Last Molar Extracted… Do I Need A Dental Implant?

Last Molar Extracted… Do I Need A Dental Implant?

Last Molar Extracted… Do I Need A Dental Implant?

My last molar was extracted… Do I need a dental implant? I have received this comment/questions so many times that I decided to write a quick post about it!

Missing Lower Second Molar –No bite support on Upper Molar after lower was lost

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 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.

Teeth need contact with one another.

Without contact with another tooth our teeth tend to drift. It will drift enough to where you will and up-biting your cheek and gum and can also become an interference in your bite causing “TMJ” which is really 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 to not aligned 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 to 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

Please 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 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 takes it does not replace it, the upper tooth will eventually be lost. He elected to have me place an 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 with 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 are 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

318 Comments

  1. Carl

    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.

    January 12, 2021 at 5:27 am Reply
    1. Fix #3 and Implant #30. That way you have one molar that opposes the other! BEST PLAN!

      Stay safe and get the vaccine 😉

      January 12, 2021 at 10:00 pm Reply
  2. BiTen

    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.

    December 16, 2020 at 11:49 pm Reply
  3. Shilpa

    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

    December 11, 2020 at 2:33 am Reply
    1. Only replace the 1st molar that is #14.

      Do not replace #16

      January 8, 2021 at 9:56 pm Reply
      1. August

        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?

        January 14, 2021 at 5:18 am Reply
        1. Your left side will likely shift but the right should be ok. It varies in each person though.

          January 15, 2021 at 1:49 pm Reply
  4. Mary Mejia

    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

    November 16, 2020 at 2:33 pm Reply
    1. 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.

      January 6, 2021 at 7:53 pm Reply
  5. Brandy

    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?

    October 30, 2020 at 9:28 pm Reply
  6. Brandy

    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?

    October 30, 2020 at 9:28 pm Reply
  7. Tooth #18 Question

    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?

    October 19, 2020 at 9:49 am Reply
    1. Ramsey Amin

      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.

      October 21, 2020 at 1:15 pm Reply
  8. Tooth #18 Question

    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?

    October 19, 2020 at 9:49 am Reply
    1. Ramsey Amin

      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.

      October 21, 2020 at 1:15 pm Reply
  9. Samy Moh

    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

    October 17, 2020 at 10:16 pm Reply
    1. Ramsey Amin

      can you post an x-ray to your google drive and show me?

      October 21, 2020 at 12:28 pm Reply
  10. Samy Moh

    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

    October 17, 2020 at 10:16 pm Reply
    1. Ramsey Amin

      can you post an x-ray to your google drive and show me?

      October 21, 2020 at 12:28 pm Reply
  11. Gabriel Daigle

    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?

    October 15, 2020 at 5:50 pm Reply
    1. Ramsey Amin

      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.

      October 15, 2020 at 5:57 pm Reply
  12. Gabriel Daigle

    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?

    October 15, 2020 at 5:50 pm Reply
    1. Ramsey Amin

      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.

      October 15, 2020 at 5:57 pm Reply
  13. Melissa

    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.

    October 10, 2020 at 2:51 am Reply
  14. Melissa

    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.

    October 10, 2020 at 2:51 am Reply
  15. Danilo

    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

    October 8, 2020 at 7:20 am Reply
  16. Danilo

    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

    October 8, 2020 at 7:20 am Reply
  17. Mayank Joshi

    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.

    October 2, 2020 at 11:07 am Reply
    1. Ramsey Amin

      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

      October 4, 2020 at 9:34 pm Reply
      1. Mayank Joshi

        Thanks Doc for your valuable and objective guidance. 😃 I sure will do some diligence once I decide to go for second round.

        October 5, 2020 at 6:43 am Reply
  18. Mayank Joshi

    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.

    October 2, 2020 at 11:07 am Reply
    1. Ramsey Amin

      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

      October 4, 2020 at 9:34 pm Reply
      1. Mayank Joshi

        Thanks Doc for your valuable and objective guidance. 😃 I sure will do some diligence once I decide to go for second round.

        October 5, 2020 at 6:43 am Reply
  19. Matthew B

    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?

    September 30, 2020 at 7:21 pm Reply
    1. Ramsey Amin

      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.

      October 4, 2020 at 9:27 pm Reply
  20. Angela

    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

    September 30, 2020 at 6:39 pm Reply
    1. Ramsey Amin

      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.

      October 4, 2020 at 10:03 pm Reply
      1. Joe Costello

        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

        November 8, 2020 at 10:48 am Reply
        1. Ramsey Amin

          At your young age I think you will be ok!
          😉

          November 10, 2020 at 9:19 pm Reply
  21. Christine

    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.

    September 27, 2020 at 3:01 am Reply
    1. Ramsey Amin

      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!

      October 4, 2020 at 9:45 pm Reply
  22. San M

    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)

    September 26, 2020 at 6:36 am Reply
    1. Ramsey Amin

      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

      October 4, 2020 at 9:49 pm Reply
    2. Jen

      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)?

