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Why Even Have Missing Teeth Replaced? – Dental Implants, Etc…

Most adults can expect to have 32 teeth. The four third molars, or “wisdom” teeth, are often extracted because they do not grow into the mouth well or there is not enough room for them to remain in proper alignment. It is very unusual to have wisdom teeth replaced. But the other 28 teeth are needed.

Your mouth, jaw, and body developed together over millions of years. They are designed to operate together at peak efficiency. When you lose a tooth, the efficiency decreases and function suffers. When you lose a tooth, you lose some ability to chew food properly. This may mean that you either place more stress on the other teeth in order to chew all the food you eat, or you do not chew well enough and what is swallowed is not quite ready to be digested. This can lead to digestive difficulty. You might have to eliminate certain favorite foods because you cannot chew them thoroughly.

For each missing tooth, you lose approximately 10% of your remaining ability to chew food.

Other problems also occur. The teeth adjacent to the space left by the missing tooth will eventually shift.  If for example, a lower tooth is extracted, the opposing tooth in the upper jaw will grow slowly (or sometimes quickly) longer in a downward direction into the missing tooth space. This is called extrusion or supereruption. Here is an example:

Collapsed bite- need for dental implantsThe teeth on either side of the missing tooth space will move and tilt off their proper vertical axis and drift into the missing tooth’s space. This can make these teeth more prone to decay and gum disease because it is much harder to keep the teeth clean when they are not aligned properly.

Root structure that is normally covered by gum and bone may become exposed. All this can happen if one tooth is lost. Other major problems can occur if multiple teeth are lost. There is a loss of the arch length, the distance from the back of the last tooth on one side of your mouth to the back of the last tooth on the other side of your mouth.

With collapsed bite and loss of vertical dimension, the distance from your chin to the tip of your nose decreases, making your face shorter.

Extrusion and movement of your maxillary (upper) alveolar bone until the gum tissue from the upper jaw can touch the teeth or gum tissue of the other jaw causes loss of facial tone and shape. The facial muscles of the cheeks and mouth sink into the edentulous (extraction) site. There can also be severe cosmetic problems when the extracted tooth’s space is visible when you talk or smile. This is not a pretty sight to anyone.

There is loss of self-image and self-esteem and a feeling that you are getting old. Once you bone loss- need for dental implantsstart losing teeth, you can actually start to look old. Losing a tooth is pretty serious. The longer you wait after a tooth is extracted, the more difficult and expensive it can become to make the replacement you need. With very few exceptions, it is better to replace missing teeth as soon as possible. Evolution designed you to chew your food with 28 teeth.

I will discuss with you the best type of dental implant replacement that will restore your mouth to health. My office is located in Burbank, California.

You can choose to do nothing at all and leave the space or spaces…this is not usually recommended. You can have a fixed replacement made that could be an implant, a conventional bridge (crowns/caps), a dental implant overdenture or a combination of implants and bridges. The advantages of the fixed replacements are that they are not designed to come out of your mouth at any time, they are the easiest to live with, feel more like the original teeth, and are more cosmetic than removable dentures.

A removable partial denture is held in place by metal clasps that may be visible. It is bulkier and may interfere with your speech for a period of time. However, generally, dentures cost less than a fixed replacement.

Your jawbone and teeth were meant to function in a particular fashion. The interaction is complex and marvelous. Loss of teeth degrades this function. Preserve your health. Replace missing teeth as soon as possible!

Ramsey A. Amin, D.D.S.
Diplomate of the American Board of Oral Implantology /Implant Dentistry
Burbank, California

245 thoughts on “Why Even Have Missing Teeth Replaced? – Dental Implants, Etc…

  1. Hello Dr Amin
    I am a 38 years old female.
    Last summer, i had my first upper molar extracted. My dentist in my country decided to remove it and told me that i can wait until next summer ( 2018) to make the implant. So it has been removed for 7 months and a half now, and I won’t be traveling to my country before the summer. I live in the States and it’s much cheaper to have it done in Beirut. Now my question doni really have to go ahead with the implant? Is there any other solution? Wouldn’t be too late to do it after one year from extraction? Especially that he didn’t do any other procedure after the removal.
    Thanks

    1. It is an important tooth to replace. It is the anchor molar of your entire upper jaw. Have it done right the first time. It is not too late but you may need a sinus lift.

  2. Sir,
    Iam a 35 year old Male,from India.I have lost both my upper second molars recently.All other tooth are in good shape as of now.I also have all my 4 wisdom tooth in place.Its only tooth number 2 & 15 that are missing.

    can i decide not to get an implant and continue having all my remaining tooth until old age?I practice good oral hygiene.

    also what will be the expected life of a well maintained bridge between 14-16 and 3- 1.

    1. Dental implants are considered elective. A bridge connected to wisdom teeth usually only has a lifespan of somewhere of 5-10 years. of course there are exceptions to the rule but I would say 20 years would be the most. These are technically very difficult bridges to do as well.

    2. Dental implants are considered elective. A bridge connected to wisdom teeth usually only has a lifespan of somewhere of 5-10 years. of course there are exceptions to the rule but I would say 20 years would be the most. These are technically very difficult bridges to do as well..

  3. Hello doctor,
    I’am 35 years old,male.I have extracted both of my upper second molars,2 & 15.can I choose not to replace them.

    My upper first molar bites on about half of the lower second molar,both sides.

    All my other teeth including wisdom teeth are good without any problem.

    What would be my ideal plan for the future.

  4. Hello doctor,
    I’am 35 years old,male.I have extracted both of my upper second molars,2 & 15.can I choose not to replace them.

    All my other teeth including wisdom teeth are good without any problem.

    1. yes…you can choose this. These specific two teeth in the mouth when missing do not cause too many problems for most people. The other 26 teeth are VERY important!

  5. I just want to say THANK YOU for your generous kind replies here. They are so thoughtful and knowing you are such a good professional, is very helpful. I wish you were here. You are a rare individual to be so patient with our questions. Thank you again!

