Which tooth is it?

I had one...maybe 2...when I had my dental implants. I can't remember now. It was no problem and it was included in the total price.

Tuesday must have been ‘bad dental news’ day. I also went to the dentist for a crown that was bothering me. It's been on for ~20 years so I was thinking it needed to be replaced. After an xray the dentist advised there is significant deterioration under the crown & he didn't know if he can save the tooth. I'm looking at either a root canal & new crown or more likely an extraction & implant. This will be as painful for my wallet as for my mouth

Perhaps it is one of those area that you live in things but the few people that I know of that have had the bone grafts have gone to a specialist for that procedure then back to their regular dentist or to another specialist for the implant. One did bone dust and I was told that it was allowed to grow/heal for about three months before any further procedure was done. The other used a chunk of bone that was glued in to the surrounding area. The $350 sounds very low for what the dentist and materials in this area would charge.

I do question the idea as it sounds odd of replacing existing bone with a graft to prevent bone loss.

It's the tooth next to the canine. You can't even see it. I am not having a implant so why the bone graft? Implants are like $3500. per tooth. I guess I will get a partial. I was also xrayed I didn't see anything on it. I just hate these root canals & crowns, they don't seem to last or work. I have had 2-3 failed root canals. The Dentist even refunded the money to me.

DH had a root canal/cap that eventually failed. It was the result of a childhood accident. He went thru the bone graft/implant procedure and is very happy with the outcome. Of course, it took over a year to complete, but he said none of the work was painful. His was a upper front tooth.

The only thing I can think of is to maintain the integrity of the jaw for biting off food and to maintain the placement of the other teeth which are both important.

I don't know how old you are but (and this is only my opinion) I think that maintaining mouth and teeth health and structure is so very important. It's important for future nutrition needs as you age and for general overall health.

When you lose a tooth the other teeth will drift out of place which can cause all sorts of bite issues. People in the past just lived with it or got a bridge which can damage the teeth it sits on. Bone loss in the jaw is why you see old people with their faces all scrunched up and their mouths caved in in old photos. Something can be done about it now.

Back in 2012 I had a molar extracted and a cadaver bone graft implanted in it's place. It took a year for the jaw to grown into it and I could have my implant. The insurance paid for the extraction and I covered the rest. This was not the back molar so it was needed for the reasons patriciae_gw points out. The only downside for me was that they wouldn't take me as a blood donor for the following year.

FWIW - my neighbor, a dentist, told me 14 years ago that he was going to focus on dental implants as that was the future of dentistry given the aging population. I guess he was right.

Second opinions in order?

My DH and I have each had a back tooth extracted and done nothing. Nothing else has 'drifted'. It's been over five years. I have a three-tooth bridge in front that is ten years old and fine...so far.

A friend had bone grafts and implants in his late 70's. Lots of office visits, time, and a LOT of money. He's nearing 90. Everything has failed. He's getting dentures.

At some point in our lives, a 'lifetime guarantee' brings a wry smile.

I got a quote for over $7,000 for a tooth extraction, bone graph, implant and all the "stuff" in-between.

Maybe I wasn't too clear. As we are retired and do have a medicare advantage plan but no real dental coverage, we got a plan whereby we pay the discounted rate the insurance company would pay the doctor. So the $350 would probably be like 450 or 500. This is strictly for extracting and synthetic bone, as Patricia said otherwise I do believe my teeth are shifting. I have another missing tooth right next to where this crown used to reside. I have other crowns.

Anyway I have a call into my prior dentist who was excellent- and I suspect he is going to agree with course. I am undecided about doing the implant but I think I will do the extraction and synthetic bone. As I am in zero discomfort, I am not in a rush to get it done, other than to get it all behind me.

Was charged for bone grafts that I do not believe were done many years ago from a dentist who did a lot of questionable stuff but who did work for some sports personalities. There is a lot of opportunity out there for dishonesty in dentistry.

If it is real bone it is from a cadaver if that would bother you. It would bother me. They do have fake bones but I think those are mostly used on a younger person.

I can only advise you to get estimates for both procedures. You may find that the bridge work, which often involves putting crowns on the teeth holding the bridge, is not that much cheaper than the implant. If all other teeth are healthy, a post can save money in the long run since you won't be compromising the teeth that would have to hold a bridge.

I've had a bone graft and the implant. I used an oral surgeon for the majority of the work, then the crown work was done by my dentist. A pretty painless procedure.

The success of any dental work depends on the overall condition of your teeth and how you maintain them throughout your life. Bone recedes when it has nothing to hold on to, so when a tooth is lost and nothing is put in its place, that bony area begins to recede. Teeth do shift over time when there is a gap, and this shift will then affect your bite and lower teeth.

I had a wisdom tooth removed( it fell apart leaving the root) my excellent dentist said I would need to get the tooth above removed along with the left overs of the broken tooth because with nothing opposing the tooth it would drift downward and would cause all sorts of problems so I looked this up. After the tooth was removed I did indeed get some drift from the next tooth. I now have a food trap that I have to keep clean. We ought to feel lucky that we have dentistry. DH had a tooth removed that had two failed root canals over a long period and he got an implant because it was towards the front of his mouth. He had a good outcome from that. Life is like that. some times it works and sometimes it doesn't.

Is your objective to have the best possible fix or the cheapest possible fix?

You don't need to respond here to that question, I'm just teeing it up as something for you to think about. Maybe either way, get a second opinion concerning procedure and cost. Ask friends for a recommendation and then see another dentist. Good luck.