      October 30, 2020 at 11:59 pm Reply
  23. Ashley

    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.

    September 24, 2020 at 9:18 pm Reply
    1. Ramsey Amin

      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

      October 4, 2020 at 9:52 pm Reply
  24. Karla

    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.

    September 24, 2020 at 6:52 pm Reply
    1. Ramsey Amin

      32 is a wisdom tooth that DOES NOT NEED to be replaced

      October 14, 2020 at 8:23 pm Reply
  25. Ashley

    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!

    September 15, 2020 at 10:35 am Reply
    1. Ramsey Amin

      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!

      September 16, 2020 at 10:31 pm Reply
      1. Ashley

        would a flipper tooth be an option in my case?

        September 17, 2020 at 7:23 am Reply
        1. Ramsey Amin

          Very uncomfortable to wear for a very last molar!

          October 4, 2020 at 10:18 pm Reply
      2. Julia

        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!

        January 12, 2021 at 4:42 pm Reply
        1. 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!

          January 12, 2021 at 9:40 pm Reply
  26. Beth Han

    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!

    September 9, 2020 at 1:31 pm Reply
    1. Ramsey Amin

      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!

      September 16, 2020 at 10:34 pm Reply
  27. Carina Asuncion

    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

    September 6, 2020 at 2:31 am Reply
    1. Ramsey Amin

      #14 is a critical tooth! First molar we get when we are six years old! It is way more important than #15!

      September 6, 2020 at 8:13 pm Reply
  28. Kabe

    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.

    September 1, 2020 at 6:37 pm Reply
    1. Ramsey Amin

      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!

      September 6, 2020 at 8:23 pm Reply
  29. Susan Gomez

    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.

    August 27, 2020 at 5:12 pm Reply
    1. Ramsey Amin

      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!

      August 30, 2020 at 7:34 pm Reply
  30. Ting

    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

    August 19, 2020 at 5:36 pm Reply
    1. Ramsey Amin

      NO —the crown is not what holds it in place

      August 30, 2020 at 8:13 pm Reply
  31. Patti H.

    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!

    August 13, 2020 at 7:22 pm Reply
    1. Ramsey Amin

      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.

      August 16, 2020 at 7:37 pm Reply
  32. Tim

    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!

    August 10, 2020 at 8:52 pm Reply
    1. Ramsey Amin

      Have two implants done at the same time for 27 and 26. You are very young!

      August 16, 2020 at 9:17 pm Reply
  33. Jennifer

    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!!!

    August 8, 2020 at 9:54 pm Reply
    1. Ramsey Amin

      not likely —Will having a top molar extracted change my appearance?

      August 9, 2020 at 7:50 pm Reply
  34. sandi anderson

    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!

    August 4, 2020 at 6:06 pm Reply
    1. Ramsey Amin

      dead link

      August 5, 2020 at 8:10 pm Reply
      1. sandi anderson

        I apologize, this link should work and I look forward to your advice:
        https://photos.app.goo.gl/8vfGHjQVK53zZKQC9

        August 10, 2020 at 7:26 am Reply
        1. Ramsey Amin

          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

          August 16, 2020 at 8:48 pm Reply
          1. sandi

            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!

            August 31, 2020 at 2:29 pm
          2. Ramsey Amin

            I would replace that one!

            September 6, 2020 at 8:42 pm
  35. JR Richards

    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

    August 2, 2020 at 8:17 pm Reply
    1. Ramsey Amin

      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!

      August 5, 2020 at 8:19 pm Reply
  36. JR Richards

    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!

    August 1, 2020 at 11:12 pm Reply
    1. Ramsey Amin

      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!

      August 5, 2020 at 8:16 pm Reply
      1. Michael T. Howard

        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.

        September 1, 2020 at 10:50 pm Reply
        1. Ramsey Amin

          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

          September 6, 2020 at 8:46 pm Reply
  37. Yve

    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.

    July 29, 2020 at 9:59 pm Reply
    1. Ramsey Amin

      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

      August 5, 2020 at 8:29 pm Reply
  38. vasu

    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.

    July 27, 2020 at 8:22 pm Reply
    1. Ramsey Amin

      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

      August 5, 2020 at 8:39 pm Reply
  39. Jo

    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.

    July 23, 2020 at 7:18 pm Reply
    1. Ramsey Amin

      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.

      August 16, 2020 at 7:54 pm Reply
  40. Barbara

    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.

    July 6, 2020 at 4:44 am Reply
    1. Ramsey Amin

      Root canal and crown!

      July 11, 2020 at 10:24 pm Reply
    2. Cherrielyn Rose

      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!

      July 15, 2020 at 5:34 pm Reply
  41. Kathleen McCormack

    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

    June 30, 2020 at 2:05 pm Reply
    1. Ramsey Amin

      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

      July 4, 2020 at 8:04 pm Reply
      1. Christina Burling

        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.

        July 10, 2020 at 8:19 pm Reply
        1. Ramsey Amin

          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.