  6. Hello, Doc!.. I am a 30 year old male.. all wisdom teeth were removed a couple of years ago, and now my #2 and #15 molars both need a root canal and crown.. (the #2 is kinda actually the oral surgeons fault, as he drilled into the back of it while removing the #1 wisdom tooth).. anyhow, right now my insurance doesn’t cover anything except for an annual exam and cancer screening.. I am debating on whether I should go the route of the root canals and crowns, or just have them pulled and get implants a little later on when I go full time at my job and have better insurance coverage.. How soon will I need to get the implants after extraction?.. How rapidly will my upper jawbone deplete and my lower molars erupt at my age?

    1. If the teeth that were given to you by nature have a predictable long-term prognosis then the obvious choice is to save them with a root canal and crown. Don’t just pull out a tooth because it implant sounds better. This area can be complicated by anatomy requiring a sinus lift.

  7. topic: replacing upper third molars with implants

    Dear Dr. Amin,

    First of all, thank you so much for this blog. It helped me a lot already.

    I am a 32 years old male. I have recently had all my teeth crowned by one of the best aesthetic dental doctor in Hungary. The process was quite long, but i am very pleased with the new bite and look. The reason we had to do this was very unfortunate. I developed a very bad eating habit for almost two years which has wore away the enamel on my teeth and that accelerated the teeth erosion. Mainly we had to restore the occlusal vertical dimension with this procedure and also create an ideal bite. I am very pleased with the result. But there is a but.

    I had all my teeth before the procedure, all wisdom teeth included. My wisdom teeth all developed well in early age (age 17-20). And i got used to them very well of course. I always had really good dental hygiene as well. Until that incident i mentioned above. Fortunately that is over. Good habits are back.

    The doctor suggested to extract all the wisdom teeth which i was really skeptic about. Even though we were arguing about this, he convinced me that i will be better off getting them removed. I let him extract the upper ones first. That was in 2017 March. After two weeks i already knew that this is a mistake. I told him that i insist on keeping the lower ones. He accepted it and we proceeded accordingly. Basically all my teeth except the lower two wisdom teeth are now crowned. Bite and look is perfect.

    My problem is that i just can’t get used to the feeling of not having my third molar. There is a big gap there. When i bite i feel that something is missing at the back. I feel so stupid that i let him extract them.

    It’s been a year now since he got them out. I am going to have our final check in two weeks. When i brought him up this topic he always told me that i should believe him, i will be better off without them in the long term. But i really don’t think that this is the case.. I feel too young to start missing those teeth.

    So my question is, do you think it would be worth getting them replaced by two implants if this causing me a lot of issues mentally? (probably physically too in the long run..)

    Thank you very much in advance for your reply.
    Kind Regards
    Sandor Nemeth

    1. Unless you have a severe underbite (class III) there will be no reason to replace your wisdom teeth. In fact replacing wisdom teeth with implants can result in permanent nerve injury. They typically have very poor tissue on the tongue surface as well which will lead to long-term gum problems Wisdom teeth for most patients are useless and do not contribute to chewing function. This has been proven there are many studies. I myself do not have wisdom teeth and would not ever want them back.

      Sorry that I agree with your dentist

  8. Hello Dr. Amin. I see this is quite a hot topic! I am a 57 year old woman and I just had my upper second molar pulled. It had been repaired previously but I cracked it so the dentist felt pulling it was the best option. I still have my wisdom teeth and I grind my teeth as well. The recommendation is for an implant but there is no way I can afford it. I understand that there are possible consequences to not filling the gap such as teeth shifting, growth of the bottom tooth to fill the gap and bone loss. At my age, and the fact That i do have my third molars, do I need to worry about these three things? If I wore my night guard like a good girl, would that reduce any of those effects? Is there any other (significantly cheaper) solution like an appliance of some sort? Thanks for any advice you might have!

    1. Upper second molars are about the least useful tooth in the entire mouth! Typically the mouth is stable without them. The lower second molar is actually more important. You are probably okay to just leave it alone!

  9. Hi Dr. Amin,
    I am a 24 year old woman who has had teeth #3 and #18 removed yesterday due to decay and breakage below my gum line. I passed out at the age of 17 and broke my jaw, which has caused many dental issues. As a result, I have a couple of teeth that are in need of root canals. Are implants necessary for spaces #3 and #18? Will I be fine without replacement teeth?

    1. At your young age your adjacent teeth will migrate and the bone in the missing areas will shrink. #3 is more important than #18 if you had to choose a single tooth to replace. without replacing #18, #15 will erupted out of its socket over time. #15 is the opposing tooth. Loss of one tooth tends to lead to a pattern of future to loss

    2. At your young age your adjacent teeth will migrate and the bone in the missing areas will shrink. #3 is more important than #18 if you had to choose a single tooth to replace. without replacing #18, #15 will erupted out of its socket over time. #15 is the opposing tooth. Loss of one tooth tends to lead to a pattern of future to loss.

      1. Hello Dr. Amin,
        I am a 33 year old female who doesn’t eat too much junk or candy. In 2005 I had all 4 wisdom teeth pulled. Now at this age I have two teeth that are decaying. The first tooth is at the top right side last tooth and the other tooth is top left second to last tooth. So the dentist wants me to pull the right tooth and do a root canal and crown on the left tooth. My insurance only pays for teeth to get pulled and I would have to pay $3000 for the left tooth so I’m stuck on whether to pull both and worry about my teeth shifting or do as the doctor say to save the left tooth and get rid of the right tooth. Please help me to decide.

        1. The best thing to do would be to ask your dentist if they were in your situation which one would they do first. Of course you do not have to wait for your insurance to pay and you can do this on your own. I’m sure you realize that dental insurance does not go very far. Maybe you can do something temporary on one of the teeth that will last another year or 2 and then deal with it and then?

  10. Good evening doctor,

    I am a 32 year old female and I have all 28 (“necessary”) teeth except #2, which I had extracted due to a failed root canal. I also wore braces for 20 months and have been out of them for about 7 months. I wear my essix retainer fairly regularly , which is holding the place of the missing tooth. Should I get an implant to fill this space?

