Options after Molar Extraction

[rs1971]

Hi,
I am 51 years old and as a result of a gum infection that has not responded to antibiotics I am about to lose my first tooth to extraction. The tooth in question is my forward most molar (third from the back) on the lower left hand side. I have a couple of questions about my options with respect to what comes after the extraction.

The dentist suggested that I could either get an implant or use braces to pull the rearmost two molars forward to cover the gap So my first question concerns the advantages and disadvantages of those two options. I know that an implant is more expensive, but what are the other differences? Would repositioning the other teeth via brace be more or less effective in the long run? Any other issues with either approach to consider?

Secondly, if the gap isn't noticeable as I suspect it won't be as I don't have a wide smile, how deleterious an effect would it have on my other teeth if I just did nothing? And if that were a bad idea, how long would it take for said effects to start to manifest themselves? (ie, is there any reason to rush into a decision?

Thanks in advance for any advice you can offer!

 

[Dr M]

Good day
Doing nothing is an option yes. Over time, as your teeth move, the teeth behind the gap will tilt and try and close the gap. This happens over a period of months to years. In the mean time, you might have an irritation of food going through the gap when chewing, but a lot of people get used to one gap quite quickly.
I am not convinced that one implant and crown will cost you less than orthodontic treatment. This depends on a lot of factors. If you had a " severe gum " infection, which resulted in tooth loss, it might be that you actually have periodontal disease. If this is the case, probing has to be done around all your remaining teeth, in order to evaluate their periodontal status. Any teeth that are periodontally compromised, are not ideal candidates for orthodontic treatment and in active periodontal disease I would not consider implant treatment as well. I would make sure the rest of my mouth is okay first, before commencing with the next stage of treatment. It won't really matter that much if you only continue with the next stage of treatment in a year from now.

 

[rs1971]

Good day
Doing nothing is an option yes. Over time, as your teeth move, the teeth behind the gap will tilt and try and close the gap. This happens over a period of months to years. In the mean time, you might have an irritation of food going through the gap when chewing, but a lot of people get used to one gap quite quickly.
I am not convinced that one implant and crown will cost you less than orthodontic treatment. This depends on a lot of factors. If you had a " severe gum " infection, which resulted in tooth loss, it might be that you actually have periodontal disease. If this is the case, probing has to be done around all your remaining teeth, in order to evaluate their periodontal status. Any teeth that are periodontally compromised, are not ideal candidates for orthodontic treatment and in active periodontal disease I would not consider implant treatment as well. I would make sure the rest of my mouth is okay first, before commencing with the next stage of treatment. It won't really matter that much if you only continue with the next stage of treatment in a year from now.

Thanks for all that; it is really helpful. I do have periodontal disease or at least I am prone to it. By which I mean that I have been diagnosed with it in the past and had a number of deep cleanings over the years and go in for regular periodontal maintance and take the best care I can between cleanings. What I'm trying to say is that my gums aren't perfect, but I suspect that, this one acute infection, which I think that I had under the tooth for months before it finally manifested in a severely swollen gum aside, they are probably as good as they will ever be.

 

[rs1971]

Good day
Doing nothing is an option yes. Over time, as your teeth move, the teeth behind the gap will tilt and try and close the gap. This happens over a period of months to years. In the mean time, you might have an irritation of food going through the gap when chewing, but a lot of people get used to one gap quite quickly.
I am not convinced that one implant and crown will cost you less than orthodontic treatment. This depends on a lot of factors. If you had a " severe gum " infection, which resulted in tooth loss, it might be that you actually have periodontal disease. If this is the case, probing has to be done around all your remaining teeth, in order to evaluate their periodontal status. Any teeth that are periodontally compromised, are not ideal candidates for orthodontic treatment and in active periodontal disease I would not consider implant treatment as well. I would make sure the rest of my mouth is okay first, before commencing with the next stage of treatment. It won't really matter that much if you only continue with the next stage of treatment in a year from now.

Also, with respect to the pricing, the numbers he gave me off of the top of his head was $2000 for the orthodontics and $4000 for the implant. I actually live right on the border of Mexico and while it's probably not a popular option on the board, if I decide to get an implant, I might investigate a dentist in Los Algadones (basically a hub of dental tourism).

Thanks again for taking the time to reply!

 

[Dr M]

If your periodontal disease is stable-which I hope was confirmed with a periodontist, I would rather opt for the implant treatment. This minimizes the periodontal trauma on the rest of your teeth. If you move a lot of teeth, especially those which were periodontally compromised in the past, there is a higher risk of complications. You will have to confirm that you have enough quantity and quality of bone though, to support an implant