          July 11, 2020 at 9:39 pm Reply
  42. Kyle

    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

    June 20, 2020 at 10:46 am Reply
    1. Ramsey Amin

      Thank you for your thorough question. If anything I would just replace tooth #31 and not worry about 15, 32.

      June 24, 2020 at 2:57 pm Reply
  43. RobM

    (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.

    June 19, 2020 at 1:41 pm Reply
    1. Ramsey Amin

      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 🤗

      July 4, 2020 at 7:36 pm Reply
      1. RobM

        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.

        July 21, 2020 at 1:06 pm Reply
  44. RobM

    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.

    June 19, 2020 at 1:28 pm Reply
  45. Alex

    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?

    June 17, 2020 at 10:21 am Reply
    1. Ramsey Amin

      Are you having “ orthognathic surgery?”

      June 25, 2020 at 10:27 pm Reply
      1. Alex

        Yes sir

        July 18, 2020 at 3:27 pm Reply
  46. Rebecca D.

    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!

    June 12, 2020 at 11:58 am Reply
    1. Ramsey Amin

      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.

      June 14, 2020 at 9:07 pm Reply
      1. Elena

        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

        June 21, 2020 at 3:40 pm Reply
        1. Ramsey Amin

          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

          June 24, 2020 at 2:27 pm Reply
  47. Rebecca Donohue

    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!

    June 12, 2020 at 11:39 am Reply
    1. Ramsey Amin

      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

      June 14, 2020 at 9:06 pm Reply
  48. Aaron

    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

    June 12, 2020 at 8:56 am Reply
    1. Ramsey Amin

      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

      June 14, 2020 at 9:00 pm Reply
  49. 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

    June 5, 2020 at 1:36 am Reply
    1. hazel

      btw im 26

      June 5, 2020 at 1:39 am Reply
    2. Ramsey Amin

      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

      June 7, 2020 at 5:18 pm Reply
    3. Shamica

      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 ? 🙁

      June 7, 2020 at 11:38 pm Reply
      1. Ramsey Amin

        Per the article, replacing BOTH would be awesome

        June 9, 2020 at 6:39 pm Reply
  50. Kenneth

    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.

    May 12, 2020 at 3:52 pm Reply
    1. Ramsey Amin

      A guard will not stop it. It will likely keep moving and will create a periodontal pocket.

      May 12, 2020 at 4:24 pm Reply
  51. victor J

    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.

    April 27, 2020 at 4:14 am Reply
    1. Ramsey Amin

      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.

      April 28, 2020 at 11:55 pm Reply
      1. Victor J

        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.

        June 6, 2020 at 4:16 am Reply
        1. Ramsey Amin

          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

          June 7, 2020 at 5:03 pm Reply
  52. Mariyah Martinez

    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

    April 18, 2020 at 8:19 pm Reply
    1. Ramsey Amin

      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.

      April 22, 2020 at 5:59 pm Reply
      1. Aron

        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?

        April 23, 2020 at 3:20 am Reply
  53. Andre Cheeseman

    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

    April 10, 2020 at 5:59 am Reply
    1. Ramsey Amin

      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!!!!

      April 13, 2020 at 2:58 am Reply
      1. Rose

        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.

        April 15, 2020 at 2:59 am Reply
        1. Ramsey Amin

          It should be ok but keep an eye on the upper last two molars.

          April 22, 2020 at 5:55 pm Reply
          1. Rose

            Thank you for replying to myself and everyone else 🙂

            April 22, 2020 at 8:13 pm
  54. Andre Cheeseman

    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?

    April 10, 2020 at 5:59 am Reply
  55. John M Flynn

    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?

    March 22, 2020 at 4:00 am Reply
    1. Ramsey Amin

      In this article I specifically discussed the upper molars. You may be okay without it but this really depends on your bite.

      March 24, 2020 at 9:11 pm Reply
      1. John M Flynn

        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.

        April 13, 2020 at 3:08 am Reply
        1. Ramsey Amin

          Thanks for the follow up 🤗

          April 14, 2020 at 4:17 am Reply
  56. Nicole

    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?

    February 27, 2020 at 10:07 pm Reply
    1. Ramsey Amin

      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.

      March 12, 2020 at 1:17 am Reply
    2. Ashley Holcomb

      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?

      March 12, 2020 at 4:39 pm Reply
      1. Ramsey Amin

        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.

        March 24, 2020 at 9:16 pm Reply
  57. Bui, Florence

    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

    February 27, 2020 at 4:30 pm Reply
    1. Ramsey Amin

      If not Implant there’s no need

      March 4, 2020 at 6:30 am Reply
  58. Brian Eichstadt

    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

    February 26, 2020 at 12:18 pm Reply
    1. Ramsey Amin

      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

      March 4, 2020 at 6:35 am Reply
      1. 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?

        March 5, 2020 at 7:42 am Reply
        1. Ramsey Amin

          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

          March 12, 2020 at 12:56 am Reply
          1. Aaron

            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.

            June 15, 2020 at 1:12 am
          2. Ramsey Amin

            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.