    1. I just entered the same question to someone else a minute ago… Upper second molars are the least useful of all the molars in the mouth. You will probably be okay without it.

  11. I am 22 Years old and had tooth #19 removed around 17 years old as well as all 4 wisdom teeth removed at the same time. I now have tooth #18 (which was root canal-ed and crowned) tipping inward as well as tooth #20. Getting terrible TMJ symptoms, pain in left shoulder and neck, facial tension, pain behind eyes, jaw just doesn’t close correctly anymore. My question is what I should do with the missing gap. Should I just take out tooth #18? Implant in between? Braces to close gap? I don’t have a lot of money but can afford one procedure if it’s the right one. Not much bone left from the missing tooth, gum seems very small. Been to plenty of different dentist and they all say the “gap” isn’t a problem, but I know it is to me. Just wondering if you heard anything along these lines or know any options.

    1. A molar that is tipped forward will definitely caused TMJ problems. This is a well-known fact. Most ideally, an orthodontist “upright” the molar #18 and then you can place an implant for #19. If #18 has a poor long-term prognosis then extract #18 as well and place implants that are level with the bite for both 18 and 19.

  12. I have learned so much by reading your Q & A ‘s.
    Your replies are very sympathetic to people with difficult problems and I appreciate that. Fortunately my one missing tooth is not nearly as serious as some of these people’s problems.
    Thank you for the time you spend sharing your knowledge with people worldwide.
    Lundy Wilder…Lower Alabama

  13. Hi,

    I am 48 years old, male. 25 years back I extracted second molar tooth on the lower jaw left side (No.7 lower jaw under Palmer system). I did not fill the gap. Now, the corresponding molar tooth on the upper jaw left (No.7 upper jaw under Palmer system) has decayed and needs to be extracted. Once this is extracted, I will miss both the second molar teeth on the left side.

    I understand that the missing molar teeth can cause chewing problem but given that I have been chewing for 25 years with one molar tooth missing, do I have to go for implants or filling the gaps when the corresponding tooth is extracted.

    My doctor is advising bridge capping of teeth 5,6,7 which will also cover the gaps. Is this required or can I manage without filling the both the gaps?

    1. If you are only missing the upper and lower second molars there is not good reason to replace them. As long as you have one molar on top and bottom you will likely be fine well into old age.

  14. Thank you for doing your blogs. They are informative. I have a huge decision to make in the next couple of weeks. About 6 months ago, my #14 molar broke (after having spent a fortune on a cerec inside filling, 2 failed root canals and a regular crown). The tooth was pulled and cadever bone was put in. The #15 cracked about 5 years previously (also fillings, 2 failed root canals and a crown). At that time, my dentist said I didn’t need an implant because the bottom tooth was hitting #14. Just recently, I returned to the periodontist who is doing the implant (he is considered conservative and highly reputable here in Michigan). He examined my mouth and decided to take an impression mold. A few weeks ago, he called and said that my alveolar ridge is too thin for a regular 5-6mm x 11mm implant. Instead he would put in a 4 mm x 10 mm implant. However, he is worried about the force of biting and chewing and wants to put in an additional implant into #15. He said he would perform a sinus lift on both and can’t put any extra bone into #15. He told me my situation is more complicated and risky. The implants and crowns are going to cost about $12,000. There isn’t any warranty. I’m also worried about side effects: infection, sinus problems (which I don’t have now). I’m 62, mostly healthy and have always taken good care of my teeth. However, I do have osteopoenia. Unfortunately, most of my problems stem from 3 years of braces when I was a young teenager and a very conservative dentist as a child who never drilled deep enough to remove all of the decay. Also, 4 teeth were removed before braces. I also have larger teeth with a bigger chewing surface. I don’t know if I should go ahead with this implant procedure. It’s going to cost about $12,000 (the periodontist is charging for only 1 sinus lift). There is no guarantee or warranty. The alternative is to have a removable partial made.
    What do you think? Are there other questions I should ask the periodontist or my dentist? Sorry for this long email. Thank you for your time.

    1. Your question is very well written. Thank you for your details. Sometimes saving teeth at all cost is not worth it especially if they have a poor long-term prognosis.

      The upper back part of the jaw is very unique in that the bone is very soft. Soft bone combined with the area of the highest bite force in the mouth is a bad combination. Definitely a second implant is suggested to distribute the loads between 2 implants. Very important besides the sinus lift is to make sure that both of these teeth are splinted or connected for strength.

      This is known to help stabilize implants over the long-term. It sounds like you are being treated by somebody who knows what they are doing and wants to see you succeed in the long-term rather than a quick fix that may be cheaper.

      A sinus lift is an extremely predictable procedure and it sounds like your dentist is very experienced at this. As long as you’re sinus passages are clear, long-term complications are quite rare. Again, the experience and judgment of surgical dentist in this case is very important. Being that you have osteopenia, everything needs to be overengineered a bit for you to have long-term success. I have done this procedure on 80-year-olds!

      I prefer implants in the sinus to be 13 mm long. A shorter one can be used if it has a larger diameter.

      I would do this procedure on my mother if I had to.

      Ramsey A. Amin, D.D.S.
      Diplomate of the American Board of Oral Implantology /Implant Dentistry
      Fellow-American Academy of Implant Dentistry

      1. Dr. Amin,

        I really appreciate your feedback. The periodontist and the lab decided on 10 mm long after looking at the results of my cone beam scan – there’s probably not enough length available for anything longer. But I’ll ask him again why he is choosing 10 mm. And yes, the crowns will be splinted. I had forgotten about the price for the abutments, which will run another $2000. Now I’m looking at $14,000.
        Your response gives me a little more reassurance. I’ll ask the periodontist if and how he will overengineer the procedure. I pray this huge investment of time, money and pain will pay off.

        Again, thank you for taking the time to answer questions.

      2. Dr Amin, you give me hope for humankind because are a kind person to share your time and knowledge with people in need.

