I had a tooth extracted over the summer (#28, if it matters) with the intention of getting an implant. Its going to cost near $4000 out of pocket when all is said and done. Is not doing anything a viable option? I’m used to the gap, its not really visible and $4000 is a fair bit of money for me. The dentist says that the neighboring tooth will begin to move forward and mess up my bite and the tooth on the upper jaw will begin to drop. The implication is that this is a “must do” procedure, even though insurance covers none of it. I pretty much trust him but, of course, he has a financial interest in doing the work. I’m 62 years old. What do you think?
Dentist here. There are always options. the other teeth shifting or dropping into the space depends on your bite so I can’t say about that. If the teeth in front of and behind the space are suitable a fixed bridge may be a good option. Generally cheaper and much quicker then an implant and generally covered partly by insurance but you cut down two other teeth. A removable appliance is also an option, and a lot cheaper, but not an option that I would ever want in my mouth. Doing nothing probably won’t do any harm. Puts a bit more strain on the other teeth but if your bite is stable there are no great drawbacks.
I have both an implant and a fixed bridge. I did the implant after I found that my insurance would pay half. It took a long time to accomplish, and after three years, it still doesn’t feel all that natural.
If I had to do it again, fixed bridge would be my choice.
I got an implant for one of the upper canine teeth. My dentist recommended it over a bridge because he said at my age not replacing the tooth and root would allow the bone in my jaw to degrade. I don’t think I’m saying that correctly, but it’s the thing where when you are missing teeth, your jaw fills in but poorly.
It took me a while to get used to it, but it’s no problem now. It has a slightly metallic click when I tap it with another tooth and it’s slightly colder than my real teeth which is weird. But it’s strong.
Yes, the bone were the tooth does resorb after an extraction and implants help retain it. In most folks and for a single tooth it isn’t a major concern.
I got an implant for a lower molar and am glad I did. Yes, it was expensive. However, my mouth is pretty crowded and I didn’t want the other teeth moving into the space. Also, the hollow created by the tooth removal, would catch every damn thing, mostly my tongue. I’m very happy with the option though, despite the expense. I’m now used to it, and can use it to eat the same chewy things I liked to eat before the tooth was removed. There is a difference when flossing as there is more room for food bits to get stuck at the gum line, but I like it better than the crown I have on the opposite molar because it is easier to floss.
At 62, I wouldn’t consider an implant. I’ve had a couple extractions at about that age, and over 20 years since, no issues with the gap. Live with the gap, do something you enjoy with the 4k.
Or do both. Take a nice vacation to Mexico and have the implant done just as well for a quarter of the price. My ex- got an implant at the border ten years ago and is wonderfully happy with it. She had excellent work done in Chile, too.
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I’ve had an implant done and it took 6+ months across multiple dentist visits, which I understand is typical. Which is more time than a nice vacation (or nicer than I can afford).
Thanks for the replies. A bridge was initially ruled out as the adjacent teeth are in great shape and why mess with that? Plus, I was told they don’t last as long. I’m leaning toward the “do nothing” option. I had the preliminary work (graft) done and my primary dentist showed me an xray where it appeared the tooth to the rear was moving forward a bit, As long as I’'m not likely looking at major work down the road due to the missing tooth, I think I’ll go on vacation.
There’s plenty of places offering same day implants (random dentist office page) although not everyone is a good candidate for it.
If I might ask a related question?
I was having a crown replaced, over 121 years old, and jokingly said “maybe we should just pull them all and I’ll go to Clear Choice for implants”.
He smiled and replied “Folks think they are fine until it’s time for maintenance”.
What exactly is required in the way of maintenance?
That’s an old crown!
Can’t say for sure but I assume they take the dentures off by unscrewing them from the implants to clean the implants. They need cleaning similar to a tooth root.
At your (our) age, I would not spend 4k on a single tooth that is not noticeable.
Just this morning I got a crown placed on a more forward tooth. I also have two near-the-back gaps that I’m considering doing bridges for. But I’ve had them so long I don’t even notice them anymore, so I may just continue living with them. I considered implants for maybe five minutes.
mmm
A lot of dental insurance will cover implants - though there are some caveats.
