Missing Molars

Dear T and D,

I am missing my two back left lower molars.

My dentist told me I need implants to replace them, but the oral surgeon told me I would need major grafting first. Is it worth the expense and risk considering I do not miss them at all.

What would do?

-- Tri Dog

Dear Dog,

I thank you for writing. My quick answer is yes; you should always try to replace missing teeth. You miss them; you just may not know it yet. My long answer is maybe not with implants. Replacing these missing molars is very important because of the changes that will absolutely occur over the next several years. Imaging, implants, bone grafting, and the final crowns will cost between $8,000 and $12,000; so you can see it will be quite an investment; it will also take about 1 to 1 ½ years to complete. Of course, there will be some discomfort with the treatment as well. If your only dental concern is the loss of these two teeth, then the commitment may make sense. If, however, you have other dental problems that will worsen if you focus all of your effort on replacing two teeth, that may not be the best decision. Make sure you have a thorough exam of your gums and remaining teeth so that you can reasonably keep the rest of your teeth for a lifetime. If not, make the effort to save any and all other teeth. Dental issues such as this are usually complex, and cost, treatment time, number of visits, and pain tolerance are all factors that must be considered. If you are not able to commit now, I strongly recommend that you think about having a well-made, metal, framework partial denture fabricated to give you something to chew with and keep other teeth from moving around.

-- Terry

Dear Tri Dog,

What he said.

Seriously. I couldn't possibly say it better. Terry is a dentist and one of the things that his patients liked about him was his careful explanations of treatment options.

I will add that although you say you don't miss your molars, your other teeth probably do. Maintaining your full complement of teeth helps to keep your other teeth from moving around, But I'm sure he covered that.

A good dentist can help you to make the best decision for your situation.

-- D