Hi Willy,

Yes, it is best to consult with your cardiologist to try and get the INR down prior to extracting that tooth.

The cost of $2200 for extraction of the tooth, placement of the graft and an immediate implant is actually a bit low. Sometimes they give a break on the fee when doing an immediate implant. HOWEVER...... please don't make your decision based on what will be less expensive. Depending on the health and integrity of the bone due to the chronic infection, the immediate implant may or may not be a wise option at the time of the extraction. Any residual infectious bacteria residing in that site after the extraction could prevent the bone graft from integrating with the jaw bone which could result in additional infection and would compromise the longevity of the dental implant.

Bone grafts as well as dental implants ideally should be placed in healthy bone only. If there is any question as to the health of the bone, it is best to just remove the tooth and go back in at another time to place the graft and the implant. Sometimes this requires one or two additional surgeries depending on the individual case. When the dentist or surgeon tries to rush this process.... the outcome is often unfavorable.

It is important that you make a personal decision which way you want to pursue this tooth issue because I really get the impression that although your surgeon is sure about the inevitable of this tooth, he's unsure you are ready to remove it at this time. Dentists will "procrastinate" on treatment if the patient is not in imminent danger (that is purely subjective) until the patient is ready to move forward with it. In doing this, they are simply covering their own behind so that if complications should arise at any time ... they can say well we advised you of so and so and you choose to have such and such at that time.

Yes, all dental implants require a restoration on top of them. The implant is similar to a root of a tooth as it lies in the jaw bone underneath the gum. A small piece of the implant is above the gum and several small parts attach that portion of the implant with a crown. When all is said and done, the crowned implant should resemble one of your own teeth.

I cannot find where you said which tooth this is.....?
Some teeth do not need to be replaced while others really should be. It depends on which tooth it is... how it fits into your existing bite... and how many other teeth you are missing.

Bryanna