            June 15, 2020 at 6:39 pm
  59. Earl

    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

    February 25, 2020 at 4:40 pm Reply
  60. Sory E

    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.

    February 22, 2020 at 10:06 pm Reply
    1. Ramsey Amin

      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

      February 23, 2020 at 8:49 pm Reply
      1. Sory E

        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!

        February 24, 2020 at 11:41 pm Reply
        1. Ramsey Amin

          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/

          March 2, 2020 at 6:28 am Reply
  61. 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.

    February 21, 2020 at 5:50 am Reply
    1. Ramsey Amin

      Why take them out!! Keep them as long as you can!! Unless they are loose or decayed do not remove!

      February 21, 2020 at 6:29 am Reply
  62. LJ

    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?

    February 19, 2020 at 2:08 pm Reply
    1. Ramsey Amin

      Not necessarily based on the article but you need to have a proper bite in order for this to be relevant

      April 28, 2020 at 11:57 pm Reply
  63. Sunny

    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?

    February 19, 2020 at 4:22 am Reply
    1. Ramsey Amin

      Likely will be ok

      February 19, 2020 at 5:50 am Reply
  64. Candice

    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?

    February 9, 2020 at 2:16 pm Reply
    1. Ramsey Amin

      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.

      April 28, 2020 at 11:59 pm Reply
  65. Judith

    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

    February 1, 2020 at 6:01 am Reply
    1. Ramsey Amin

      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 ✅

      February 3, 2020 at 6:02 am Reply
      1. Judith

        Thank you so much. I will get implants for 19 and 30.

        Kind regards

        February 9, 2020 at 2:57 pm Reply
      2. 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.

        February 21, 2020 at 5:50 am Reply
  66. Josefina Gomez

    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?

    January 25, 2020 at 2:26 am Reply
    1. Ramsey Amin

      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

      February 3, 2020 at 6:11 am Reply
      1. Josefina Gomez

        Could a single tooth denture stop 15 from shifting? Will boneless only occur on the missing tooth?

        February 9, 2020 at 1:05 am Reply
        1. Ramsey Amin

          Correct as long as the tooth wear on the plastic tooth is always replaced/maintained. It will wear down

          February 10, 2020 at 3:11 pm Reply
          1. Should I worry about bone loss in the future?

            February 10, 2020 at 3:37 pm
          2. Ramsey Amin

            Yes. It will happen if the tooth is gone. 🦷

            February 16, 2020 at 5:48 am
  67. Josefina Gomez

    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?

    January 25, 2020 at 2:22 am Reply
    1. Ramsey Amin

      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

      April 29, 2020 at 12:08 am Reply
  68. Gerrie

    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?

    January 22, 2020 at 7:36 pm Reply
    1. Ramsey Amin

      It may be best to just remove both #2 and #31 and do not replace either one

      April 29, 2020 at 12:04 am Reply
  69. Jonathan

    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

    January 17, 2020 at 8:33 pm Reply
    1. Jonathan

      Sorry, I believe I’m missing #31,30 and 18,19 on the bottom jaw instead.

      January 17, 2020 at 8:39 pm Reply
    2. Ramsey Amin

      It’s a problem that you don’t have those molars. They are critical to you in the long term!!

      January 22, 2020 at 6:24 am Reply
  70. David

    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.

    January 15, 2020 at 6:46 pm Reply
    1. Ramsey Amin

      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

      January 22, 2020 at 6:31 am Reply
    2. Jerry

      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?

      February 12, 2020 at 2:03 am Reply
  71. Brian

    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.

    December 29, 2019 at 1:56 pm Reply
    1. Ramsey Amin

      Not a concern. Very anecdotal information on galvanic interactions.

      December 31, 2019 at 7:17 pm Reply
  72. Denise

    I’m 32 and had my last molar lower left side removed , do I need bone graft and implant?

    December 27, 2019 at 3:24 am Reply
  73. Christopher

    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!

    December 25, 2019 at 5:54 am Reply
    1. Christopher

      Forgot to mention that I am 24 years old!

      December 25, 2019 at 5:58 am Reply
    2. Ramsey Amin

      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!

      December 31, 2019 at 7:20 pm Reply
  74. William Cooney

    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?

    December 7, 2019 at 12:10 am Reply
    1. Braces first..ALWAYS!

      January 4, 2021 at 12:02 pm Reply
  75. Carrie

    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.

    December 5, 2019 at 10:19 am Reply
    1. Ramsey Amin

      correct

      April 29, 2020 at 12:06 am Reply
  76. Carrie

    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.

    November 27, 2019 at 1:25 am Reply
    1. Ramsey Amin

      Likely will be fine without them since losing the “pair” that chew against each other. Plus he is a bit young..

      November 30, 2019 at 1:14 am Reply
  77. Melanie

    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.

    November 11, 2019 at 3:12 pm Reply
    1. Ramsey Amin

      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!

      November 30, 2019 at 1:19 am Reply
    2. Ramsey Amin

      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!!

      November 30, 2019 at 1:19 am Reply
  78. Kristin

    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.

