Delaying or Skipping Dental Implant?

[ksr]

I'm looking for some input from anyone who has been down this path. Just FYI, I have consulted already with my regular dentist as well as an endodontist and an oral surgeon to whom I was referred. So what I'm really looking for is any real-life experiences from anyone who has opted to skip a dental implant or wait it out a while.

I have a very old root canal with a crown on a first molar that now needs either a retreatment or extraction. Both the endodontist and oral surgeon felt that the retreatment would likely not last long. So to me it is a no-brainer that I'll have the tooth extracted.

The oral surgeon says I am a good candidate for an implant, with enough bone to support it. He also said that if I want to, I can wait 6 months or so after the extraction before deciding on the implant, to see how comfortable I am without the tooth. Of course there are pros and cons to either option, and while I would like to save the money I am not really basing my decision on cost.

My goal is to minimize or eliminate any long-term issues with this tooth. With an implant, there are the possible issues with the procedure itself as well as long-term possibly needing repair or replacement of the crown. If I skip the implant, there is the possibility that teeth could shift and I could lose bone mass.

Has anyone decided to skip the implant, at least for a while, and if so what was the end result? I'm just trying to gather as much info as I can before I make the decision. Thanks for any input.

 

[Dawg52]

As much as I would have liked to save money I decided on having implants done. I've got 3 and had no issues with any.

 

[Aerides]

Is it on the top or the bottom?

If it's the bottom, you have a risk of the top tooth (its pair) becoming an issue without the support it's used to. It can become loose or infected. Of course, this can happen even during an implant as the time between the extraction/base-post and final new tooth isn't overnight.

And yes, other teeth can shift. If there's no real reason NOT to get one, I'd get it. Sure, money, but that's not a great reason.

 

[easysurfer]

I had a similar experience several years back.

In my case, an implant wasn't the first thing on my mind. I had a root canal done on a tooth when I was a teenager and just had crowns and when the crown would get too worn, I'd just get a new crown.

Then after all the years of no pain (other than being a bit sensitive, being a crown) the old tooth area of the crown started giving me a toothache. As mentioned, I wasn't really thinking about getting an implant so ended up just getting a new crown thinking that might fix the toothache. Mistake on my part as not only paying for a new crown but I still had the big toothache.

Then talking to my dentist, decided to get an implant. But first dentist had to extract the small bit left of the old tooth root, I guess to stop the toothache before the implant.

The overall process from start to finish took about a year. I wish that I went the implant route from the start. Looking back, what I liked lease was having to wear a retainer before having the implant done so my other teeth wouldn't shift. Not painful but a bit gross and annoying.

I'm very happy with my dental implant.

 

[Golden sunsets]

I've had 2 implants with no issues. I've also had one bridge(way back, before implants were a thing) that I've had replaced once already.

If cost is not the issue, I wouldn't hesitate?

Question? Do you by any chance have dental insurance? If so you can likely spread the coverage over 2 years, doubling the insurance subsidy. Reason: There are generally two insurance coverage points to any implant: 1) to the endodontist for the extraction and implant of the base, and 2) the claim for the cap that screws into the base. Good timing spreads these claims over 2 different calendar years.

 

[pdxgal]

FWIW my housemate is facing a similar situation (although cost is more of an issue for her). She decided to have the implant. I'll ask her what her rationale was. Will pass on the tip about spreading over two years, as that may help her out.

 

[W2R]

I have about 4-5 implants I guess by now. But, when my furthest back molar on the upper right had to be extracted, I didn't get one. I never used that tooth much and it was too far back to be visible, so the expense seemed unnecessary, and my dentist agreed.

With the implants that I *did* get, I was pretty unhappy without the tooth even during the months long implant process! Months with no tooth, made me feel like an extremely ugly, snaggle-toothed old lady. I was embarrassed to open my mouth even to speak. So, I was very sure that I had made the right decision.

 

[bolt]

I'm looking for some input from anyone who has been down this path. So what I'm really looking for is any real-life experiences from anyone who has opted to skip a dental implant or wait it out a while.

Both the endodontist and oral surgeon felt that the retreatment would likely not last long. So to me it is a no-brainer that I'll have the tooth extracted.

The oral surgeon says I am a good candidate for an implant, with enough bone to support it. He also said that if I want to, I can wait 6 months or so after the extraction before deciding on the implant, to see how comfortable I am without the tooth.

Has anyone decided to skip the implant, at least for a while, and if so what was the end result? I'm just trying to gather as much info as I can before I make the decision. Thanks for any input.

I just had similar issues rectified w/a number of implants, along w/replaced lost bone.
Why gamble with what oral health you have left considering todays treatments ?


Good luck & Best wishes.......

