Hello! I'm a 33-year-old male, located in the US, non-drinker, non-smoker.
I've been having some pain chewing with my 2nd lower right molar (tooth 31). My dentist thinks that it can be root canal'ed, I went to a second dentist who thought that root canal has a poor prognosis and recommended extraction + implant, and I went to an oral surgeon who thought that I could go either way, and also gave me the option of extraction + bone graft only, or extraction + bone graft + implant in the same session (he said that my tooth looks like it's amenable to doing the implant in the same session).
I like my oral surgeon (he also did my wisdom teeth last year and did a great job), but with so many options, I'm honestly confused on what to do here. I've heard that extracting a 2nd molar without replacement is usually fine for chewing, but risks the upper 2nd molar erupting, and I don't want to lose so many teeth (especially with the 2nd molar on the left side also having some issues that will probably need RCT/extraction down the road - it's just got a filling on it for now).
I'm also not sure if doing an implant in the same session is a good idea - my oral surgeon said I could wait 4 months and come back for the implant if I wanted to take a wait-and-see approach to see if I really want to replace the tooth, and I'm also wondering if doing the implant in the same session has a worse prognosis than waiting for more bone to grow back after the extraction? Or, it doesn't matter, and I should consider myself lucky that I can do it in one session instead of multiple like most situations?
Lastly - I'm quite anxious when it comes to dental work, so I've asked for valium for the extraction (+implant) since he only wants to do local anesthesia. It'll be my first extraction while awake (he did my wisdom teeth with IV sedation), so I'm a little nervous about how this extraction would go? He said he'll do a "surgical extraction" that takes ~30 minutes (implant an additional 20 min), which sounds rather... scary.
Would love to hear your thoughts. Thank you all so much!
X-ray attached is from Feb 2023.
I've been having some pain chewing with my 2nd lower right molar (tooth 31). My dentist thinks that it can be root canal'ed, I went to a second dentist who thought that root canal has a poor prognosis and recommended extraction + implant, and I went to an oral surgeon who thought that I could go either way, and also gave me the option of extraction + bone graft only, or extraction + bone graft + implant in the same session (he said that my tooth looks like it's amenable to doing the implant in the same session).
I like my oral surgeon (he also did my wisdom teeth last year and did a great job), but with so many options, I'm honestly confused on what to do here. I've heard that extracting a 2nd molar without replacement is usually fine for chewing, but risks the upper 2nd molar erupting, and I don't want to lose so many teeth (especially with the 2nd molar on the left side also having some issues that will probably need RCT/extraction down the road - it's just got a filling on it for now).
I'm also not sure if doing an implant in the same session is a good idea - my oral surgeon said I could wait 4 months and come back for the implant if I wanted to take a wait-and-see approach to see if I really want to replace the tooth, and I'm also wondering if doing the implant in the same session has a worse prognosis than waiting for more bone to grow back after the extraction? Or, it doesn't matter, and I should consider myself lucky that I can do it in one session instead of multiple like most situations?
Lastly - I'm quite anxious when it comes to dental work, so I've asked for valium for the extraction (+implant) since he only wants to do local anesthesia. It'll be my first extraction while awake (he did my wisdom teeth with IV sedation), so I'm a little nervous about how this extraction would go? He said he'll do a "surgical extraction" that takes ~30 minutes (implant an additional 20 min), which sounds rather... scary.
Would love to hear your thoughts. Thank you all so much!
X-ray attached is from Feb 2023.