Dental Implant After Extraction

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Ann, a patient, asks us:
I recently had tooth 31 extracted after it cracked. My periodontist suggests a dental implant and says that I’ll have problems with the tooth above if I don’t. I don’t want one: It is expensive, and seems like a big ordeal.

I know that
there are possible problems.  My dentist thinks that a dental implant isn’t
necessary and is risky.  He says if it were him, he wouldn’t have it and
would manage quite well without the tooth.  (He’s also the one with no
financial interest.)   So, what would I be risking if I were to forego a dental
implant?  What future consequences might I face and how surmountable
might they be?

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12 Responses to “ Dental Implant After Extraction ”

• Dr. Michael Weinberg June 27th, 2006

  
  

  Ann,

  With all due repect, your dentist is ignorant and misinformed. It is this lack of knowledge of dental implants by most GP dentists that plagues dentistry today.
  I myself had that same tooth replaced with an implant and I wouldn’t have considered not doing it. The loss of 31 will cause the opposing tooth to over erupt and render it useless. You will then end up having it extracted as well. Ask your dentist if he restores dental implants. He probably does not. Trust your periodontist and ask him to refer you to another dentist with a more positive view of dental implants.

• Anonymous June 27th, 2006

  
  

  Many factors needed to be considered.

  Advantages of having an implant in #31:

  1. Keeps the bone around.
  2. Prevents surpraeruption of upper tooth/teeth in contact with #31.
  3. More biting power.
  4. More stable bite if other teeth were not in good periodontal bone support.
  5. If tooth #32 is in function, having implant in #31 prevents mesial tipping of #32.

  Disadvantages:
  1. Cost
  2. Surgery
  3. Multiple dental visits
  4. Potential complications associated with implant surgery and prosthesis

• DR. Zev Kaufman June 27th, 2006

  
  

  Dear Ann:
  I am also truly surprised by your dentist!!! The loss of #31, aside of the other factors named above, will also mean loss of support to your temporomandibular joint on that side. However, I completely disagree with the second comments. I am a Prosthodontist who also is certified in implant surgery. I place and restore several hundreds of implants a year and the only disadvantage to implants is COST. The surgical procedure for a simple single implant, done by experienced hands, is a half an hour to an hour procedure start to finish, and is just about as traumatic as getting a large filling. The complications of implants are also usually minor. The restorative phase is also usually a fast two visit procedure that required no anesthesia, or drilling. A single tooth replacement like yours can actually take only two visits, since I can actually take an impression for your final crown at time of impalnt surgery. In short, implant dentistry has changed my life and the lives of my referring doctors and their patients. Go and find a qualified prosthodontist (which I’m sure your Periodontist can recommend to you) and don’t hesistate to proceed with treament that has proven to be the most successful tooth replacement modality in the history of modern dentistry.
  By the way, have your general dentist call me, I’ll get him up to date.

• Anonymous June 28th, 2006

  
  

  Your dentist is an ignorant! Just this.

• Dr. Joel Moskowitz June 28th, 2006

  
  

  Ann,

  Your periodontist knows what he’s talking about. Get the tooth replaced, you won’t be sorry. Your periodontist probably also places implants. Have the restoration placed by either an experienced G.P. or a prosthodontist (either one should achieve an excellent result as long as the implant is placed in the right position which should be choreographed by the restorative dentist). The dangers of waiting too long are post extraction bone and tissue shrinkage which might then necessitate a bone graft in addition to the implant placement. I do agree, that the cost is the ONLY disadvantage.

• Alejandro Berg DDs PhD June 28th, 2006

  
  

  Dear Ann:
  Sometimes is painful to see cases like yours. Your only real problem,is your dentist, so put him aside allong with all your fears and go for an implant. Risk is minimal and as many of my patients say “Implants are my best friends”, it will probably be yours too.
  Good luck

• Marc July 11th, 2006

  
  

  I must object. First, maligning a dentist as ‘ignorant’ is, well, ignorant. No where do I see information on what opposes #31; full denture? does #2 even exist? is it abutement for bridge (so no danger of drifting)? is patient 15 years old or 95? Is patient heavy smoker, diabetic, immuno-compromised? Way too little info is known.

  Also, many people live to ripe old age, healthy and happy without 1, 2 or any 2nd molars.

  Beware, the most ignorant people here are those speaking without sufficent data.

• Anonymous July 12th, 2006

  
  

  Dear Ann: In January/06 I had a an implant procedure to replace a lost molar in the back of my left jaw. The biggest mistake of my life. I am in excellent health and was considered a prime candidate to have this surgery. My periodontist was very qualified and highly recommended. He has been doing implant surgery for 20 years. During surgery, some nerves were disturbed (I felt this during surgery). I have since had nerve sensations, pain and a metallic taste in my mouth. This procedure has greatly impacted my life in a negative way and I would not recommend it.

• Albert Hall July 13th, 2006

  
  

  Ann ,if you are really a patient, do not beleive in your doctor.If you are a dentist asking like a patient, beleive in all comments posted

• TW July 15th, 2006

  
  

  For any of the dentists here to insist that cost is the only con, I disagree.

  The degree of relevance for the factors mentioned in comment #2 may be different among patients, but not to bring it up to a patient who is considering a treatment option is not exactly informing the patient of the pos and cons.

  Since dentists on this post don’t know Ann’s exact clinical picture, how can anyone say that her dentist is ignorant? What if the opposing tooth/teeth has/have poor long term prognosis and her dentist believe that Ann’s remaining dentition provides enough masticating power and TMJ support?

  Comparing to the option of not restoring tooth #31 with an implant, placing an implant has the disadvantage of cost, surgery, time, and complications.

  How can any dentist be so definitive on a forum like this to give a definitive opinion without all the facts?

• Anonymous July 26th, 2006

  
  

  Dear Ann: Don’t do it. There is a reason why most insurance companies don’t cover this procedure - many failures. Also, there could
  be permanent nerve damage and problems can erupt even years after placement. I have been in pain for l year and have been with no resolve. The implant was placed at an angle which hit the next door tooth which is perfectly fine. Now if I remove these implants my good tooth will be lost the second implant next to the failed one and my entire jaw may be break. Also, these surgeons, dentists, Perios and so on never tell you the risk that once you put it in, it is almost impossible to get someone willing to take it out. Good luck. Nerve pain is awful - it’s like a 24/7 toothache and we all know how horrendous that is. Good luck. I wish someone would have educated me prior to my implant nightmare! Jack Lanson.

• chris April 2nd, 2008

  
  

  just had two implants, this is one week later, I feel great and lookig forward to the final attachment in August. There are payment plans and nothing looks bad than a bad mouth. This is your first line of contact with the public, a smile brings warm welcomes. You also will eat and sleep better knowing you did the right thing. Get a Good Specailist and live life.

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