 

[RAE]

I had to have the farthest back molar on the lower right extracted about 3 years ago. The tooth was causing me a lot of pain, and it was eventually determined that there was a crack in the root, so a root canal was not an option. Implants were discussed after the extraction, but I was told there was plenty of time to make that decision after everything healed up. As it turned out, everything healed up fine, and I eventually decided against the implant. I have read all the stuff about teeth shifting and other possible issues if you do not replace the tooth, etc, but so far I have had zero problems - I don't even realize there is a gap there anymore. If it was any other tooth beside one of the farthest back molars, I probably would have gotten an implant.

 

[donheff]

I had three implants. The last two failed after a couple of years. In all three cases I had bone grafts, then the implants were screwed in, then the crowns affixed. Took half a year each time. When the last two were done I got an infection and had to redo the bone graft before the implants were put in. Over time the bone eroded and one implant came loose. The other was partially affected as well. Both were removed a couple of weeks ago. I will eventually need the two teeth above these replaced as well (also because of bone loss). After discussing this mess with the oral surgeon I decided to go with removable dentures instead of implants or a bridge. A good friend of mine is an endodontist. When I told him about the latest development he mentioned that implants fail more frequently that most people realize.

 

[finnski1]

I had three implants. The last two failed after a couple of years. In all three cases I had bone grafts, then the implants were screwed in, then the crowns affixed. Took half a year each time. When the last two were done I got an infection and had to redo the bone graft before the implants were put in. Over time the bone eroded and one implant came loose. The other was partially affected as well. Both were removed a couple of weeks ago. I will eventually need the two teeth above these replaced as well (also because of bone loss). After discussing this mess with the oral surgeon I decided to go with removable dentures instead of implants or a bridge. A good friend of mine is an endodontist. When I told him about the latest development he mentioned that implants fail more frequently that most people realize.

Interesting.
I had a bridge removed 6 months ago and a tooth extracted leaving a now 2 tooth gap. I had the bone graft with lots of sutures and pain for weeks. Now that it has healed I need to decide on 2 implants plus crowns and a 3rd crown on the one good tooth that was part of the bridge. I think it will be about $10k. I know I would be very unhappy if they only lasted a few years. Maybe I should look into a partial denture there? I think because they are in the upper back I have taken my time about this. If they were visible it would force my hand.
I also know that I might be able to go down to Tufts dental school in Boston and get the price down to 5-6k if they'll accept me.
Decisions decisions.....

 

[ksr]

Thank you everyone for taking the time to describe your experiences. It is very helpful and gives me more to think about before making the decision.

I don't have dental insurance but have a dental discount plan. So it will all be out of pocket, but at negotiated rates. As I mentioned above, I am not really making the decision based on cost but rather trying to figure out the best long-term solution for me.

And W2R, your comment about looking like a "snaggle-toothed old lady" made me laugh! My tooth is pretty far back so I think it would only be noticeable if I opened my mouth wide. Still, it's a consideration as it's not a look I'd be happy with ;-)

 

[donheff]

Interesting.
I had a bridge removed 6 months ago and a tooth extracted leaving a now 2 tooth gap. I had the bone graft with lots of sutures and pain for weeks. Now that it has healed I need to decide on 2 implants plus crowns and a 3rd crown on the one good tooth that was part of the bridge. I think it will be about $10k. I know I would be very unhappy if they only lasted a few years. Maybe I should look into a partial denture there? I think because they are in the upper back I have taken my time about this. If they were visible it would force my hand.
I also know that I might be able to go down to Tufts dental school in Boston and get the price down to 5-6k if they'll accept me.
Decisions decisions.....

It's a tough call. My niece is my dentist and she is quite good. She does the crowns that go on the implants and suggested maybe a bridge this time. The oral surgeon (who, admittedly, probably doesn't want to deal with me anymore) suggested that a lot of people actually prefer the removable dentures. Easy to clean them and the adjoining real teeth. For me it isn't the money, it is the time, discomfort, and hassle. Also, I never get the bridges and implants flossed well enough so being able to pull the damn thing out and clean it seems a plus.

 

[pacergal]

I needed to wait over a year from the extraction to the implant due to infection and needed bone grafts. I seriously considered not having the implant, but after a while, it bothered me, as you could see the space when I laughed or smiled, even though it was a second to the last molar. And eventually, not being able to chew as thoroughly on that side became an issue for me. So I scheduled the implant. so far, so good!

 

[Bamaman]

I had a tooth shear off, and the local oral surgeon (MD) removed what was left for $875.

To do an implant was $2250, and the abutment (post) was another $850. Then my regular dentist would install the crown which is another $850. Total cost--$4825.

I was referred to a dentist in another state that did the implant for $999, including the abutment. After the tooth was deadened, the whole procedure took 6 minutes. There was no pain at all, and it was an easier procedure than a typical filling even.

Our local oral surgeons are taking advantage of their patients for simple implants. And there are very few general dentists in our market attempting to do them.

I'm getting my local dentist to do the crown and it should be ready this week for installation. The abutment is just a simple screw in post--no big deal to install.

 

[brett]

I delayed an implant for nine months or so. By the time I was in the chair a year had passed.

