excellent post that I might probably need an implant in the near future to replace that molar. However, I am pretty sure that they did not do a bone graft. Will that negatively impact my ability to get an implant? I’m getting very concerned about bone reabsorption and tooth over-eruption, since these are things that were not discussed with me prior to getting the molar removed.
Thanks for your help!
Forgot to mention that I am 24 years old!
You don’t need a bone graft all the time. Just get it done quickly because you are 24. See a really good DDS! Happy New Year!
My last back molar in the back on the top right was extracted 6 months ago. Since then, I know my teeth have shifted a bit; the spaces are larger between some teeth. I have a grinding my teeth problem at night and some problem with my jaw (TJM). I don’t think my teeth are in good alignment. Should I have an implant done or braces?
Braces first..ALWAYS!
My dentist filled a big cavity in #15 two months ago, and it still hurts. She recommends a root canal, which my plan will cover in 2020, but I don’t know if I can tolerate the pain for 4 more weeks. Can I just have #15 extracted and not replaced? I’m 44.
correct
My son is 18. It has been recommended that he have #15 and #18 pulled. He has a retainer for both top and bottom. Will he need implants to maintain the structure of his jaw or just new retainers? Also, will he have issues chewing? Thanks.
Likely will be fine without them since losing the “pair” that chew against each other. Plus he is a bit young..
When I was 27 i had the removal of all my wisdom tooth due to they were laying horizontal. In prior years I have had a root canal on #13 and the tooth continue to break within days and I only have the root of the tooth. Years later I had root canal on #28 and also, within days the tooth broke and feel out completely. I have a chipped # 31 and is causing pain and was recommended a root canal. Yet, I fear i will also fall out. Should I proceed to extract or should I do the root canal and hope for the best.
It sounds like you had root canals on teeth that were NOT savable in the first place. I would go to a different DDS for the crown/root canal!
It sounds like you had root canals on teeth that were NOT savable in the first place. I would go to a different DDS for the crown/root canal!!
Hi Doctor,
I am 25 years old. I had a root canal done on molar #18 and it is now infected. I also have a fractured molar #15. My dentist recommended a root canal for both but I do not want to do that and end up with more infections. Both of the teeth are starting to become painful and I would like to extract them. If I extract both, do I need to put in implants for both? Would I be okay without any implants? If I do have to get implants, how long could I wait?
Thank you for your time.
just take out both if they are that bad and do not replace them. That should be fine.
Will not replacing these molars cause major issues for my other teeth in the future and/or my overall health?
Hi Doctor,
I am 25 years old. I had a root canal done about 4 years on tooth #18 and it now has an infection. I also have a fractured tooth #15. My dentist is recommending root canals for both but I do I not want to do it and end up with more infections down the road. They are becoming painful so I would like to get them extracted. If I remove both, can I leave that space empty or do I need 2 implants? Will all of my teeth shift backwards?
Thank you very much for your time.
My #18 bottom molar is cracked and requires removal rather than crown. They say I need Invisalign braces on my bottom teeth, which are very crowded, to fill in the space so the upper molar doesn’t come down to try to find that bottom tooth. I still have the wisdom tooth beside it. Do you think braces are necessary?
braces are always a good idea!
You have a clear, concise style that is informative. With continuing pain after 2 root canals on upper 2nd molar I am ready to get it pulled. Am hoping to get away w/ no implant as have already spent thousands and am tapped out. Was told by a friend I should make sure they remove the periodontal ligament during extraction. Is this standard practice? Thanks.
It will dissolve on its own once the tooth is gone. Nothing needs to be done any differently than a standard extraction. Sometimes there are holistic dentist that make up strange procedures that have no scientific basis.
It will dissolve on its own once the tooth is gone. Nothing needs to be done any differently than a standard extraction. Sometimes there are holistic dentist that make up strange procedures that have no scientific basis..
Thank you for your informative article and delightful, direct communication style, responding to questions.
My #2 bottom molar needs to be extracted. But my wisdom tooth has not come through. When I have my #2 molar will the wisdom tooth come through? I am thinking of waiting to see if the wisdom tooth comes in after extraction instead of getting an implant. What is your recommendation?
In this article says
So do you need to replace this tooth? If it is the bottom molar and you still have the upper opposing molar than I would typically say yes. The reason for it is if you do not replace the bottom molar, the upper opposing second molar will begin to over erupt out of its socket trying to reach its old partner that got extracted.