    September 28, 2019 at 3:02 pm Reply
    1. Ramsey Amin

      just take out both if they are that bad and do not replace them. That should be fine.

      October 10, 2019 at 2:41 am Reply
      1. Kristin

        Will not replacing these molars cause major issues for my other teeth in the future and/or my overall health?

        November 30, 2019 at 4:56 pm Reply
  79. Kristin Trejbal

    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.

    September 28, 2019 at 2:35 pm Reply
  80. Bonnie Flory

    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?

    September 14, 2019 at 3:56 am Reply
    1. Ramsey Amin

      braces are always a good idea!

      September 14, 2019 at 10:20 pm Reply
  81. Jason

    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.

    August 20, 2019 at 10:04 pm Reply
    1. Ramsey Amin

      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.

      August 22, 2019 at 12:52 am Reply
    2. Ramsey Amin

      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..

      August 22, 2019 at 12:53 am Reply
  82. Christine MacKenzie

    Thank you for your informative article and delightful, direct communication style, responding to questions.

    August 9, 2019 at 7:43 pm Reply
  83. 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?

    July 26, 2019 at 2:36 pm Reply
    1. Ashkaliu

      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.

      August 12, 2019 at 3:34 pm Reply
      1. Teresa

        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

        March 9, 2020 at 3:44 pm Reply
        1. Ramsey Amin

          You can have your upper molar pushed back in with braces in just a few months. It is call orthodontic intrusion!

          March 12, 2020 at 12:58 am Reply
        2. Ramsey Amin

          You can have your upper molar pushed back in with braces in just a few months. It is call orthodontic intrusion! n

          March 12, 2020 at 1:04 am Reply
  84. Jose

    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?

    July 12, 2019 at 1:36 am Reply
    1. Ramsey Amin

      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

      July 23, 2019 at 5:49 am Reply
      1. Sasha

        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

        August 30, 2019 at 8:15 am Reply
        1. Ramsey Amin

          Are you sure? Who would place an implant for a wisdom tooth…that is crazy!!

          September 1, 2019 at 4:14 pm Reply
  85. S c

    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

    July 4, 2019 at 11:01 pm Reply
    1. Ramsey Amin

      I would do the root canal if it were my tooth.

      July 30, 2019 at 5:23 am Reply
  86. Juan

    How about a cantilever teeth for a second inferior molar?

    July 3, 2019 at 3:09 am Reply
    1. Ramsey Amin

      Really bad idea. Way too much force. Will fail miserably 😦

      July 3, 2019 at 5:08 am Reply
  87. Mike

    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?

    July 2, 2019 at 4:59 pm Reply
    1. Ramsey Amin

      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.

      July 12, 2019 at 6:28 am Reply
  88. Dante

    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.

    June 29, 2019 at 12:28 am Reply
    1. Ramsey Amin

      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

      June 30, 2019 at 3:24 am Reply
      1. Dante

        Thank you for your answer. How much do you think a molar can be enlarged in order not to have problems?

        June 30, 2019 at 9:04 pm Reply
        1. Ramsey Amin

          Not too much. Not greater than 13mm

          July 2, 2019 at 2:09 pm Reply
  89. Annice

    Great well written article!

    I had tooth #15, 16 and 17 removed. The lower ones were removed first. Do I need implants?

    June 23, 2019 at 12:14 pm Reply
    1. Ramsey Amin

      Usually not

      June 30, 2019 at 3:26 am Reply
  90. Carey

    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.

    June 19, 2019 at 2:23 pm Reply
    1. Ramsey Amin

      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

      June 30, 2019 at 4:00 am Reply
      1. Shane Cruz

        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?

        August 15, 2019 at 12:42 pm Reply
        1. Ramsey Amin

          Likely do nothing has nothing is necessary but of course I have not seen you

          August 22, 2019 at 12:56 am Reply
  91. Ashleigh E

    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?

    June 11, 2019 at 2:49 am Reply
    1. Ramsey Amin

      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.

      June 15, 2019 at 9:52 pm Reply
  92. William Cooney

    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.

    May 29, 2019 at 10:00 pm Reply
    1. Ramsey Amin

      not really….
      sorry

      May 30, 2019 at 3:26 am Reply
    2. Susa Bernard

      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?

      June 22, 2019 at 9:27 am Reply
      1. Ramsey Amin

        yes!!

        June 30, 2019 at 3:42 am Reply
    3. RD

      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…

      April 20, 2020 at 8:47 pm Reply
  93. John Sterbentz

    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.

    May 16, 2019 at 9:06 pm Reply
    1. Ramsey Amin

      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

      May 30, 2019 at 4:34 am Reply
  94. Anne Marie

    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.)

    April 21, 2019 at 3:01 am Reply
    1. RamseyAminDDS

      very good idea . 😉

      April 25, 2019 at 3:22 am Reply
    2. Anthony

      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?

      January 30, 2020 at 4:50 pm Reply
      1. Ramsey Amin

        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.

        April 29, 2020 at 2:35 am Reply
  95. Daniel Lim

    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?