I had two implants. Happy that I had the procedure. It was a snap. I did not even use the T3's that I was given after the procedure. Healing was much faster than I anticipated.

I was quite surprised at how painless and easy entire procedure was. I was a bit apprehensive going into it. The big plus...as soon as I got into the chair they put me under. No time to worry or stress out. Out like a light.

 

[jim584672]

I have a missing bottom molar. Eventually will get an implant, but I have gotten used to it now, so no rush.

 

[Teacher Terry]

Back when I had real teeth I had some missing in the back and it never bothered me. I also had a permanent bridge. Then I lost my teeth due to my cpap machine causing excessive dry mouth. I have really long implants holding a 4x4 on the bottom done by a oral surgeon with no issues. I had the tops done by a regular dentist that specializes in implants and they all failed. I now have a denture on top that fits perfectly and no glue needed. It took 4 times before this was perfect. Not my dentist’s fault as things shrink and change once you lose your teeth.

 

[KM]

I had to have the farthest back molar on the lower right extracted about 3 years ago. The tooth was causing me a lot of pain, and it was eventually determined that there was a crack in the root, so a root canal was not an option. Implants were discussed after the extraction, but I was told there was plenty of time to make that decision after everything healed up. As it turned out, everything healed up fine, and I eventually decided against the implant. I have read all the stuff about teeth shifting and other possible issues if you do not replace the tooth, etc, but so far I have had zero problems - I don't even realize there is a gap there anymore. If it was any other tooth beside one of the farthest back molars, I probably would have gotten an implant.

I had the same issue with the same tooth. I opted not to replace also and everything has been just fine. Mine was close to 15 years ago.

In another situation where it wasn’t the back molar, I opted for a bridge.

I have a hard enough time in a dentist chair as it is. Just the thought of what they do for an implant is enough to make me shiver

 

[Golden sunsets]

I've had 2 implants with no problems as mentioned above. Both required bone grafts. The total time from extraction to setting the cap though was a solid 9 months-10 months in both cases, the absolute minimum time according to my endodontist.

 

[stephenson]

Hmmm ...not having the tooth replaced ... not an option . Would be like having a finger cut off with replacements available, but deciding it wasn't necessary.

30 months ago split a tooth while eating a "hand cut steak" at a restaurant near the Rome airport - bit and the tooth split (I think is is #15) - made so much noise people stopped and stared in horror ...

Got back and started the process - because it takes about 12-15 month prior to installation of the final new tooth.

BTW - I was told the oral surgeon almost always inserts cadaver paste into the open socket - regardless of how much bone is present, but there are circumstances where grafts are required.

However, I have heard of clinics that are now doing this same thing much faster - with oral surgeons, and dentists in the same practice - was told about half the time.

I would never consider not replacing a tooth (wisdom teeth excepted).

 

[ksr]

Just thought I'd come back and update this thread with my decision, in case it might help someone else. I had the tooth extracted about 10 days ago, and went ahead with the dental implant. I didn't need a bone graft, so the oral surgeon was able to do the implant at the same visit as the extraction.

Overall the experience wasn't too bad (well, except for the cost). The extraction took much longer than the implant. Apparently it is common when a tooth has previously had a root canal, for the roots to break up as they are removed. There was a fair bit of drilling to get everything out, but just pressure and no pain. The implant seemed to only take 5 - 10 minutes.

I'm in the healing phase now and go back in 3 to 4 months for the next step. Hopefully it will be a smooth process.

Thanks again to everyone who chimed in with your experiences. My biggest concern was long-term issues with an implant and it was helpful to hear from so many who had a good experience.

 

[athena53]

Overall the experience wasn't too bad (well, except for the cost). The extraction took much longer than the implant. Apparently it is common when a tooth has previously had a root canal, for the roots to break up as they are removed. There was a fair bit of drilling to get everything out, but just pressure and no pain. The implant seemed to only take 5 - 10 minutes.

Wow- they did it with a local? My oral surgeon has done the extraction (including root-canalled tooth) plus bone graft plus placing the implant all at once but he uses "light sedation"- I drift off and when I wake up it's all over.

I'm glad yours went well.

 

[ksr]

Wow- they did it with a local? My oral surgeon has done the extraction (including root-canalled tooth) plus bone graft plus placing the implant all at once but he uses "light sedation"- I drift off and when I wake up it's all over.

I'm glad yours went well.

Yes, just local. The entire visit, including time to numb the area, was about 45 minutes.

 

[cat4ever]

I had my first one early this year. My dentist has a process where extraction and bone graft are done the same day, which shortened the time from extraction to installed implant to about 4-5 months. It has been great. I plan to add another to an old extraction that I have left open for probably 10 years now. Haven't had any major problems leaving it open, but have had some slight tooth shifting and minor looseness and pain a couple times. I really like the solid foundation the implant has given my teeth compared to the area where I didn't get an implant.