The Cosmetic Dentistry Blog

December 4, 2009

How long before I should get my dental implant?

Filed under: Dental implants,Extractions — iowasmiles @ 3:40 pm

Dr. Hall
I found out today that I have a dead first molar underneath a crown that just broke. My dentist felt that he could not get all of the decay out if he did a root canal, therefore, he recommended having an oral surgeon pull the tooth and then come back in 3 months for a bridge. I am waiting back to hear from an endodontist to see if she can do the root canal to save the tooth. I am learning that an implant is the better route if the tooth can’t be saved. I just took out dental insurance today and I know that crowns are not covered for one year. I do not know yet if the insurance gives any coverage for implants yet as I haven’t asked. Do I have to have the tooth pulled right away? If I do have to have it pulled, how long can I go before I start having problems in my jaw due to a missing tooth? If I have to wait one year to do something which I hope I don’t have to, will this cause any problem or does it need to be taken care of sooner than one year? I am 52 yrs old and have fairly healthy teeth. This particular tooth should have had a root canal when the crown was put on 9 years ago and the dentist opted not to do it because he put the crown on too fast and didn’t want to do the root canal through the crown. The pain that I was having at the time stopped when the crown was put on and it seemed to be okay. But there were no tests done to determine if the tooth needed a root canal after the crown was put on.

Thank you,
Rosemary from Oklahoma

Dear Rosemary,
There are some dentists that seem to me to be too eager to pull teeth. It’s better to save the tooth. I’m not sure I understand why the dentist would feel that he can’t get all the decay out. I’d be inclined to get a second opinion on that one. See what the endodontist (root canal specialist) says.

And yes, for replacing a single missing tooth, I think a dental implant is nicer. But I wouldn’t go more than a couple of weeks with the tooth gone before getting something in the space. Even at age 50, the teeth can start to tip into that space rather quickly. You haven’t told me anything that makes it seem like there should be a rush to take this tooth out. Is it not hurting? You didn’t mention any pain. Now a dental implant needs time to heal before actually placing the tooth on it, but they should make something temporary to fill the space while you are waiting for the implant to heal.

I generally recommend people going to dentists who try hard to save teeth. I associate that attitude with a higher level of integrity and greater skill and knowledge. I hope that’s not too blunt. Sometimes teeth really can’t be saved, but then some dentists are just too eager to pull them. A second opinion should help clarify whether it is really hopeless or not.

And I don’t know if I understand what you’re telling me about this tooth needing a root canal treatment years ago. If you are giving me a correct sense of what happened, then I think the dentist who put the crown on didn’t do the right thing. It’s a basic rule – when you have infection or decay, there is no benefit to watching it grow. Just because the dentist would have to drill through the crown is not a good reason for not doing the treatment – that is done all the time. Getting it taken care of promptly saves trouble down the road. I guess you’re a walking illustration of that principle.
Dr. Hall

About David A. Hall

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