My lower molar needed an implant 7 years ago, I couldnt afford it back then. My x ray shows top molar has erupted from socket , is there any option to fix it besides extracting? Is it to late to get implant ,which kind do you recommend and do I need to get implant for upper and lower molars?
Thank you
You can have your upper molar pushed back in with braces in just a few months. It is call orthodontic intrusion!
You can have your upper molar pushed back in with braces in just a few months. It is call orthodontic intrusion! n
Hello Dr. ,
Tooth #31 is decaying because it cracked while eating some chips , dentist said it was too far gone to save and that a root canal , bone graph and implant followed by a crown will be necessary .
I have insurance but supposedly they don’t pay for the bone procedure .
Would my best option be to extract #31 and #2 to avoid the upper #2 hitting lower gum and getting a retainer like I read in one of the comments? I’m scared of future issues with bone graphs and infections .
Also I have #17 , which I believe is giving me issues with my ear canal .
Would I have any issues removing the teeth I mentioned?
Although you may read about comments with problems, most pts that are treated by a skilled DDS have no problems at all.
Just replace 31 and keep 2
Dr. Ramsey,
I am in a similar situation at stated above however my dentist is recommending that my bottom 3rd molar #32 be extracted and have an implant place. I am not leaning towards the implant due to extreme cost. She stated that if I don’t get an Implant that it will cause me to talk funny and my upper molar will start to fall down. However, my upper molar #1 has a root canal and a crown so is this possible? I am also in braces which are scheduled to be removed in the next 12 weeks. What are you suggestions
Are you sure? Who would place an implant for a wisdom tooth…that is crazy!!
Hi,
I went to the dentist who told me I need a root canal on my top last molar. My wisdoms teeth have not come through yet. I am 28 so may not but on the X-ray it did look likey wisdom tooth was impacted on my last molars root. The root canal will cost $1600. Is it worth it? Or would extraction be an option to consider?
Thanks
I would do the root canal if it were my tooth.
How about a cantilever teeth for a second inferior molar?
Really bad idea. Way too much force. Will fail miserably 😦
No wisdom teeth, and my #14 (US) was extracted last year. Fully healed and no chewing problems. You have mentioned 14 is super important. Can you please clarify a bit? So an implant is absolutely necessary even if partial half-tooth contact still exists?
Yes. This is a critical tooth that anchors the upper jaw at the base of your cheekbone.
People that are missing this to tend to have facial changes over time making them look old.
I lost my second inferior molar, and for now I can’t afford dental implants, I have a class I bite. My first inferior molar is crowned. My question is, may I enlarge the crown of my first molar in order to have more teeth to match my second superior molar, like 3mm.
It is not a bad idea but over contouring teeth may exchange one problem for another. Over contoured natural teeth tend to get pockets and periodontal disease. This is a decision from a dentist to make
Thank you for your answer. How much do you think a molar can be enlarged in order not to have problems?
Not too much. Not greater than 13mm
Great well written article!
I had tooth #15, 16 and 17 removed. The lower ones were removed first. Do I need implants?
Usually not
I have a crown on my right 2nd molar which has a #7 pocket. That’s what my dentist said when I had my teeth cleaned. He referred me to a periodontist who says I should have an implant. Could I have the tooth removed and then get a permanent retainer or maybe just treat the molar and see if it gets better. I have no pain or bleeding. What are your thoughts.
This is possible but typically retainers will not prevent the super eruption of the tooth where it starts to stick up higher than the rest. I am not sure whether you are replacing the upper or the lower but the article does discuss the difference between upper second molars and lower second molar dental implants
My dentist extracted number 17. There was some complications he had to grind on the crown in order to get the wisdom tooth extracted. He took an xray after. There was no bone graph or implant. What should I do?
Likely do nothing has nothing is necessary but of course I have not seen you
Thank you for the article. When I was about 16 I had an infected molar extracted, my first molar on the upper left side. Later on my wisdom teeth came in, and I had all but one removed – the upper left wisdom tooth was left in to “replace” my missing first molar. I am now 26, and the gap has fully closed, but it doesn’t feel great – my second molar is tilted upwards towards the old extraction space, and does not touch the bottom molar when i bite down. when i bite down i only feel it on my right side. I think this has caused me to grind my teeth a lot and my right molars are showing a lot of wear. The part that bothers me the most is that my top midline has shifted a lot to the left. I don’t know if this is caused by bone reabsorption, but my top front teeth look really asymmetrical to me now. i really used to like my smile, and i really want to get this fixed.
