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Posted 9/13/2022 11:13 AM (GMT 0)
OK-- bottom line: I need to have a lower rear molar removed ("#19") as well as a nearby wisdom tooth ("# 17) removed. So after that's done, I'll have a far lower rear molar in place, then a gap, then more teeth.

My question: what to do as a follow-up. I suspect they will push doing an implant. From everything I've read, I would rather not roll that die. My first choice will be to do nothing. If it doesn't bother me, then situation resolved. But if it does bother me, what choice(s) do I have? Can one get a "false tooth" and how does that work? I've been blessed with good teeth. Crowns and many fillings, but no issues until now.

Mel
Posted 9/13/2022 2:30 PM (GMT 0)
I was in a similar situation, with the added concern of 'lower jaw necrosis' from Prolia injections. An impacted wisdom tooth broke through and became infected so I had it cut out. It was up against the adjacent molar which then became wobbly. As usual, I researched the topic and ultimately chose to go with an implant for that molar despite the cost and pain. That tooth (and now a couple of others I replaced later with implants) performs very much like a natural tooth and the fit is fine. If you allow a tooth to go missing, the surrounding teeth will go out of alignment which will effect your bite and chewing ability.

A 'false tooth' is wired to the 2 adjacent teeth at the base.

If you go for an implant, don't get the cheap, fast ones as they eventually fall out. The ribbed titanium ones I have are best, and the cubic zirconium ceramic crowns look very natural as well. Best of luck, Mel.

Rich
Posted 9/13/2022 3:02 PM (GMT 0)
Mel, I'm no dentist but I do have a little experience with permanent bridges as I have two of them. I opted for bridges rather than implants because of the trouble, cost and sad stories I heard from friends about implants.

My understanding about your situation is that for #19 a bridge (false tooth) is possible as long as #18 and #20 are fine. They will prepare 18 and 20 then permanently attached a false tooth via bridge between the two good teeth. Google "permanent bridge" and you will get details on the procedure.

Re the wisdom tooth there is likely no chance for a bridge because there are not good teeth on both sides. However, are you sure that the wisdom tooth really has to go? I've had several opinions over the past 40 years that one or more of my wisdom teeth need to be pulled. I have resisted and still have them all with no problems. Even if it does have to go, I'm not sure you need to replace it. Many people have wisdom teeth extracted, even as children, with no replacement.

Good luck,

Jim
Posted 9/13/2022 4:13 PM (GMT 0)
I had my lower wisdom teeth removed in my 40's and still have the uppers, as they have never erupted. Brief mention of wisdom teeth removal was made around age 20 but no one gave me any particulars, so I never had it done. Hindsight being 20/20 I had both of my son's wisdom teeth removed around age 20.

Currently I have four implants, which have only minor problems due to the fact that the surrounding teeth move around but the implant does not. Three of them were just done recently. The first one actually was a permanent bridge that I had for about 20 years. The problem is that any problem with either of the adjacent teeth becomes a problem for all three. Eventually the front tooth (#12) developed decay and I was faced with replacing the bridge for $3000, or having the bridge "sectioned", crowning #12 and getting an implant in #13 for $4000. The advantage is that each tooth becomes independent again. The rear portion of the bridge - essentially a crown on #14, remained serviceable for another decade and was recently replaced with a zirconium crown. The new materials and techniques are far superior to what was commonly used as little as a decade ago.
Posted 9/13/2022 6:56 PM (GMT 0)
Re: the wisdom tooth. They call it non functional (no opposing upper tooth). about 15 years ago, dentist wanted to pull it (cavity). He said they don't fill those. That filling did fine until it feel out recently. But no pain and no problem. I've been advised to get that pulled when I get the molar pulled.
I am 76 years old with other health issues. I really don't want to mess with implants based on what I've read. But, questions:

1) Has anyone just had the tooth pulled and lived with the gap?

2) Implants. Is that a bunch of painful procedures?

3) Same question for a bridge.

Mel
Posted 9/13/2022 7:41 PM (GMT 0)
I had an upper rear molar - #2 - extracted two months ago. There is now a gap between #3 and the wisdom tooth. I have all of my other teeth. Since the site healed, the gap doesn't bother me. I won't see my dentist until late October and don't know if she will recommend replacing it with either a permanent bridge or an implant. I'm fortunate to qualify for free dental services as a disabled veteran, but even so, I don't see any need to go through the bother and discomfort of another dental procedure for something that isn't bothering me.

I don't know if a permanent bridge is an option in your situation. But my wife has a permanent bridge for her 4 upper front teeth that doesn't bother her at all. She's had it for at least 20 years and for all practical purposes they are like her original teeth.
Posted 9/13/2022 8:14 PM (GMT 0)

compiler said...


3) Same question for a bridge.

Mel

Mel, I can't speak about the gap issue except I sure would not replace an extracted wisdom tooth. Nor can I speak about the implants except for the anecdotal issues that I've heard second hand so that info is pretty much worthless so you're better off getting first hand anecdotal comments here.

Re the bridge, the only difficult and painful part is the extraction itself. Given that it's way back in your mouth I'll just tell you that the extraction won't be much fun even with the anesthesia (unless you decide to go under completely which could be easier - I didn't do that, just the novocaine shot). From then on it's not much of a big deal. They do some prep work (read drilling/grinding) on the adjacent teeth then fit you with a temporary bridge. In a short while (I think it was two weeks?) they put in a permanent bridge that is purportedly cemented in "permanently". The one I have on #3 has been in about 20 years and still fine. The one I have on #31 is about a year old, hence my ability to remember the procedure!

Jim
Posted 9/13/2022 9:57 PM (GMT 0)
They supposedly do twilight sleep (same as for a colonoscopy).

By the way, I'm not at all thinking of replacing the wisdom tooth. The dentists claim it will give me trouble. There is a large cavity where the filling fell out. Since I'll be out -- more or less -- for the molar, they suggest we do both. Scheduled for 10/22.

Meanwhile, PSA is rising so Pylarify PSMA scan Thursday. Meet with RO following Wednes to get results.

Mel
Posted 9/14/2022 3:42 AM (GMT 0)
Retired dentist here, options:
1) Do nothing. Teeth will eventually(years) drift, both 18 and 20. Also the tooth that opposed 19 might slowly extrude. No cost.

2) Fixed bridge. 18 and 20 are trimmed (prepared) followed by impressions and cementation, just like a single crown (cap). A high % will last a lifetime. You will need to floss or proxibrush under the bridge daily. They are costly but not nearly as much as an implant and don't require surgery.

3) Implant. Success requires healthy bone (no periodontal disease) or bone loss. Sometime the mandibular nerve can be close to proposed implant location requiring bone augmentation surgery. Big Bucks! These are heavily marketed, might consider second opinion. Might also ask how many they've done, just like researching prostate tx options.
Posted 9/14/2022 9:08 AM (GMT 0)
I was told that if I had a gap on #17, I'd be motivated to only chew on the other side.... Having various types of food hit the gums isn't fun...is what I was told.
Posted 9/15/2022 9:00 PM (GMT 0)
I had my lower right molar removed when I was in my early 50's, due to a crown failure and cracking. I still have the other three molars. When the guy (can't remember what type of dentist that is, maybe an oral surgeon?) who removed my molar looked in my mouth, he said that I had been using them, so there was no reason to pull any more of them. That right top molar is above the space at the end of the line of teeth, but I don't notice anything and still chew equally on both sides. The worst part of the deal was that I experienced "dry socket" over a weekend and was in real pain until Monday when I could see the doctor again.
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