  15. I am 22 yrs old and my second premolar on my right side has a terrible cavity. Looking to remove the tooth soon. Is it necessary for me to replace it with an implant? What will happen if I dont?

  16. Hi Dr. Amin,

    I am a 27 year old woman with a baby tooth where my top right canine should be. The adult canine is somewhere near my nose and is not protruding out of my gums or pallat. Physically, it does not work but I do not find this aesthetically pleasing and I would love to correct it.
    The lateral incisor adjacent to my baby tooth grew in very crooked (not aligned horizontally) but the rest of my teeth are fairly straight.
    I have yet to see an orthodontist, but I would like to consider getting lingual braces to straighten out that crooked incisor while my baby tooth is in place, then cover the baby tooth somehow (veneer? Bonding?) without necessarily having to remove either the baby tooth and especially not the adult tooth way up in my skull.

    Is keeping your baby tooth forever possible? Again, there has been no physical problems so far. Does my plan seem feasible to you?

    Thanks so much for your input.

    Lily

    1. I like your plan as long as you’re baby tooth is not loose. I have had a ton of patients come visit me for your exact situation and I end up suggesting against the implant and keeping the baby tooth as long as possible with a crown, veneer or bonding.

    2. Hi Lilli

      I had the same .Two impacted adult canines . I left them but they started moving in my 20 s and I had to have N op to remove them very deeply impacted .If I left them they would absorb other teeth roots .I left baby teeth for years (slight bonding to protect )and only just lost one baby canine 30 years later (and I think wisdom teeth finally won battle for space in my opinion ) baby tooth went super loose and I pulled it myself !! . Problem is missing adult canines are problems for most dentists for closing gaps with braces . If you are happy to leave them until they fail and you get implant /orthodontic braces to close gap .baby teeth roots are often not attached to any bone . . Your x ray will show their stability

  17. I am a 20-year-old female who’s had 4 teeth removed – 3, 14, 19, 30. Wisdom tooth 17 has already grown. Wisdom tooth 14 is growing. Prior to removal, I was told that my wisdom teeth will push my teeth forward – that way there would be no gap. How long would that take? Considering two of my wisdom teeth have not grown yet
    Thank you

    1. That is extremely unlikely to happen at your age. I am sorry but you have been given wrong information. You would have to be much younger about 12-year-old for the wisdom teeth to possibly push the second molars forward into the first molars and the wisdom teeth drift into the second molar position. They will come in but everything will be tilted badly. You will need an orthodontist

  18. Hello, Dr. Amin!

    I came across your blog and am becoming increasingly concerned about the effects of an extraction I have scheduled next month. While I understand that it is needed, it is clear from your responses to others that bone loss and, especially, facial changes were not relayed to me. Apparently the slightly less defined right side of my face that I see in the mirror is not an illusion and may not be just aging. Anyway, I am 49 years old, and here is my crazy dental story.

    At the age of 10, I was sent to an orthodontist with a big mess in my very small mouth. With no space for teeth 7 and 10, they were protruding through high above the gumline and had to be extracted. Tooth 6 was high up inside the gums and coming through at an angle. Braces fixed these issues. There was no room for teeth 23 and 26, but they didn’t come in anyway. I also never developed tooth 31 or any wisdom teeth. (Wisdom teeth would have had zero space to come in if they had developed, despite the teeth missing towards the front!)

    In my 20’s, I was told that tooth 2 was dropping and would eventually need to be pulled. I was offered a bridge if it bothered me. It didn’t, so I passed on the bridge. Nothing was offered after that. I was never been told about bone loss or facial changes by ANY dentist despite having always had regular check-ups every 6 months. My bite has always been fine, and I take good care of my teeth–only 1 cavity in the last 15 years, and I even went back to wearing retainers to correct shifting. However, the upcoming extraction of 2 has me concerned about facial changes. Here are my questions:

    1. At this point, I presume it’s too late for me to get an implant in 31’s place, correct?
    2. Should I get an implant to fill in 2’s space after it is pulled?
    3. If I get an implant to fill in 2’s space, then should I finally get a bridge in 31’s spot?

    No post-extraction issues, options, etc., have been mentioned. Please advise!

    Thank you so much!

    1. if you do not have tooth #2 and you do not have tooth #31 you may want to consider not having him implants at all! Google a tooth chart. As long as you have the first molars in all 4 quadrants #3, #14 #19 and #30 you have what we call a shortened dental arch. This will function very well over time. I am not saying that you cannot have them but sometimes they are not needed because they are second molars and not first molars. 90% of my full mouth reconstructions is do not involve the second molar. I would have to assume your mouth is very small to begin with. Good luck!

  19. Greetings Dr. Amin,

    I am a teen and have recently had my braces taken off. I currently have empty spaces where the 29 and 20 adult teeth never formed, but am comtemplating if it is worth getting implants due to the fact that the spaces are not easily seen and that I have a retainer to keep surrounding teeth in place. Is it absolutely necessary to get these replaced? Thank you.

    1. If you are a teenager I would wait until you are 20 years of age or later. For now keep things the way they are and be reevaluated sometime between age 20-25. By that point any last growth spurts you might have typically have past.
      Some people that have implants at a younger and age can “outgrow there implants.” This happens because the teeth move but the implants do not. If this occurs your implant teeth will look submerged in comparison to your regular teeth.
      You may require extensive bone block/GBR grafting or it may end up being very simple. Don’t rule that out just yet but my suggestion is that you wait.

  20. Hello,
    I’m a 24 male and I have one missing tooth (Lateral incisor). Should I go for an implant or use braces so other teeth will fill the gap of the missing one. Because I don’t have the budget to do them both.
    Thanks

  21. Hello, I have overcrowding and orthodontists suggest removal of premolars. however, i also have an impacted mandibular second molar, that was extracted a week ago along with my wisdom teeth. Is it possible to have serious bone loss in the extraction site of the second molar, weakening the adjacent first molar? May I start orthodontic treatment then without extracting my premolars? Many thanks in advance.