What is your recommendation? Do i need an appliance to open up the extraction space and place an implant in it? Will I need braces to move my midline back or will that happen naturally once the implant is in? will they even do an implant since technically i have the right number of teeth on both sides because my left wisdom tooth was not removed? Will I need a bone graft?
the most simple solution for you is to just get orthodontics. Whether that be in this align or classical braces likely this will fix the problem your young age of 26. The tooth can be made to be upright and correct the midline etc. Make sure you see a very skilled orthodontist and do your due diligence.
Hello Dr.
Two weeks ago I had my upper second molar extracted. I’m constantly rubbing my tongue against the tooth that is next to the one extracted. Also, I’m sucking my cheek against this same tooth. Is this a normal nervous habit that happens after an extraction?
Thank you.
not really….
sorry
I live you Canada. Due to infection since April, I’m supposed to get molar 47 removed, 48 has already been removed years ago. I was going to leave it without an implant, because they are so costly and take time, many appointments, to put in place but after reading this I should change my mind and have the implant, right?
yes!!
Just wanted to say — I’ve been guilty of doing these same habits over the past few years since a gap was created in my upper molars a few years back. To the point that I would make a clicking sound with my cheek from sucking the cheek against my teeth which eventually started irritating my cheek. I have since had a root canal in one molar and then just had the second molar removed last week. I was hoping with the extraction that I would stop the habit…
Dr. Amin,
I am a 57 year old male who had the #15 upper molar extracted several months ago. I was planning to have an implant done. I was told I will need the sinus lift procedure first, based on CT scan exam.
My question: What would be the drawbacks if I elected to not have the implant done. What would be the likely effects on long-term dental health, appearance, etc? Would I be in any danger of other upper teeth shifting over time, lower molar erupting, or any other concerns? Just based on my own judgment, I seem to have the Class I type of bite you discussed in your post where my lower molar contacts half of the next upper tooth over when I bite down. Thanks.
it sounds like you kind of answers your own question. You definitely landed on the right article. The benefit of adding the upper second molar is often up to the patient
I have the exact situation in the example given in the article: my bottom second molar was extracted 7 years ago. The upper second molar is now supra erupting. I can’t afford a tooth implant. Can extract the upper molar, then get a permanent retainer to keep teeth from moving? (I currently have a permanent retainer on my bottom teeth.)
very good idea . 😉
Dear Dr.Amin,
I might need to get my bottom first molar removed. I have not got my wisdom tooth extracted. Is it possible for my second molar to replace my first molar and the wisdom tooth take the second molar’s place?
Really great question! You have to be very young in order for the wisdom tooth to drift into place of another molar. Typically he would need to be between 10-15 years of age. Orthodontically is hard to move that tooth forward after you are older.
Hi, I need some advice regarding this. I’m 30 now, I had my bottom left 2nd molar removed due to it partially being decay by the wisdom tooth partially erupted.
I had both the TOP wisdom tooth removed already.
I did not had my bottom left wisdom tooth removed due to it being too near to the nerve.
Now that it is clear from the nerve, i had some problem of it affecting the 1st molar and it is crooked outwards of alignment.
My question is, should I do extraction+implants OR should I do a braces to fix the alignment of the tooth?
BRACES!!!
Hi, can u kindly explain why braces? Is it cheaper cost/ better benefits? Thanks
keep your teeth if you can….teeth are always best….THEN implants!
i had my 18 and 19 tooth removed. bone graft is done. I am extremely sensitive to the changes in my body or surroundings. if i decide not to do anything like implant how will my teeth shift. ? I am 42 year old female and in great health. all other teeth are also great. Dr said to have to bone graft just in case so he did it during extraction. I was hoping i can chew from that side (may be soft food ). i would really appreciate ur advice doc.
Part of why you are in great health is because you have 18 and 19!!
It is a slow downward spiral once all the molars on one side have been removed.
You will do great. I have many patients just like you 🙌🙏
Seems you may not have understood her question…
Just saw my dentist. My #31 tooth has cracked since getting a root canal 4 yrs ago.
Lots of pain but advil and tylenol are alleviating it a little. I will def have my tooth extracted, but I am up in the air about getting an implant. I did read your post about replacing the cracked tooth with an implant, but cost is my concern. Can I get my tooth extracted this month, and maybe a year or two from now get an implant? Thanks so much.
yes!