There’s some hardware that the dentist won’t even attempt to bill through to insurance - several hundred bucks.
If your insurance carrier has an annual limit (2,000 is typical) that comes nowhere near the cost of an implant plus the crown.
I have two implants - the upper “6 year molars” (#3 and #14). Tooth #3 was extracted 10 or so years ago after a crown and a nightmarish root canal failed to solve problems. I did nothing for well over a year. The surrounding teeth hadn’t moved appreciably.
That implant was a 2-step process. I opted for IV sedation when they placed the post (insurance covered part of the cost), then about 4 months or so later he numbed the gum and opened it up to attach the part of the hardware that sticks up to attach the crown. Then i went to my regular dentist for the crown.
With the second one, I’d been fighting a losing battle including 2 and a half root canals (don’t ask) and when it flared up again, the dentist tried to push me to go back to the endodontist. I threw a mild fit and said “I am NOT wasting any more time on this!”.
So I went back to the oral surgeon, who extracted that tooth and placed the post in the same procedure. I opted for IV sedation again (insurance didn’t pay for that part, that time, no clue why), and the agreement with the surgeon was that he might be able to place the post in the same session, or he might not, and he had my permission to use his judgment. It required a bit of a bone graft because the tooth was extracted at the same time - with the first one, the socket had long since filled in.
Anyway, I got lucky in that it did not require a second procedure; he was able to place the post that day. And he used different hardware, so the metal was above the gumline from the start, which saved me a procedure later on.
Both times, there was a 4+ month gap before the crown could be installed. And both times, I had the implant done late one calendar year, and the crown done the next - so I came in under the 2,000 in two separate years vs 3,500 (mostly out of pocket) in one.
The first time I brushed after the one implant was bizarre - the fake tooth and metal post transmitted the sound and vibration directly into my skull. Very, very weird. I don’t notice it at all any more.
I can’t imagine that there’s truly a “same day implant” procedure. At a bare minimum, you’d need one visit to place it, then a few months to let the bone join with the metal, then another visit to make the crown. My dentist doesn’t have the equipment in-office to do that - it has to be sent out to a lab - but some do. So there are 2 visits minimum.
Well there is such a thing. Somehow they found a way to make the implant stable right away. The screw for the implant looks quite a bit different with much wider flat bladed threads. It appears to me that though the top of the implant (nearest the tooth) could experience some degree of overforce while the deeper part would be much more stable and can set over time and use. Much like how a house set on piers hold’s itself up. The holding comes from the side friction, not the bottom. Thus the bottom of the pier has very little force on it, perhaps zero.
The standard implant works for more cases however, and single day implants require a lot of visits ahead of time, so it’s not walk in and walk out the same day done.
I sort of have that. I broke off my front tooth in an accident and in the procedure they carefully took out the remaining bit (not sure exactly how, but I think they broke into a few pieces). Then put the implant in the socket and put on a temporary crown. All of this without incisions, so also no stitches.
The crown is ground down, so it doesn’t connect with my bottom teeth and I have to sleep with a teeth protector. I also not allowed to bite off anything (soft or hard, no pressure on the tooth at all). After 6 months the titanium should have grown into the bone, and then I’ll get my real and functioning crown.
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I had my rearmost lower molar removed because it was dead. Less that 3 years later the upper tooth started moving down, so I got an implant. They had to shave off some of the upper tooth to make space for the implant, so I wish I hadn’t waited.
Around the same time I got a wire put across the back of my front lower teeth because they were moving back to their original positions, the ones they had before I had braces as a teenager.
I had to have invisilign for about 6 weeks before they could put the wire on. I still have a bit of an indent on one of the upper top teeth, because the facing tooth had twisted and was no longer meeting the top tooth.
So my message? If you’re going to do something, don’t wait. It just gets worse.
I had a bridge put in 27 years ago and it’s still doing fine. The only issue was my gums receded a bit allowing food particles to get under the bridge. My dentist bonded a veneer to the back of the bridge to fix that.
My tooth bed is prepared, but I have put off getting the implant because of the cost. O really want to get it done this year but o can’t believe there’s such little coverage for this. It’s very frustrating.