I had a back molar crack and when a root canal was ineffective, it was ultimately extracted. My family member dentist (who has nothing to gain from doing more or less on me since there's no charge) said to wait to see what happens with the unopposed tooth, they don't always move.

It's been three years and no drift. Another approach is to have the dentist make a mouth guard you use when home or sleeping to provide resistance to the tooth now missing its opposing one.

I had a tooth upper right in the back pulled. My dentist wanted to do an implant ($3,000). I had special x-rays taken to check the bone. My sinus was very close to that bone so the dentist said I would have to have a sinus lift ($2,000) and there was no guarantee that it would work. I looked up the sinus lift on line and that clinched it for me. There is no way I would go through that. Also that's all for one tooth. I don't have that kind of money, even for the one tooth. I opted to do nothing and I have had no problem with my teeth shifting or any other problem. That was probably 5 years ago now.

Is the tooth in question upper or lower? If lower, I would definitely go for the implant over a partial.

Anyone have a dental school nearby? We have the UT College of Dentistry understood to provide excellent dentistry at greatly reduced prices. People come from all over the tri-state area. It takes quite a while to actually get started as the waiting list is long, but then it zips along. Another advantage is that you work with the same student for many procedures. They have a whole floor devoted to children's dentistry, a floor of graduate students at all levels and even a TMJ floor. I'm thinking of checking it out.

If you need a bone graft, best to have it done by an oral surgeon.

Joann:

Do you have the full story? Bone grafting is sometimes done when a post is to be installed. If the jaw bone has thinned and there isn't enough bone to support an implant, a bone graft is done to build up bone material. Its best to have this procedure done by a dentist who has been certified for this type of oral surgery.

I have never had a bone graft recommended to me after a simple tooth extraction. However, when it came time for an implant, a bone graph was done ( following the extraction). My dentist determined that I did not have a thick enough jaw to accommodate a post and would not do the post unless the jaw bone was thickened. I was under the impression that an empty tooth socket would fill in, but according to my dentist, it does not fill in with true bone. A bone graft encourages the tooth socket to become solid bone and fused with the jaw.

As we age, the jaw does loose some material. The loss of a tooth can encourage bone loss. The jaw bone is stimulated by loads imparted to it by the teeth. Bone tends to strengthen at high stress stress zones.

You asked about pain. The procedure is more uncomfortable than painful. On the day of the surgery, you will be given a shot of anesthetic in the jaw, the same as for a tooth extraction. The gum will be opened, the tooth socket cleaned out and ground up bone put in place with medication to encourage new bone to form. (You won't feel any pain for this. You'll have the discomfort of having your mouth propped open for the duration of the procedure.) The bone particles act as an armature for the new bone growth. At the end of the surgery, the gum is sown shut and you'll be given instructions about aftercare. You will need to use care not to injure the site over the next few hours because it will be numb and you may not know it is being damaged. The Dentist may prescribe pain medicine in case there is pain after the shot wear off. I did not need any pain pills afterward. Yes, there was soreness, the same as for any surgery, but that went away. There will be several followup visits. In a week or two, the stitches will be pulled and then you wait, you wait for new bone to grow. This will take from 3 to 6 months. Mine was ready after 3 months. Bone progress will be checked by x-ray when the dentist suspects it may be complete.

This procedure can be abandoned up to the point where the dentist orders the implant and the tooth cap. After that, it does not make economic sense to stop, so make your decision before this. However, to my way of thinking, it does not make sense to stop the procedure after it has begun, therefore, one should make the go, no-go decision before the bone graft.

Elmer, my dentist has no economic incentive, he sent me to an oral surgeon because they were wisdom teeth with the wonkiness inherit in that sort of tooth. The upper tooth was already some what dropped to meet the lower one. It was an educated decision based on his experience as a dentist.

From the patient's perspective, two telltale signs that you have a terrific dentist are 1) procedures and approaches to problems are pursued conservatively, in stages, with the most simple/least aggressive steps tried first to see if they work, and 2) they refer patients to specialists for procedures they don't themselves do day in, day out.

The choice of taking out the upper tooth was just that - a choice, not an educated decision. A more conservative approach would have been to leave it and see what happened. My dentist said it was as likely to stay put as move with neither being more likely. He said there was no sense to remove it before it caused a problem, and a mouth guard was a less aggressive way to deal with it had it started to move. I understand, one dentist won't always agree with another.

He sent you to an oral surgeon, that was certainly done with your best interests in mind, as it should always be but isn't with some.

My dentist, who never does anything that doesn't need doing, decided It would be best to do it all at once. It cost less, the inconvenience was only the once, the pain dealt with all at once. I have plenty of evidence of my dentists honesty in what should be done. He was amazed as every dentist I have had over the years that I had wisdom teeth at all. They are inherently problematic. He has dealt with them over the past 20 years. These teeth crowd my other teeth. I am confident he knows what he is talking about. And he tells endless jokes as he works on you and has the same excellent staff he has had for years. Now that is the sign of a good dentist. The same careful and efficient assistants for 20 years.

My unopposed upper is a wisdom tooth.

As for continuity of staff being a sign of a dentist's skill? I don't think so. It may be more a sign of the prosperity of the practice. Which is something that both many (but not all) honest dentists and those on the conniving end have in common.

It does sound like you have a good dentist. A better sign of integrity is those who complain (often behind closed doors and to close friends and some family) of the practices and shoddy work they encounter of the scoundrels. It's easy to turn a $750 solution into a $2000 one, just as a for instance, and patients trust and get scared enough that it can be easy pickings to always up-sell what's done. Especially with insurance patients.