    April 18, 2019 at 2:06 am Reply
    1. RamseyAminDDS

      BRACES!!!

      April 18, 2019 at 5:01 am Reply
      1. Daniel

        Hi, can u kindly explain why braces? Is it cheaper cost/ better benefits? Thanks

        April 18, 2019 at 12:56 pm Reply
        1. RamseyAminDDS

          keep your teeth if you can….teeth are always best….THEN implants!

          April 18, 2019 at 5:31 pm Reply
  96. KT

    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.

    March 31, 2019 at 8:07 pm Reply
    1. RamseyAminDDS

      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 🙌🙏

      April 2, 2019 at 4:59 am Reply
      1. Mom

        Seems you may not have understood her question…

        April 2, 2019 at 6:39 pm Reply
  97. Yardley

    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.

    March 11, 2019 at 6:38 pm Reply
    1. RamseyAminDDS

      yes!

      March 25, 2019 at 5:08 am Reply
  98. Mimi

    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?

    March 11, 2019 at 9:34 am Reply
  99. Terrence Williams

    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?

    March 6, 2019 at 4:25 am Reply
    1. RamseyAminDDS

      root canal and zirconia crown if it can be saved!

      March 7, 2019 at 12:08 am Reply
  100. Enrique Pagan

    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.

    March 5, 2019 at 4:23 pm Reply
    1. RamseyAminDDS

      Endodontist

      March 7, 2019 at 12:30 am Reply
  101. Brooke

    My second tooth to the back on the top is falling out what should I do

    March 2, 2019 at 3:26 am Reply
  102. Aaron

    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.

    February 3, 2019 at 9:57 am Reply
    1. RamseyAminDDS

      Not too many options since it is the last tooth.

      February 7, 2019 at 5:05 am Reply
      1. Aaron

        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?

        April 19, 2019 at 1:30 pm Reply
        1. Aaron

          *would

          April 19, 2019 at 1:31 pm Reply
        2. RamseyAminDDS

          I would have to see it

          April 25, 2019 at 3:26 am Reply
          1. Aaron

            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.

            September 20, 2019 at 11:15 am
          2. Ramsey Amin

            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

            September 22, 2019 at 12:29 am
          3. Aaron Chan

            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.?

            January 19, 2020 at 12:21 pm
          4. Ramsey Amin

            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! 🤗

            January 22, 2020 at 6:23 am
  103. Lindsay

    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!

    December 30, 2018 at 3:22 pm Reply
    1. RamseyAminDDS

      no need!

      December 30, 2018 at 3:30 pm Reply
  104. Annette Harris

    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!

    December 17, 2018 at 12:15 pm Reply
    1. RamseyAminDDS

      this link on zirconia dental implants should help you make that decision

      December 18, 2018 at 2:25 am Reply
  105. Q Hosain

    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

    December 16, 2018 at 2:25 am Reply
    1. RamseyAminDDS

      yes the upper can be intruded via orthodontics but it is difficult

      December 18, 2018 at 2:26 am Reply
      1. Pearly

        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.

        March 3, 2019 at 4:52 am Reply
        1. RamseyAminDDS

          I have screws in my daughter’s jaw to move things around…. That should probably answer how I feel about it 😉

          March 7, 2019 at 12:39 am Reply
          1. Pearly

            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

            March 11, 2019 at 12:05 pm
  106. Judy Sinclaire

    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!

    December 7, 2018 at 12:01 am Reply
    1. RamseyAminDDS

      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

      December 12, 2018 at 1:07 am Reply
  107. Debra

    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

    November 20, 2018 at 7:39 pm Reply
    1. RamseyAminDDS

      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!!

      November 29, 2018 at 12:02 am Reply
  108. Nate

    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.

    November 19, 2018 at 5:12 pm Reply
    1. RamseyAminDDS

      Case by case basis of course…your dentist should help you with this decision

      November 21, 2018 at 10:46 pm Reply
  109. Chris

    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.

    November 11, 2018 at 3:27 pm Reply
    1. RamseyAminDDS

      no problem at all!

      November 12, 2018 at 5:12 am Reply
  110. Jess C

    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

    November 9, 2018 at 1:01 am Reply
    1. RamseyAminDDS

      YES….super important tooth

      November 12, 2018 at 5:05 am Reply
      1. Karen

        Why is that ?

        March 4, 2019 at 9:36 pm Reply
  111. Dawn Pieczonka

    I’m having tooth 31 pulled. They strongly recommend an implant. What are your thoughts on pros and cons, please.

    November 6, 2018 at 4:49 pm Reply
    1. Mom

      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?

      March 22, 2019 at 6:54 pm Reply
  112. Sarah

    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?

    October 22, 2018 at 6:54 pm Reply
    1. RamseyAminDDS

      you are on the proper post that will answer your question. Just read the whole post and look at the pictures 😉

      October 28, 2018 at 6:10 pm Reply
  113. Peter

    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.

    October 18, 2018 at 8:23 pm Reply
    1. RamseyAminDDS

      If you really want to be very safe I would give it four weeks

      October 23, 2018 at 5:28 am Reply
  114. Sharla

    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?