    1. Try expansion rather than extraction. Wisdom teeth should be extracted usually but premolar removal shouldn’t be for limited cases only. It was popular long time ago but sometimes it is still required. This blog is intended for implant dentistry not for orthodontics but I understand your relationship. As long as teeth are moved into the area where the teeth were removed and the bone will stay like normal and will not shrink.

  22. Im 36 years old. 2 years ago I had 4 wisdom teeth removed and braces for 15 months. My face has changed a lot. It’s flatter, my lips look smaller and my eyes too.
    How can I reverse all this?

  23. Hello I am 29, and two of my lower teeth are missing. I am planning to make two implants. But the problem is that one of my upper teeth which is above the missing ones has dropped a bit and its ever so slightly moving. Do I need to remove that one too? Or can it just be filed and put a crown over the top? Thanks in advance

    1. What you describe is one option. You also may be able to orthodontic leet intrude those teeth so that they are more level thereby eliminating the need to place crowns on them. This is an older post on bite leveling which may help you understand.

  24. I am almost 62, I will have an upper back tooth extracted on Friday (I think it is #28). I have all my natural teeth; this will be my first/only extraction. The extraction is due to a failed root canal retreatment procedure. My oral surgeon wants to put in a bone graft (is this the same as a socket graft?) and let that heal and my missing bone grow before an implant is installed. Should I get the bone graft and stitches after the extraction, even if I am not sure I can afford the implant? I assume it is good to have new bone growth in the empty socket, right? Is extraction and bone growth enough to keep the surrounding teeth and gums from collapsing into the empty socket? Thanks for your help.

    1. if you are considering having an implant than having the bone graft in most cases is beneficial. But keep in mind if you do nothing with the bone graft after a year or 2 it will begin to shrink also depending on what was used and your genetic propensity to maintain bone mass. Also the upper jaw is in the region of the sinus or some of the bicuspid and molar teeth. Your tooth #28 does not correspond with the upper tooth unless you are using the European numbering system.

  25. I am in my mid 60’s and will be getting tooth #20 pulled which has grown inward has become a tartar trap and has some decay below. There are 2 molars behind that tooth. When I bite/chew the tooth does not align with my other teeth. I do not have plans on getting an implant or anything else. If my bottom teeth move slightly that’s ok since they are quite crowded.
    Is a bone graph still necessary and why?

  26. As a teenager, I had a lower tooth extracted. Now 35 yrs later, the upper tooth (believe #16) is receding. Just this one tooth. I thought my dentist could seal it or bond it, but he suggested I consultant a Periodontist. I’m concerned how he will treat this one tooth. Also, how much it will cost me to fix it.

  27. I had tooth #12 extracted.had a cavity for a year.x-rays showed it but didn’t find out till a year later when the dentist decided to tell me and the cavity was at the nerve.im 18 years old female and I got it extracted 10 months ago.they told me the space is too narrow for an implant.would a mini implant work.would braces work.can anything be done.i literally cry myself to sleep over this and was tramatized getting the tooth pulled.i look so much more ugly now with this one tooth gone and my smile looks different.im more depressed and anxious about losing another.It’s hurt my mental health big time and I’m afraid of the bone loss.and my teeth have shifted already.its making my life very hard and need some sort of advice please. I wont do bridge because I don’t want my teeth shaved down for something I would get 15 years maybe 20 if I’m lucky till they would have to pull those two teeth.i don’t want flipper either because I’d have to take it in and out to eat.Do I have any options.advice is appreciated.

  28. I retained 2 baby teeth until I was 18 years old, later on they start hurting therefore my dentist decided to extract those teeth ( Lower left #19, and Lower right #30) and suggested having dental implants. After extracting my 2 teeth and in the process of completing the implants, things happened back home and I had to come back to the US so he did not complete the whole procedure that was 7 years ago.

    My question is: Would they be able to complete the implants procedure at US ? The place where they extracted my teeth hurts a lot and I feel too much pressure and pain why should I do?

    1. Surely a skilled dental implant provider can take over and finish things off.

      The pain in the area is very unusual. You need to be looked at.

  29. My two front teeth is missing it start in 2010 and I don’t have money to pay to get them fixed I’m ashamed of my mouth I hate to smile in front of people or talk because of my missing tooth

  30. I’m 18 years old and had #12 pulled.the dentist failed to inform me I had a cavity and it got worse over one year and I had it pulled.its been 10 months since it was pulled.they said space is too narrow for a regular implant.am I screwed do I have options.i do not want a traditional bridge because I don’t want my teeth shaved down and they only last around 15 years.i cry randomly and am so depressed losing this one tooth.its painful emotionally and I am desperate for a solution.please help.

    1. There are options to do some limited braces in the area to open up the gap a bit. This will create a more ideal spacing for a regular sized implant. You may want to seek another opinion but you need to move quickly because at your young age your teeth can move fairly fast. Perhaps the orthodontist can close the space altogether you want even need an implant! Good luck and please keep us posted

  31. I had all four of my wisdom teeth removed in July of 2016, and have since noticed a substantial change in my facial structure. My fave has gotten longer but the jawline seems collapsed/less supported, leading to a narrower but “puffy” appearance due to loss of structure. I know that dental implants would help with functional use of teeth, but would an implant, because it does not grow into the jaw, cause a return to original jaw structure?

    1. No, it will not return original jaw structure. Changes to your face after wisdom teeth removal are unheard of although I believe you!

  32. Hi doctor,

    I had to have my tooth (canine) removed when I was 18, unfortunately not knowing any better and since it was costly, I never got an implant.

    Now my teeth have shifted to fill that space, I have an appointment with my dentist in about 3 weeks and plan on getting this treated.

    What can I expect as far as treatment? Braces?

    Thank you very much!

    1. if you are going to do it right the first time, orthodontics is almost always a necessity since the space has narrowed.

  33. Hi i had my lower left back molar removed about a month ago the tooth that was directly next to it has always been tipped although its tipped about another half millimetre or so and that tooth and the one next to it are sensitive is that normal after a month? Im really worried about it as i dont understand if its normal plus the first time i had ever been to the dentist was the day i had the back molar removed

    1. This is not totally uncommon. Make sure you see your dentist for a follow-up visit to have it looked at. Sometimes your bite just needs to be adjusted.

