Do I need to replace a 2nd molar?

[jsnelling]

I had a root canal done on #18 about 10 days ago, but I've had constant issues ever since. My endodontist suspects I have a vertical root fracture and is leaning toward extraction, but he wants me to try some more antibiotics first. After months of anguish I am actually looking forward to parting ways with this tooth.

If I get this tooth extracted, what would the potential consequences be of not replacing it? I am 28 years old, and this will be the first tooth I have lost(besides my extracted wisdom teeth), and my remaining teeth are in good shape. I take good care of my teeth-- the problems with #18 were caused by an impacted wisdom tooth from several years ago.

The only option appears to be an implant, which is costly, time consuming, and potentially risky in my view.

I know supraeruption of the opposing tooth is a likely consequence-- can this be controlled via a custom night guard, or perhaps by linking it to the first molar in some way with an orthodontic appliance?

My biggest concern is potential bone loss in the jaw... I have read that this can lead to losing further teeth. Also, the remaining teeth would have increased masticatory pressure put upon them obviously, but I would likely alter my diet to account for this.

Are there any dentists here who have experience with people who have lost their 2nd molars and neglected to replace them? Does this turn out to be a big problem over time regardless of how well you take care of your teeth? Will the bone loss affect the health of my remaining teeth?

Thank you.

 

[DrMike]

Hi
in my opinion you would likely have no ill effect of having the tooth removed with regards to the issues you raised.
Overeruption can occur over a period of years, however it is less likely to happen to lower teeth as the tongue tends to keep them in position. It is more common for a top tooth to overerupt following the removal of a lower tooth.
A lower nightguard would help if you were espcially concerned about it, or if the dentist ever spotted early signs that it was happening.
ask the dentist to check your occlusion- there is a chance that the opposing tooth has some contact with another tooth anyway whch would help prevent the problem.
i don't thnk that losing one single molar would increase the forces on the other teeth significantly.
An upper second molar is probably the least likely tooth have knock on effect problems if removed. Although all the issues you raise are possible, in my experience and opinion, they are unlikely.
Talk to your dentist about these concerns and ask him to address them- hopefully s/he will say similar things to me!
regards]
Dr Mike

 

[jsnelling]

Thanks for the response. Maybe I have my numbers mixed up-- the tooth I would be extracting would be a lower 2nd molar.

My primary concern is bone loss, and potential problems with other teeth because of this... I will talk to some dentists about it, but I am not sure what to do.