Missing Molars: Dental Implications and Treatment Options

Missing the first and second molars?

Hello, doctor.
I have lost my lower right first and second molars, while the upper right ones are normal natural teeth.
The dentist has assessed that I need to extract the last lower right wisdom tooth and place two implants.
I would like to ask you: 1.
Is this treatment plan correct? 2.
Due to financial constraints, can I just have the first molar implanted? 3.
Is it possible to avoid extracting the wisdom tooth? 4.
If I have lost the first and second molars and rely on the premolars for chewing, what impact might that have? Thank you.

Mr. Chen, 40~49 year old female. Ask Date: 2020/07/21

Dr. Huang Tingfang reply Dentistry

Dear Mr.
Chen,
Hello! Your questions are challenging! Ultimately, it all comes down to choices!
1.
(Extracting the lower right wisdom tooth and placing two implants) should yield results similar to natural teeth, which are very functional.
The downside is the higher cost!
2.
(Is it sufficient to only implant the first molar?) Yes, that can work.
It should be adequate for chewing.
However, the upper right molars may gradually loosen over time, and eventually, that tooth will need to be extracted!
3.
(Can the wisdom tooth be left in place?) If you choose to get implants, and if the wisdom tooth interferes with the angle of the implant, it is best to extract it.
If you are not getting implants, you can opt for a removable denture, and of course, you can choose not to extract it!
4.
(If the first and second molars are missing, will relying on the premolars for chewing have any effects?) Actually, if you get used to it over time, it can be okay! However, the upper right first and second molars will gradually loosen, similar to the second question!
Take care! Wishing you peace and smooth sailing!
Sincerely,
Dr.
Huang Ting-Fang, Dentistry

Reply Date: 2020/07/21

More Info

Hello! Thank you for your questions regarding missing molars and the associated dental implications and treatment options. Let's break down your concerns one by one.

1. Is the treatment plan correct?
The recommendation to extract the wisdom tooth (third molar) and consider dental implants for the first and second molars is a common approach in dentistry. When molars are missing, especially the first and second molars, it can lead to various complications, including shifting of adjacent teeth, bite issues, and increased stress on remaining teeth. Removing the wisdom tooth may be necessary if it is impacted or if it could interfere with the placement of implants. Therefore, the treatment plan seems reasonable, but it is essential to have a thorough examination and possibly imaging (like X-rays) to confirm this approach.

2. Can I just implant the first molar due to economic constraints?
Yes, you can choose to implant only the first molar if that is what fits your budget. However, keep in mind that missing both the first and second molars can lead to functional issues. The second molar plays a significant role in chewing and maintaining the alignment of your bite. If you only replace the first molar, you may experience uneven wear on your remaining teeth or discomfort when chewing. It is advisable to discuss this option with your dentist, who can help you weigh the pros and cons based on your specific situation.

3. Can I keep the wisdom tooth?
Whether or not to keep the wisdom tooth depends on its condition. If the wisdom tooth is healthy, fully erupted, and not causing any issues, it may be possible to retain it. However, if it is impacted, decayed, or poses a risk to the placement of implants, extraction may be the better option. Your dentist will assess the wisdom tooth's position and health to make a recommendation.

4. What are the implications of leaving the first and second molars missing?
Leaving the first and second molars missing can lead to several complications. The most immediate concern is the impact on your chewing function. Molars are designed to grind food, and without them, you may find it challenging to chew certain foods effectively. This can lead to digestive issues if you are unable to break down food properly. Additionally, the absence of these teeth can cause the remaining teeth to shift, leading to misalignment and bite problems. Over time, this misalignment can cause jaw pain, headaches, and even changes in facial structure due to the loss of support from the molars.

In conclusion, while the treatment plan to extract the wisdom tooth and consider implants for the first and second molars is sound, it is essential to discuss all options with your dentist. They can provide personalized advice based on your dental health, financial situation, and long-term goals. Remember that maintaining a healthy bite and function is crucial for your overall oral health, so consider the implications of any decisions you make regarding your dental treatment. Thank you for your questions, and I wish you the best in your dental journey!

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