Hello I’m 27,
Theres a possibility that I might need to get one of my 2nd molar on the upper jaw removed,
Is it nessasary to get a dental implant?
Will it change the shape of my jaw due to bone reduction?
My bottom second molar tooth broke a few. month back ehile I was eating. I basically left it untreated and now the right side of my face (jaw) is constantly throbbing and cramping up. What exactly should I do?
root canal and zirconia crown if it can be saved!
Hello, your article was very informative – question, I’m 66 y/o, my 31 molar had a root canal with a crown placement many years ago, but since I had it done it has always bother me, while chewing food on and off. On occasion I’m unable to chew with that tooth, too painful. My dentist said the following: sending me to see an Endodontist or a Prosthodontist. I will like to know what would be your suggestion.
Endodontist
My second tooth to the back on the top is falling out what should I do
Hi ,
I have my bottom second molar extracted. My surgeon told me there is a good chance the top molar would shift down, since teeth need contact with one another. But I don’t intend to get a dental implant, what are other possible actions rather than ignoring it. As it would cause further periodontal diseases to the other healthy teeth.
Not too many options since it is the last tooth.
Thank Dr for the implant I did it was buried underneath my gum. However through the x ray, I saw the distance between my implant and natural tooth was a bit far apart. How it affect my implant crown placement? How there be a gap?
*would
I would have to see it
Sorry Dr cant provide you with the photo as it does not support photo attachment. Have more questions in mind. How long would it take to make get the crown after uncovering the buried implant.? And how do make implant for second molar lasts a lifetime.
If the tooth is in the back of the mouth just a few weeks should suffice.
Wait longer if it is in the front of the mouth. Unfortunately uploading of photograph is not permitted At this time due to possible security breaches
with regards to your other question… Dental implants are not permanent. please watch this video to learn more about this misleading information
Hi Dr,
I am having systemic symptoms such as flu and dry mouth. My periodontist was not sure is it titanium allergy. But it is making me sick and fatigue. Should it be removed with zimmer biomet.?
The chance if it being your implant is Lower than half a percent or less. That is a good brand. Likely just coincidence!! Get well! 🤗
Thank you for sharing Doctor! I had my 32nd molar extracted 6 years ago (age 24), similar to this story. But my #1 top molar rests/bites on my bottom 31st molar. Originally my oral surgeon said an implant may not be necessary because it was less like for the upper tooth to erupt. Would you agree? Would I need an implant to prevent jaw bone loss? Thanks for your help!
no need!
Hello Dr.
Thanks for your time…
Do you prefer zirconium implants vs titanium due to its biocompatibility?
What implant type do you recommend for all missing molars in back of mouth, both top and bottom? I hate wearing partials- they make my mouth feel like plastic. Getting implants would help me eat and enjoy food again. My molars were extracted in August 2018 when I decided fully detox my body and get rid of teeth that once had mercury fillings and composite fillings due to their toxicity to the body. I now need teeth again! I’m heavily considering Zirconia because metal doesn’t belong in the human body.
Thanks in advance!
this link on zirconia dental implants should help you make that decision
I’m in trouble. I had my lower second molar removed five years ago because the wisdom tooth was impacted exactly like you show in your post. And my upper second molar has erupted out of its socket. My dentist had told me implant was optional. Is there any way to push it back into socket, or do I need to get it removed? Thanks
yes the upper can be intruded via orthodontics but it is difficult
Hi Dr,
I have the same situation as Husain and i am in dilemma. I am currently on braces to intrude the upper tooth so that I can do an implant but it’s not working. My orthodontist suggested to intrude it using screws to put back in place. Do you think it will work? Or should I just forget about the idea and take out the tooth when it touches the lower gum?
Thank you so much for your professional advice.
I have screws in my daughter’s jaw to move things around…. That should probably answer how I feel about it 😉
Hi doctor,
Thank you for replying my previous post.
Based on your previous comment is it recommended to do the screws ?
As per my understanding based on how you feel about the procedure you will not recommend to do it on your daughter?
My apologies if there was any misunderstanding
Thank you
I am 66 years old. I had molar 20 extracted more than 25 years ago and never had a replacement done. Other than that all my other teeth are healthy. Recently I visited a new dentist and she suggested I get replacement done with a permanent bridge. The missing molar has never bothered me, esthetically nor otherwise. Should I get the replacement after all these years and have 2 healthy molars grinded down to fit a bridge?
