Dr. Crapo: I have been a smoker since my teens. I’ve tried to quit for various reasons but I think I really like to smoke. When I’ve stopped, it’s been for as much as nearly a year and then I resume for reasons that seemed as strong as when I quit. In any case, over the years I’ve lost my upper molar teeth. Since losing them I’ve been told I have no bone for implants in that area so I only have my front teeth and the two teeth behind each eyetooth. I was functioning quite well until all of a sudden, the tooth behind my eyetooth on the upper left side, went crazy with pain. The dentist I saw told me that the tooth had to come out and that I could get implants for it and my back teeth if I would stop smoking and get my sinuses grafted with bone, so the implants could be anchored properly. The investigation took some time but I came away with an estimate that was way out of my ball park. I realized that I couldn’t afford that extensive a procedure. So now I’m almost stopped in my tracks, not knowing what to do. I’ve got to get this one tooth out but where do I go from here?
If finances are an overriding factor, it’s important first to define what is satisfactory as far as chewing is concerned. By that, I mean, ask yourself if the tooth that has abscessed was the real reason you sought dental care. Another way of saying that, is if that tooth was still perfectly good, would you be chewing and eating without too much thought to replacing your molar teeth.
If you have a dental plan you will get the most financial help from your plan by first having the bad tooth removed and the extraction site grafted. Once the bone and gum have stabilized, a fixed bridge could be made that will return the function and appearance you had. It’s important to stop smoking for healing purposes.
If you decide on an implant, the grafting site should be left to heal for six months. If the graft is very solid at six months, the implant can be placed and three months later restored with a crown. In this scenario, you will see a gap when you smile for nine months before the crown can be placed. In the bridge scenario, a temporary bridge is put in place at the time of extraction and graft placement. It will provide better function and better cosmetics.
If we can help, we’d like to. Call 778-410-2080 for a consultation.
Based on actual patient cases.