  34. My 3 years old daughter front teeth has decayed very badly as she refused to have her teeth brushed. What can be done about it?

    1. this blog is intended for implant dentistry questions. You may want to search something more related to pediatric dentistry. This is not my area of expertise.

  35. im curious, if the tooth (molar) have been extracted for many years (couldn’t get the bridge due to budget and insurance) and the wisdom tooth have been crooked due to shifting like you mention in this article, is it too late to fix the wisdom tooth to get back to have alignment straight once decided to get a bridge for missing tooth?

    1. It’s likely not too late. It just becomes more costly, takes longer and less predictable to correct the tipped molar.

    1. Teeth by themselves are very strong as long as there is no bone loss on the adjacent tooth. Over time, the long-standing tooth may become wobbly especially if it is a back tooth with a heavy bite force.

  36. am 32 years old my incesor teeth was not correct if i replace it with a new teeth then is there any side effects or difficulty

  37. I just had a root canal don’t on my back molar! I’m thinking about getting the tooth pulled because I’ve heard that teeth that ha e undergone a root canal are dead and harbor bacteria!! This bacteria lead to blood toxicity, heart problems, cancers, etc.

    MY QUESTION:
    I have other impacted teeth! Is it a possibility for dentists to extract those teeth and place them where my molar currently is? That’s the molar I had the root canal on that I’m seriously considering removing!!

    1. tooth transplantation is what you are mentioning. It has been tried for many years and is **rarely** successful. A well done root canal will not cause you problems. The key word is well done!

  38. Please advise me. I have an dentist, endodontist, dental surgeon and now orthodontist. Number 10, a year ago, needed a crown. Fine, but that started a mess..infection, ab, no bone above, tooth removed by surgeon who was planning an implant after bone graph healed. Now he will not u til my bite is fixed due to huge overbite and lower front teeth banging into palate. I’m 66 with lymphoma, now missing a fro t tooth. I thought getting through an extraction and bone graph and implant was bad enough, but 2 years in braces and a missing tooth? Admittedly I’ve had 10 teeth removed by Ortho when I was a teenager in the 60s for crowded mouth and braces. My dentist wants to pull all my front teeth for implants even though they have to be straightened. I’m in horror at this mess. Plus flippers are horrible, with a huge increase of plaque now. Yikes!

    1. Why not just have a cantilever bridge made off of your canine #11? Going through all this with lymphoma may not be what you really want. This way you can bypass the implant surgery and the orthodontics and have a tooth back again within about 10-14 working days. This particular style of cantilever bridge can work very well for a long time. There not intended for all situations but tooth #10 is often the most ideal situation.

  39. I want to ask if there is any need for wisdom tooth replacement afyet getting it extracted at age of 48 years. Extraction was done as the wisdom tooth became loose from its roots. Please suggest if it is a goid idea to go for replacement of my wisdom tooth.

  40. Please advise me as I am seeing my dentist tomorrow and am panicking I made the wrong decision.
    2 abutment teeth(14, which he rootcanaled) and 12) were grinded down to fit a 3 crown bridge on extracted tooth #13 .I I would rather live with the missing space (I am 62) . But is it too late for 2 crowns for 12 and 14 (he already removed a perfect crown that was on 12) since they are already prepped to be abutment teeth and probably are pegs now? Is there a denture for 1 tooth? I just can’t live with a cement block of teeth which will probably not last and then #14 or #12 will be lost as a probable future. I’d rather live with no #13 than a bridge. Is it too late if the abutment teeth were already grinded down? Thanks so much. Wish I were in CA again but I’m in NY. Linda

      1. Thanks for your speedy reply Dr. Amin! I will be seeing you as my future dentist when I return to LA in December! Thanks.

  41. My dad age is 49.he drink coc.nitric acid before 25years back…so he cannot eat normally because esophagus gets constricted so he eat everything after mixer and make it liquid drink slowly..now he remove entire tooth… he feel very difficult not able to chew the food… its there is any treatment for my dad??

    1. Your father needs to see an excellent dentist and have a diagnosis and treatment plan. He may or may not be a candidate for dental implants but at least he should have dentures so he can chew food. I wish him the best.

      Ramsey A. Amin, D.D.S.
      Diplomate of the American Board of Oral Implantology /Implant Dentistry
      Fellow-American Academy of Implant Dentistry

  42. I got tooth 12 pulled several years ago. About a year or so ago tooth 13 and 14 had to get root canal done. I just received the root canal on both teeth. I would like to know if possible can I get the crown big enough on tooth 13 to look as if I have a gap in the missing tooth?

  43. hello

    im 26 yrs old and 3 years ago, i had one lower (lower jaw ) right side tooth removed ( had the one behind it removed some years before) so it two teeth are missing. As such, will the upper teeth ( upper jaw) continue to grow since they are no longer making contact with the teeth that use to be below them? will those continue to grow and need to be
    removed ? im concerned.

    1. Yes. What you have described happens commonly. It is called supra eruption. This is the beginning of your bite collapse. This is the time to do something before the domino effect occurs and you start to lose more.

  44. Hello
    I am 30 years old and just had tooth #14 extracted (upper left, second to last) today. I’m getting conflicting information as far as how long I need to wait to get an implant. Also, what are the other alternatives to implants that won’t damage the adjacent teeth? Finally, could I just have a spacer put in? Thanks in advance.

    1. Ideally better to wait 4-6 months for that specific tooth. Not all teeth need that much time but the upper molar has VERY SOFT bone so most cases are done as delayed placement.

      A spacer is an option but it is not a tooth. You can wear a one tooth denture also.

