[sharmar]

I broke a lower molar (#19) - the inside of the tooth is broken at the gum, the outside of the tooth is still OK. I visited an Oral Surgeon today. I was originally going to have the tooth pulled and be done with it. He said that if I do that, the upper tooth that aligns with the lower tooth will loosen over time since it will no longer have the bottom tooth to chew with, etc. Is that true? I'm over 60. He wants me to get a dental implant. He said that at the time of the extraction, he would place the titanium screw in one of the now vacant roots the tooth was in. He made it sound as if this decision needs to be done prior with the extraction. I have some concerns about making such a quick decision. I'd appreciate some help - thanks!

[tickle]

I could understand this procedure being done if you were 50, but not 60. Oral surgeon is partially correct, your teeth will move around and that is a given even with all of your teeth as you age.

This decision is entirely up to you and your pocket book; it will certainly not effect your looks having it out, and it will certainly not endanger the rest of your teeth for the time being.

[sharmar]

Thank you! I have a follow up question. In your opinion, if I just have my tooth pulled and leave it at that, and in the future I decide to have the implant, is it still possible? The dentist implied that the screw needed to be put in at the time of the extraction. I don't understand why the gum couldn't be opened up and the screw placed in at a later time. The dentist did say that he would fill the empty roots with bone, put the screw in, and let the jaw heal for about 3 months. Thanks.

[honestwriter]

:)
A very Genuine Question
Well first and foremost... wrt to your Age - You are 60 and Considering from a dentist's point of view... esthetics is not of prime concern. Especially cause it is a posterior tooth.
Now Discussing about your Tooth in question... this is what my Treatment plan would have been
I would have extracted the tooth and suggested you to either put in a Removable partial denture... or get an implant or leave it as it is.
Here's the Catch
A Removable prosthetic Denture is Much Cheaper than the implant... The Implant is A Money Making Little thing and the last option basically depends on the condition of your teeth in the mouth especially the adjacent teeth and the opposing upper teeth.

Suppose you extract the tooth and decide to not go for either the RPD or the implant and decide to leave it like that itself... 'Supraeruption' of the opposing tooth occurs... which means that the tooth above the tooth in question starts erupting downwards cause it does not have support of the lower tooth. This is a slow process and would actually take years to occur but... again... it depends on your oral hygiene status.
Regarding your Follow up question... Yes you are right... You can always allow your gums to heal and then place an implant... the dentist you visit probably wants to get it over now cause it is easier for him to do so... rather than opening it up later and doing it.
Now the ball is in your court ;)
Hope your doubt is cleared... feel free and ask me anything.
Cheers :)

[sharmar]

Thank you, I appreciate your input. When the doctor explained how the bridge would work, I didn't care for it. He said the price for the bridge and the implant would end up being about the same. Nowadays they bridge two caps for the surrounding teeth and create a false tooth between. The caps are glued to the existing teeth after they are ground down. I already have a cap on one of the teeth, so I'm throwing away money I've already spent. There are also hygiene issues because the new false tooth does not fit in the gum but above the gum. There is extra cleaning that needs to be done below that tooth. Because of my age, I'm seriously considering just getting the tooth pulled. Thanks again!

[tickle]

I was going to suggest a permanent bridge for that missing tooth; I have a couple of permanent bridges and find them no more work then brushing twice a day and flossing everything anyway. I have had these bridges for about 35 years now but my mouth is well maintained with regular cleaning every six months. I have all my teeth at 70.

Of course you can always have the bridge work done at a late date should you choose to do so.