How long can I wait from the time my implant post is placed, to having the crown put on? They say 4-6 months is typical, but can it be longer? Maybe 6-12 months? Pros and cons? Thank you!
that timeline should be okay. The main disadvantages would be if the other teeth shift in the area or the bone begins to shrink more aggressively. 6 months is most ideal but I’m sure it will be okay
I am 47 years old and been on osteoporosis medicines for 9 years due to premature menopause. I have an upper tooth (the one next to the last one) that has a crack and needs to be removed. I know the risks of osteocronosis of the jaw and higher risk of dental implant failure due to the medicines. Should I try for the implant or a bridge?
Thanks
almost all of them heal just fine because you have been taking hopefully and oral bisphosphonate type of Fosamax medication as to oppose to an intravenous forms. See your dentist and have a long discussion about this but generally speaking he does not occur very often on the upper jaw!!
Your article has been helpful! I am deliberating on an implant after tooth #2 is removed. I read your article and it mentioned the bottom tooth was a bit more important so I am thinking about saving the money. Any additional thoughts would be appreciated.
Case by case basis of course…your dentist should help you with this decision
I had #15 pulled in January 2018, the socket is all healed over now and I am used to the missing tooth but I am considering the possiblity of an implant. My question is can an implant be installed into a socket that has healed over and has had it’s tooth missing for some time? Can bone that has filled the empty socket be drilled out for the post? Better asked, does an implant necessarily need to be grafted and installed at the time of tooth extraction or can it wait a year plus down the road? Thank you.
no problem at all!
Hello, very informative article – question, my second molar is fine but it is my pre molar tooth #14 (USA ) that needs to be extracted – would that tooth need to be replaced? Thank you in advance
YES….super important tooth
Can you elaborate? I’m in a similar position (May need to have #3 extracted) and really don’t want to have to get an implant if I can help it. Any further insight would be great!
Why is that ?
I’m having tooth 31 pulled. They strongly recommend an implant. What are your thoughts on pros and cons, please.
Isn’t that what he spends the entire article discussing? Do you want him to copy and paste the article as his reply to you?
When removing a lower 2nd molar with no wisdom tooth behind it, is it beneficial to get a bone graft even if you are not going to get a dental implant?
NO!
Hello.
Let’s say I need my second upper molar extracted. Tooth 15. I still have my first molar as well as my lower molars(save for the wisdom teeth). Will I need to replace the extracted molar or can I live without it?
you are on the proper post that will answer your question. Just read the whole post and look at the pictures 😉
How long does it take for the gum tissue to grow over a second molar extraction site after placing a bone graft and membrane for ridge preservation? I have other dental work that needs to be done that is not as urgent as the extraction ( removal of amalgam fillings in adjacent teeth) but I am concerned about the amount of time for the socket to heal over so no amalgam particles and associated liquids get into the open wound.
If you really want to be very safe I would give it four weeks
Hi,
I am 20 years old , and I just came back from the dentist who said that I have to get a root canal on my second molar #15. I was thinking if maybe it would be a better idea to have that tooth extracted since I still have my wisdom teeth. If I extract that molar, will my wisdom teeth move forward replacing the missing molar?
very unpredicatble at your age. Maybe if you were 5 years younger. Ask your oral surgeon. He is going to depend on the position of your wisdom tooth in relationship to your second molar. Some of them are inclined and a very favorable position while some of them are not.
Hi Mr. Ramsey, thanks for your article. I recently removed an upper second molar and no third molar behind. I want to know if I could experience any jaw problems or drfting teeth if i dont implant the missing upper second molar ? I’d be grateful to your answer.
Hi Grace….this post covers your question. You will likely be fine without as long as your bite is normal class 1.
Hello!
I appreciate your article and i have a question.
I recently got my bottom 2nd molar (18) extracted 3 days ago and the other 2nd molar (31) extracted exactly a month ago. However, I still have my wisdom teeth halfway out of the gums. The dentist informed me that the wisdom teeth will close the gap in between the 3rd and 1st molars. How long do you think this will take? Is it safe or should I get implants immediately?
Thank you for your time.
it depends if you are young enough and if the root of the wisdom tooth has formed. Generally you would still need to be in your teens for this to work but sometimes it happens!