  45. Hi, great site. I am due to have a wisdom tooth on right upper and a “dead” decayed tooth left upper back side extracted tomorrow. I am 29 years old and i want to save as much teeth as possible for long as possible. The wisdom tooth pain went after a course of anti-biotics. The dead tooth doesn’t hurt at all and has been this way for a year or so. I already have other fillings & a gold tooth at the bottom & dont wanna mess up the top. Also, my dentist told me these extractions will affect my sinuses. Is keeping the teeth a good or bad idea considering the above? Please advise

    1. Keeping bad teeth will spread the disease to the good teeth. Keep in mind cavities are caused by bacteria and so is periodontal gum disease. Keeping your entire mouth healthy is critical.

  46. I had all my teeth pulled and am waiting for the dentures. No problems with the extractions but now when I try to close my mouth I get nauseous. Bad. Real bad. I cannot close my mouth at all without throwing up.
    Is this normal. What’s wrong with me. I have many more weeks for my dentures. Six weeks till impressions. Help me

  47. I want to join the police force but I am worried that I will fail their dental examination of the mouth…I have 1 incisor at the top missing and 2 premolars at the bottom missing. (1 pre molar at the left side and 1 pre molar at the right side) . Will this affect my oral examination of the mouth by the police force? Will I fail or pass?

    1. hmmm…not certain on this one –I’m sure they have guidelines that you can refer to someone. Good luck and thank you for keeping our streets safe!

    2. Hehe. 😉 No worries. An oral examination means they’re wanting to hear you speak. It’s about oral communication, not that they’re going to be looking in your mouth at your teeth.

  48. Hello Dr
    I’m 31 I had a baby tooth pulled out in 2010 my dentist said if she pulled it out the permanent tooth will come out so she pulled it out and the permanent tooth is still not out what to do I hate having this gap.

    1. hmmm…at 31 it is unlikely that any of your teeth that are stuck will erupt…..you need to see an orthodontist to help bring this tooth in if it is even possible.
      good luck

  49. I am seventy five years old. I am told by dentists that my teeth and gums are excellent.
    I had three wisdom teeth removed over the years and lost number 36 (I think, two forward from the wisdom tooth on the lower left) when I was 29 due to it being an impacted tooth. My teeth did drift back filling the space but as my teeth were all very close, the change was not noticeable.

    I now have number 37 (next to the wisdom tooth, lower left) which has a crown on it, with decay below the bone. It will have to be removed. The wisdom tooth is still there and it has a large filling. I was also told it had some “cracks” but that it could be crowned to protect it and it be used to support a bridge.

    I guess I have been fortunate to have only lost one tooth besides my three wisdom teeth. I guess this is great for my age.

    Here is my question: At my age, should I bother to fill the space when the tooth is removed? The dentist is encouraging me to get a bridge but I worry not only about the cost and my age but the fact it would be anchored to a wisdom tooth?

    What are your thoughts on this? Thank you.

    1. it depends on if the roots is an tooth are really substantial and strong/long. Many wisdom teeth have very small short root and are tilting towards the front. Loss of even one tooth will lead to further tooth loss

  50. I have to remove 2 upper molars one on the left one on the right side. I removed my molar on the bottom right side and a wisdom tooth started popping out and slowly filling in the gap. On my bottom left jaw i have to also remove 2 molars but i noticed my wisdom tooth slowly popping out. So my question is: Could I remove my upper molars and expect for my wisdom tooth to fill up the gaps again?

    1. this would only work if you’re age 12-15. Wisdom teeth will not drift that far forward after that. Even then, orthodontics would likely be needed to pull forward. they will come and very tipped. Tipped teeth have their own problems with gum disease later on in life. Teeth need to be perfectly upright

  51. 5 piece gold cap not able to remain on broken crooked teeth on lower front bottom ….can a temporary denture piece be placed over until I can find funding thru Medicare or other source for me age 76….thank you…

  52. Hi Doctor,
    I had the same problem as Megan did, only my bracework was ruined and then I got my wisdom teeth out. It looks as though my jaw has receded significantly as well. Is this possible due to getting my teeth out? Will I need implants?
    Thank you so much,

    Ann

  53. Hi, I had all four wisdom teeth extracted because I felt they were making all of my teeth crooked. Little did I know that it changed my entire face, my jaw is not as long and is way shorter and my face feels like it has sinked in. It’s difficult to look straight at something, difficult to hear, difficult to breathe and swallow sometimes all because I feel it was because I got my wisdom teeth removed. I feel no support for my face whatsoever. I also feel exactly how I was when I was in 6th grade or lower. Not only that but my voice sounds like a little girl. I don’t even feel like a human being anymore. It is very difficult to chew I feel like I don’t even have a muscle anymore to chew hard foods like hearty sandwiches, meat, broccoli. It’s like all that’s in there are teeth and feel when I eat hard foods I feel my teeth are going to break. Is this even normal? Where should I go to get this fixed? I’ve asked my dentist many times but he will not help me.

    I’ve been thinking that dental implants will fix my face back to normal? As in putting dental implants where my wisdom teeth were.

    1. Hello Megan

      This sounds a bit odd. I would have somebody take a 3-D CT scan of your entire skull and have it looked at by an oral and maxillofacial radiologist.

      Removal of wisdom teeth does not cause the type of signs and symptoms that you have described. I know that’s not what you want to hear but it is so extremely unlikely that it had anything to do with this. Reimplanting wisdom teeth is not something anyone should do.

      Respectfully, Dr. Amin

      1. Hi,
        Thank you so much for your response! Yes that’s not quite what I was wanting to hear. Is there anyway that getting my wisdom teeth removed changed my jaw structure? Or my face for that matter? I am currently getting my teeth straightened and am wondering if that’s what’s making my face change and voice change. But I am not getting much corrected so I feel that’s not what did it. I do feel my jaw is not defined anymore and is way shorter almost like it has receded, post wisdom teeth removal, making my face shorter as well. I will get the radiologist to look at my skull like you mentioned. However, is this something I should worry about getting done? I would just like my face back to regular and feel like getting my wisdom teeth removed dramatically changed my face. If there’s anything I can do to get this fixed please let me know. You said it’s not a good idea for dental implants, is there anything else that can get my face back to normal? Thank you again for all of your help.

