I have moved 9/2010 and I am seeing new dentists. About 6 months ago the dentist wanted to replace the crown on the tooth in front of the wisdom tooth on the lower left. I did not do anything at this time. This tooth has had a root canal. I am not sure when the root canal and crown was done. It was probably many years ago. Now the current dentist says there is a cavity under this crown and recommends pulling the tooth. He says that it should not affect my chewing. My question is should I pull it and leave it or pull it and replace it with an implant. I have 2 implants in the upper right.

How is your health ? Do you have an auto immune condition ?
I know a good dental surgeon that will not do an implant on an RSD person- like myself.

If you had 2 implants done, maybe you can do well with another only.
It there is decay, and the tooth already has a crown on it, it may be not savable.

Just my thoughts..

Hi GStuttman,

Your dentist recommending removal of this tooth because to try and repair the cavity and replace the crown would only be a temporary measure as the tooth will eventually need to be removed anyway. Also, drilling into a root canaled tooth in injurious to the tooth and also sets off the bacteria residing inside of the tooth. You will eventually end up with an abscess.

Replacement of this tooth may or may not be necessary. It is your last molar on the bottom, so there is no tooth behind it to shift forward. The first molar may shift back a bit or may even become sensitive but no one can determine if that will happen. Regarding chewing ability.... many people have what is called first molar to first molar occlusion and do very well with that. The main concern is with regard to the tooth above it. The upper second molar needs to have a lower tooth to occlude against or it will drift downward into the space below. If this molar is occluding (biting) with your lower first molar then the drifting may not be a concern. Your dentist can tell you what the status is regarding your bite.

Dental implants of course are an option if you want to keep a full dentition of teeth. You have experience with them already so that is not new news for you. What are your thoughts about replacing it as opposed to not?

Bryanna