Had emergency visit 6/8 on 2nd molar ‘next to wisdom on right lower side because feet, ankles swollen ~8days becoming worse, blurry vision viewing TV nite before, & a 20 yr old root canal capped & filled, sorta loose, ached if ate hard food & gum was very red & I felt sick. Knew it had to be pulled now & it was at 5p by Michael Ahn @ U Dream Dental in Fullerton who I never saw before but felt lucky to find someone. He also said he was going to pull my wisdom and do bone grafting which he did immediately. After several shots of novacaine. Prescribed Z pak antibiotics, prescription mouthwash, 800 ibuprofen (I refused steroids for swelling as I read it causes bone loss) next 2 days pain& could barely talk nor open my mouth, size of apple swelling, pain in ear, face, jaw throat & bad pain when swallowed. Swelling/ugly bruising went down slowly after 10 days, I was better & had sutures removed in 14 days. He said it healed well & return in 3 weeks 7/13 to remove membrane. Here is my QUESTION. @ 75 yrs old, on no medication at all, basically healthy walker, exerciser & eater…..Is this previously infected site 100% OK for an implant after all the bone grafting material he put in? Also can the Bone Grafting become infected? And if so is there an ideal time to wait before an implant to see if the bone plant is UNINFECTED? Thank you for your honesty which I need. I want to do what is best for my health. My landline is 714 680-3467…busy in mornings walking & sr.centers, etc
Thank you for providing such an educational blog! So without a doubt, upper first molar (3, 14) extractions should definitely get implants? Or does bite support still factor into the decision process?
Hi,
I had my 2nd molar bottom patient left extracted and prepped with bone graft and membrane which will be removed 5 days ago (now 120hrs out from procedure)
The molar was in bad shape – route canal with cap falling off 5 days before extraction. Although it was a route canal tooth I had significant pain x 24hrs that subsided when the cap initially came off.
The procedure was done with a nerve block and was uneventful. Once the block wore off the pain was excruciating and I have required round the clock pain medicine for the last 5 days.
While I imagine that is expected my concern is the significant swelling that remains which now includes a hard area ptotruding like a small golf ball. I saw dentist for a check yesterday and he felt it was as expected and to let it progress without intervention.
Last night sleep was interrupted and the hard swelling has not improved at all with some new pain with opening my mouth (I am exercising my jaw gently to avoid it getting too tight).
I have no fever, no redness, no signs of dry socket otherwise.
I had cdiff from long term abx for a difficult upper implant in my past so to date have not been on abx for this procedure.
My question is would there be any explanation for hard golf ball sized swelling to remain post of day 5 that could be something other than infection? Is it possibly just a normal reaction to the procedure and bone graft to that will settle in time and if so what is a reasonsble timeframe?
My dentist is closed today and I am comfortable with Advil round the clock but need some understanding of expectations.
I know you can’t give medical advice but would appreciate your expert toughts?
this part is not good ….I had cdiff from long term abx for a difficult upper implant in my past so to date have not been on abx for this procedure.
Read this post on antibiotics. You are likely infected internally. I always prescribe a yeast based pro-biotic to hep reduce chance of C. diff which is a bad thing!
It may go away on its own but if infected in the bone you will lose the graft or it will be soft at time of implant leading to poor ling term prognosis if the implant that is placed into it.
Thanks so much for answering this question!
As a diabetic should I get an extraction and implant during 1 visit or should I do the extraction 1 day and return later to do the implant?
diabetes adds a risk….two stage ‘may’ be a better option.
Hi, I’ve had teeth #3, 17, and 18 extracted. I’m wondering..
A.) Is closing #3 with braces or aligners an option or will it shift my smile? Should I be replacing with an implant? I also require the spacing to be opened back up…
B.) I really would like to straighten my teeth completely, they are not terribly crooked but definitely a slight overbite that has always bothered me! For best future results and no issuses down the line, braces or aligners?
C.) What to do about #17 and #18???
Thank you so much!!!!!!
#3 is certainly an implant! You need the first molars for sure. You might need an internal sinus lift though.
Hello Dr.Ramsey,
I am 21 years old and I had my tooth last upper molar removed. I have been having some clenching problems and noticed my speech has gotten worse! I still haven’t had my wisdom tooth yet. I really don’t want get an implant because it’s very expensive and would need to save up. Is there a cheap way I can get this fixed I don’t want live without a tooth at a young age. I was thinking to get a bridge but I don’t know how bridged can work for the last molars. Can you please explain to me the best ways that can help me for the long term. Thank you in advance doctor!
In the long run the dental implant will be the cheapest option. It is less invasive than a bridge because you don’t need to grind down the other teeth. Bridges do not last more than 7 to 20 years at best in the back of the mouth. They do much better in the front.