Replace this tooth?

July 16, 2014 9:56 AM

Had a split tooth a few weeks back, which the dentist pulled. Insurance covered it, but they won't cover an implant to replace it. It's the 1st premolar, upper -- third back from front. What do I risk by not replacing it?
posted by LonnieK to Health & Fitness (9 answers total)

You risk your other teeth migrating to fill that spot, so you could end up with uneven/crooked teeth if you don't already have them.
posted by Safiya at 10:15 AM on July 16, 2014 [1 favorite]

I'm missing that tooth. For me it is fine. Other teeth moved but I still have a gap there and my teeth don't look crooked or anything.

A flipper might be a better option over an implant. It's less invasive. You might want to talk to your dentist about all the options you have, an implant is not your only option.

Your bite may be uneven. I am missing four teeth on the left side and I don't really chew over there at all. I also am at risk of my top teeth "dropping" but that is not a concern for you.

When I do chew on the left I get food - meat especially - stuck in a way that requires flossing in that top spot. That is the most annoying part about missing that tooth to me.

I also think my smile - when I smile really wide - looks weird, but I don't care much about all that. YMMV.
posted by sockermom at 10:21 AM on July 16, 2014

Your other teeth can also weaken if they don't have teeth surrounding them, according to the orthodontist who pulled a molar for me a few months ago. You can risk breaking other teeth just because you're hitting a side that is unsupported on other sides.
posted by xingcat at 10:35 AM on July 16, 2014 [1 favorite]

You do risk trouble in the future. Think of a cog missing a spoke, or a chorus line missing a dancer. It is expensive! but cheaper to fix now rather than later when the rest of your teeth have been affected. Restorative dentistry is not cheap.
posted by Cranberry at 1:35 PM on July 16, 2014 [1 favorite]

I had to wait several years before putting an implant in where I'd lost a tooth. I had some bone loss where the top tooth was missing, and the opposing tooth on my jaw has erupted noticeably from having a gap above it.
posted by not that girl at 2:33 PM on July 16, 2014

I've had that particular tooth missing for many years - over a decade - and it hasn't caused me any trouble. No teeth shifting, nothing... But, as always, YMMV
posted by patheral at 3:40 PM on July 16, 2014

Response by poster: Quite a range of advice. Let me add one more thing: I'm 62. Does that change anything?
posted by LonnieK at 7:31 PM on July 16, 2014

I would talk to your dentist about your different options. There are a lot of factors here that are specific to your particular case that we can't know or understand. For example, in my case I have very good medical reasons to avoid an implant, and missing all the molars except for one on the bottom of my mouth is not going to cause tooth droppage because of the way the top teeth align with the remaining teeth. But that is specific to me and my mouth and my own situation.

I do think it is helpful to know that there may be good reasons to get something in that space, whether it is an implant or a bridge or a flipper/partial denture. If you don't like the information you're getting from your dentist about this, get a second opinion from another medical professional.
posted by sockermom at 8:12 PM on July 16, 2014

I had the same tooth pulled three years ago because my baby tooth never got replaced by an adult tooth. I lived with the gap for about two years. I noticed that the gum in that spot became rough, and I hated to smile. I eventually saved up my money and went for the implant surgery. I am very happy to have done it, but it set me back by $3000 (and I have good insurance). I will have to do the same thing on the other side, as I have a lingering baby tooth there too (at the age of 35).

If it bothers you, get the implant. If you're only asking because you think it's sort of weird to be missing a tooth but it doesn't really affect you, wait. The longer you wait, the harder it is to get the implant, just so you know. The bone it would need to attach to erodes over time. You have about 3 years to decide, I would say.
posted by hippychick at 4:35 PM on July 17, 2014