    October 3, 2018 at 1:52 am Reply
    1. RamseyAminDDS

      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.

      October 8, 2018 at 1:42 am Reply
  115. Grace

    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.

    September 3, 2018 at 4:44 pm Reply
    1. RamseyAminDDS

      Hi Grace….this post covers your question. You will likely be fine without as long as your bite is normal class 1.

      September 7, 2018 at 4:35 am Reply
  116. Rodrigo

    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.

    August 24, 2018 at 11:33 pm Reply
    1. RamseyAminDDS

      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!

      August 25, 2018 at 2:29 pm Reply
  117. Jane

    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?

    June 22, 2018 at 4:08 pm Reply
    1. RamseyAminDDS

      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.

      June 23, 2018 at 12:13 am Reply
  118. Sarah Cummings

    Thanks so much for answering this question!

    June 20, 2018 at 11:23 pm Reply
  119. 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?

    June 20, 2018 at 11:17 pm Reply
    1. RamseyAminDDS

      diabetes adds a risk….two stage ‘may’ be a better option.

      June 21, 2018 at 12:11 am Reply

Write a Comment

Monica D.
Monica D.
December 29, 2020.
There aren't enough words (and I have a lot of words) to tell you how grateful I am to have found Dr. Ramsey Amin and his wonderful staff. I had an enormous amount of bone loss and I was hopeless after being treated by a different doctor for two years. I had multiple procedures such as gum graft, extractions, and a sinus lift. After all of that, the doctor released me and told me he could not help me any longer. He sent me to a large teaching hospital - who also had no idea how to help me. I was terrified and embarrassed. I had been missing teeth due to those procedures since 2017. That sent me out on a journey of meeting with no less than five different dentist/oral surgeons. Most of them shamed me for the bone loss and wondered what I had done to cause this. In reality, I had done nothing. The bone loss is my body's immune system fighting me, as well as hereditary traits. In fact not only was I having difficulty being able to have implants, I also had so much bone loss that I was also not a candidate for dentures. I researched "what to do when you have bone loss and can't get implants" and I found Dr. Amin's website. Then I researched him, read his reviews, watched every one of his You Tube videos. I called and got an appointment, and kept going to consultations with other providers. I had long since stopped smiling and being social. Missing teeth and the shaming was affecting my life so adversely. When I met with Dr. Amin for my consultation he was ready. He had all of my records and had already reviewed my scans. But more than that, he genuinely wanted to get to know about my life. He was/is authentic, kind and extremely professional with so much success and experience in difficult cases like mine. He worked up a treatment plan & I came back two weeks later to discuss my options...and the journey began. I have had three procedures under IV sedation, no pain, no narcotics needed for aftercare. Dr. Amin is a consumate, experienced oral surgeon who cares about your health & understands your fears. He communicates every step of the way and will provide you with all the information you need to make a decision to improve your health. I am still working toward my end goal, and we had to zig from traditional implants and zag to zygomatic implants instead...which is the reason I chose him in the first place. If there was nothing else that could be done to get me healthy & smiling again, I knew he would have that option to help me. And of course 2020, the year of CV-19. Don't worry, Dr. Amin & his staff follow all health & safety protocols. This review is long, because it is important you know my journey, so you might understand how fortunate I feel to be healing. I'm torn, because this place is like a great restaurant, I want to shout from the rooftops how great it is, how great he is. And at the same time, I want to keep this all to myself. I come 75 miles each way to see him. I know people travel from all over the world for his expertise. Do yourself a favor, have a consultation. You won't regret it. Dr. Amin is amazing and so is his staff.
Jennifer B.
Jennifer B.
December 18, 2020.
I cannot speak highly enough of Dr. Amin and his professional staff. I have to start off and say that I am absolutely TERRIFIED of the dentist due to several past experiences. I found myself putting this off for YEARS until I was referred over to Dr. Amin. I was petrified on my first visit... but he along with his WONDERFUL staff made me feel so calm and at ease. I had quite a bit of work that needed to be done, but we found the perfect plan that worked out for me, and I couldn't be happier. Words cannot express my gratitude to each and every staff member that made me feel safe and comfortable. Dr. Amin was always so attentive in asking if I was ever in pain... and I never was. These are truly remarkable individuals, and I'm so lucky to have a dentist that I can trust. I ABSOLUTELY LOVE each and every one of you! Thank you,
D M.
D M.
December 17, 2020.
