Tooth Loss Consequences: Should You Consider Dental Implants? - Dentistry

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Tooth loss without replacement?


Seven or eight years ago, I had a cavity in my lower left horizontal wisdom tooth, which led to the erosion of my lower left second molar, causing it to fracture.
At that time, the dentist said that it was not possible to place a crown, so I left it untreated.
Since that tooth was not a key occlusion point and my first molar was still intact, I only had the decayed horizontal wisdom tooth extracted.

One or two years ago, the fractured molar began to cause intermittent pain, so the dentist extracted the fractured molar and advised me that dental implants were unnecessary due to their high cost and because it would not affect my occlusal function.
However, the corresponding upper molar would likely become more prominent since there was no opposing tooth for occlusion, which could lead to it potentially falling out on its own.
At that time, I thought this might be a distant issue, so I didn’t ask further questions.

Recently, I noticed that my upper left second molar is significantly more prominent; it is noticeably protruding compared to the right side when I touch it.
I am concerned that it may fall out soon.
If that happens, wouldn’t it mean that if I want to get an implant later, I would have to pay for two teeth instead of one? This seems even more disadvantageous.

I would like to ask the dentist: Will my upper left second molar fall out soon? If I get an implant for the missing lower tooth now, can it help push the upper left second molar back to its normal position?

Niming, 30~39 year old female. Ask Date: 2020/12/26

Dr. Lin Jiayong reply Dentistry


Hello: 1.
The upper left second molar is expected to grow downward, but the chance of it fully erupting is low unless there is a severe periodontal issue.
2.
No, if there is already insufficient space, the approach is to first perform root canal treatment on the upper left second molar and shorten it, and then wait until there is enough space to implant the lower left second molar.
Thank you!

Reply Date: 2020/12/26

More Info


Tooth loss can have significant consequences on both oral health and overall well-being. When a tooth is lost, especially a molar, it can lead to a cascade of dental issues that may affect your bite, jaw alignment, and the health of surrounding teeth. In your case, the loss of the lower second molar has already led to the upper corresponding molar becoming more prominent, which is a common phenomenon known as "eruption" or "supereruption." This occurs when the opposing tooth no longer has a counterpart to provide resistance, causing it to drift out of its normal position.


Potential Consequences of Tooth Loss
1. Supereruption: As you've noticed, the upper second molar may become more prominent due to the absence of the lower second molar. This can lead to misalignment of your bite, which may cause discomfort and further dental issues.

2. Shifting of Teeth: Adjacent teeth may begin to shift into the space left by the missing tooth. This can lead to misalignment and can create gaps that are more susceptible to decay and gum disease.

3. Jawbone Loss: The jawbone requires stimulation from teeth to maintain its density. When a tooth is lost, the bone in that area can begin to resorb, leading to further complications, including changes in facial structure.

4. Increased Risk of Tooth Loss: The shifting of teeth and changes in bite can increase the risk of additional tooth loss over time, as the remaining teeth may become stressed and more prone to decay or fracture.


Considering Dental Implants
Given your situation, it may be wise to consider dental implants for the following reasons:
1. Restoration of Function: An implant can restore the function of the missing tooth, allowing for normal chewing and biting, which can help prevent the upper molar from becoming overly prominent.

2. Preventing Further Tooth Loss: By replacing the missing tooth, you can help maintain the alignment of your remaining teeth and prevent further shifting.

3. Jawbone Preservation: Implants can help preserve the jawbone by providing the necessary stimulation that a natural tooth would provide, thus preventing bone resorption.

4. Long-term Solution: While the initial cost of dental implants may be higher than other options, they are often more durable and can last many years, potentially making them a more cost-effective solution in the long run.


Addressing Your Concerns
Regarding your specific questions:
- Will the upper second molar fall out soon? It's difficult to predict exactly when or if the upper second molar will fall out, but the risk increases as it becomes more prominent and misaligned. Regular dental check-ups can help monitor its condition.

- Can an implant push the upper molar back into position? While an implant itself won't physically push the upper molar back into position, restoring the lower second molar can help realign your bite over time. Your dentist may also recommend orthodontic treatment if significant misalignment occurs.


Conclusion
In summary, while your dentist initially suggested that an implant may not be necessary, the potential consequences of leaving the space unfilled could lead to more complex issues down the line. It would be beneficial to have a thorough discussion with your dentist or a specialist about the possibility of getting an implant for the lower second molar. They can provide you with a comprehensive treatment plan that considers your current dental health, the status of your upper second molar, and your long-term oral health goals. Taking proactive steps now can help prevent more extensive and costly treatments in the future.

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