Is it necessary to extract my tooth and get an implant?

Joined
May 31, 2016
Messages
3
Good afternoon everyone,

About 10 years ago, I had a large cavity on my upper left 6th tooth. I got treatment on one of the roots and had a silver crown inserted. For the last few months, I've had a bit of pus discharge from the gum above the upper left 6th tooth. I went to the dentist recently and was prescribed antibiotics for the infection. I also had scans taken and the dentist advised me that the upper left 6th tooth and roots need to be completely extracted and that I need an implant. I have no pain in the tooth and I am scared of having this procedure done.

Could you please kindly have a look at the attached x-ray scans and provide your independent opinion on this matter.

Thank you very much.
 

Attachments

  • Upper left 6th tooth.jpg
    Upper left 6th tooth.jpg
    96.9 KB · Views: 233
  • x-ray 2.jpg
    x-ray 2.jpg
    97.3 KB · Views: 254
  • x-ray 3.jpg
    x-ray 3.jpg
    96.3 KB · Views: 243

honestdoc

Verified Dentist
Joined
Jun 14, 2018
Messages
1,535
Solutions
165
UL 6th tooth (in the US, the tooth is labeled #14) does have extensive damage and missed 2 (Mesial buccal and MB2) canals. The tooth does need to be extracted because it is a source for infection and contamination.

The extraction process for this case is not bad. Since there is already an infection, the bone around is softer and less prohibitive to remove the tooth (the body wants to get rid of any infected material). The tooth will come out in pieces so don't let that scare you.

You may not need an implant. Implants are expensive and are just elective. I think leaving the space is realistic. Back teeth will shift (tip) forward and the opposing tooth will erupt up. However, judging from the upside down bitewing x-ray, your bottom opposing tooth will not hyper-erupt due to opposing the tooth in front and the upper back tooth should minimally tip. As long as you are functioning without difficulties, you may not need an implant.

If you desire an implant for certain, I recommend placing bone graft immediately after tooth extraction to strengthen and prepare for future implant. You may also need sinus lift surgery to accommodate an implant.
 

Vote:

MattKW

Verified Dentist
Joined
Mar 18, 2018
Messages
2,080
Solutions
152
Extract it because even though the RCT could be redone, it has a poor crown on it that would need replacement too. Have to disagree about leaving a gap. Tilted teeth create cleaning problems. If you want to leave the gap, then I would suggest extracting the wisdom tooth to minimise risk of 2nd molar tilting over. Aim for implant in long term, but don't let whoever did the RCT or crown anywhere near this.
 

Vote:

honestdoc

Verified Dentist
Joined
Jun 14, 2018
Messages
1,535
Solutions
165
Leaving a gap is what most of my patients could only afford. I live in an expensive state and most of my patients are poor and put almost all of their money into housing/rent much less into dental prosthetics like implants. I have no opinion with removing the wisdom tooth to minimize #15 tipping. However I always prefer the least traumatic plan. I do agree that tipped molars create undercuts for food trap but I observe many patients adapt...they don't have much choice.
 

Vote:
Joined
Dec 18, 2018
Messages
13
That tooth is very infected and needs to be removed ASAP. Additionally, the tooth is right on the sinus so most likely it is draining into your sinus cavity and causing a widespread infection. Start off by taking a few days of antibiotics, Augmentin or at least Amoxicillin, and remove the tooth and place bone graft to close the space. If you can afford an implant great, but at a minimum you should remove the infected tooth to prevent infection from spreading to the rest of your body.
 

Vote:

Ask a Question

Want to reply to this thread or ask your own question?

You'll need to choose a username for the site, which only take a couple of moments. After that, you can post your question and our members will help you out.

Ask a Question

Members online

No members online now.

Forum statistics

Threads
7,566
Messages
22,149
Members
11,344
Latest member
JudeRossi

Latest Threads

Top