I cannot say enough positive things about Dr. Amin and his staff. I originally found them on Yelp about two years ago. I needed an implant, front tooth of all places, and was extremely nervous not only about surgery but about how it would turn out. Let me just say I just adore the staff. Everyone is crazy friendly and the whole office has a very positive vibe. The staff is adorable and always has me smiling by the time I leave. They are all thorough and on-point about what they do, and I truly appreciate it. They are quick to respond to my emails no matter the question, and their appointment reminders are great too. Dr. Amin is very thorough and reassuring, and answered any questions my husband or I had. My regular dentist had questions about the procedure and Dr. Amin's office even reached out to them at my request (my dentist said they never received a call, but Dr. Amin's staff had date, time and notes - love the thoroughness!). After surgery the Dr. called to leave me a message about how it went. Very minimal pain during healing, never any pain during any visits. It took a few tries to get everything just right for the permanent crown (color, etc), but the end result is beyond fantastic! At one point during healing I thought I was experiencing some looseness or wiggling but unfortunately couldn't make it to the office. When I was finally able to make it in the Dr. was so relieved, bless his heart. Luckily it was just a false alarm and everything checked out ok. They're a bit further out from me, but I wanted the best. I sure found it! I wish they were my regular dentist, and I'm looking forward to seeing them again for my check-up which was delayed due to COVID.
Melissa E.
Melissa E.
December 9, 2020.
I found Dr. Amin a few years back after I hadn't been to a dentist in a decade. Many traumatic dental experiences in childhood have made me so phobic that even getting a cleaning was a knee-knocking, heart-pounding trial. But finally I couldn't put off some things any longer. During my first anesthesia session, Dr. Amin replaced five old metal fillings, and during the second he did three more plus a crown. I was completely comfortable, and never felt a thing. Because they were extra-long sessions, I did sleep for about 12 hours after, but the next day I felt just fine. This past week, my back top tooth cracked in half and fell out of my mouth, and a couple days later the crown on the remainder of the tooth fell out too! Despite being nervous about Covid 19, I had to get it taken care of, so I called and quizzed the staff about precautions, which turned out to be even above and beyond what I would have expected. So yesterday I went for the tooth extraction and plug. After they put on the blood pressure cuff and put in the IV, I gradually got a little tired and closed my eyes. I sat there for about 10 minutes and thought Gee, I wonder if they're going to get started any time soon, and a minute later Dr. Amin said "Wake up, you're all done!" That was a short session, and I didn't have the kind of fatigue I did my first time. I stayed up most of the evening. Today, everything is good! I'm taking my antibiotic and eating soft foods, and there is surprisingly little pain now that the numbness has worn off. The tooth site and my cheek are a little sore, and the corner of my mouth, and I have a very slight headache, but nothing to any great level--I'm not even taking the acetaminophen. I feel good, and wide awake. Thanks to everyone at the office for a comfortable and professional job! I really REALLY appreciate you for giving me painless dental experiences!
Tanya S.
Tanya S.
December 3, 2020.
What can I say about Dr. Amin he is the best! I'm so grateful for him. He has literally changed my life and given me the confidence to smile more. I had major restorative dental work done and everything went smoothly. Dr. Amin is very compassionate and he really cares about his patients he made me feel comfortable and cared for. He is very knowledgeable and has a great sense of humor. His office is very clean and they take the patients health and safety very serious. His staff is also amazing they made me feel very welcomed and important. I'm so happy I did my research and found Dr. Amin.  Thank you Dr. Amin and team.
Sheila S.
Sheila S.
November 6, 2020.
Two implants done! Finished all procedures and I couldn't be happier. It's the first time in years I looked forward to going to the dentist. Even during Covid life the staff and Dr. Amin took care of me. There is a possibility I may move to Long Beach but I would still travel to keep Dr. Amin as my dentist.
Allison S.
Allison S.
November 4, 2020.
I could not ask for a more caring, exceptionally knowledgeable dental care provider. He's not just a dentist, but someone who looks after your immediate dental needs and helps you plan and prepare for the future.
Julia R.
Julia R.
October 8, 2020.
I've been going to Dr. Amin since I turned 16 and have been going since. Before going to Dr. Amin's dental office, I had 4 crowns that I was not happy with and dealt with it until finally I asked Dr. Amin and because I  feel comfortable and because I trust him with his work I recently had my crowns fixed and worked on by  Dr. Amin and have never loved my smile the way I do now, I can actually enjoy my pictures, I can enjoy my smile from either angle and that really mattered to me. Thank you so much Dr. Amin still and will be in love with MY smile
Aaron D.
Aaron D.
October 6, 2020.
I've been coming to Dr. Ramsey for about five years and I have to say, he is by far the best dentist I've had - ever. The staff is professional and kind, the office is exceptionally well maintained, and Dr. Ramsey is careful and extremely knowledgeable about current developments and research in dentistry. I recently had a dental implant which was a long process but well worth it. I required a sinus lift as well as a bone graft. The surgery went off without a hitch, I was comfortable and the healing process was quick and without complication. Highly recommend!!
Flo O.
Flo O.
September 21, 2020.
This is my 1st review of Dr. Amin, and in my over 17 years of being with him, my experiences with Dr. Amin and his staff have always been positive.  I don't recall a bad experience with the several implant procedures i have had.  They run an efficient office.  I like that they are proactive and reach out to their patients to remind us of routine care needed.  Dr. Amin's bedside care is impeccable.  They are also technologically up to date in terms of sending out texts as reminders, ability to incorporate any appointment into your mobile phone.  That is certainly a plus.  Keep up the great care!!!