        Yours Truly,

        Megan

          1. Hi, I don’t know if my reply got sent, I am almost 19 years old. I think it would be beneficial if you could see pictures. But anyways thank you again for all of your help!

  54. Hi Doctor, I wish I had known all these information before now. I had two bottom molar on both sides extracted about 22 years ago in Africa. Though my dentist advised against the extractions, but the pain was terrible then. Now I’m 38 years old with noticeable sagging facial look. Is their still hope for me. Though I don’t have insurance now but will try to save up to fix this if their is still hope. My cheeks are sunk in and I’m really worried about my look.
    Thanks.
    From Texas

    1. It sounds like you are going to need extensive bone grafting to rebuild the lost bone.

      Dental insurance does not cover these procedures anyway. It will be a costly endeavor but well worth it. Do your due diligence when searching for a dental implant provider. Good luck.

      Respectfully,

      Ramsey Amin DDS

  55. Hi Doctor, I wish I had known all these information before now. I had two bottom molar on both sides extracted about 22 years ago in Africa. Though my dentist advised against the extractions, but the pain was terrible then. Now I’m 38 years old with noticeable sagging facial look. Is their still hope for me. Though I don’t have insurance now but will try to save up to fix this if their is still hope. My cheeks are sunk in and I’m really worried about my look.
    Thanks.

    1. It sounds like you are going to need extensive bone grafting to rebuild the lost bone.

      Dental insurance does not cover these procedures anyway. It will be a costly endeavor but well worth it. Do your due diligence when searching for a dental implant provider. Good luck.

      Respectfully,

      Ramsey Amin DDS

  56. My one top front teeth is out of the place and is shaking looks like it will come out any time im worried idont want to have gap what can I do?

  57. Hi I just had one of my top front teeth knocked out (the middletooth) and some of the ones next to it twisted out of place. I am 20 and although I got to a hospital fairly quickly and it was put back in and all the teeth were re-aligned and glue in place using some kind of foil and cementing agent I am really worried that I am going to lose my tooth. What are the chances I will be able to keep my tooth and is it likely to be loose in the future.

    1. Without seeing you there is almost no way I can tell you with any degree of certainty. I am hoping you were seen by a dentist at the hospital or at least seen the very next day by dentist rather than an emergency room physician.

      I would take x-rays every 6-8 weeks for the first 6 months and look for any signs that the teeth may be dying. If so root canal treatment may be a better option than removing the teeth and having dental implants.

      Sometimes the teeth goes reprocess called ankylosis and fused to the bone after they have been knocked out. You may lose these teeth within 1 year or you may end up keeping them for 20 years. There is really no way to know but I would highly recommend you see a dentist that can do follow-up on a traumatic injury.

      Ramsey A. Amin, D.D.S.
      Diplomate of the American Board of Oral Implantology /Implant Dentistry
      Fellow-American Academy of Implant Dentistry

  58. hi
    doc, you are doing a great job, …pls i have my molar tooth on both side have cavity, is it possible to implant it? it really make me not eat well ….thanks

    1. If the tooth is savable by all means have a well made crown rather than extract your tooth and have a dental implant. I’m on plants are a second place to your own natural tooth.

  59. hello im 21 nearly 22 i have 3 second molars missing im wondering how long until bone loss occurs i dont wanna look old at my age lol i just dont have the money at the moment i will within the next year though thank you.

    1. Unfortunately bone loss began the first week that the teeth were removed. Move as quickly as you can get these teeth replaced before you end up needing much more costly bone grafting in addition to the dental implants

      Ramsey Amin DDS

  60. I am 28 yrs old and I am getting ready to have my top 2 molars removed due to root exposure and decay. My dental history for the last 10 years has been spotty due to lack of insurance and 2 pregnancies that drained the calcium out of my teeth. I had an assessment done last year and was told I would have to have 5 teeth pulled, 7 root canals and a major amount of fillings etc. I needed work on every tooth but 4. I haven’t been back since. Obviously my teeth are worse now. But I am wondering what my options are considering the cost.

    1. It is difficult for me to advise you because I have never examined you or seen any type of x-rays. I would suggest having the absolute best dentistry that you can afford. Work with the best dentist that you can. No dentistry lasts for life including dental implants at your young age of 28. The less number of times you have dentistry done the better.

      Focus on education and prevention so that the work you have done last as long as possible. There must be something else going on besides pregnancies which have caused all of this. These could be things such as heavy plaque that is not being removed every day, diet, frequency of diet, dry mouth, medications medical conditions such as GERD and many other things.

      Ramsey A. Amin, D.D.S.
      Diplomate of the American Board of Oral Implantology /Implant Dentistry
      Fellow-American Academy of Implant Dentistry

  61. Hi, i had my second lower right molar extracted about 1.5 years ago. Currently I am on the last stages of invisalign and starting to notice the right side of my face drooping in pictures. I am concerned that I may have suffered from bone loss in this region. Would getting an implant after my invisalign is completed fix the slight asymmetry in my face overtime? Would the lost bone grow back or is bone grafting the best choice for my situation? I am a 26 year old male and the rest of my teeth are in good condition.

    Thank you.

    1. Hello Audrey,

      Thank you for your very kind words. I’m flattered to have a follower.

      If there were no signs of infections and the implant is firmly anchored, your bite may be the cause of all of this. Have your dentist check for what is called fremitus in your bite. Many dentists overlook this critical issue. Fremitus means your teeth removed when you bite down. You can test this yourself by holding your upper jaw teeth with your forefinger and thumb and bite up and down. If you feel your teeth move, you have fremitus which leads to overloading which ultimately leads to bone loss and implant failure…. Regardless of how well everything was done.

      Fortunately problems with your bite are easily remedied but this specific thing needs to be looked for. Many people have the outward sign of having slight recession and middle notches near the gum line who have fremitus. Fremitus leads to bone loss. Without seeing you in person, this is just a hypothesis but I see this fairly frequently when people get pain from a crown.

      About 2-4 weeks after even major dental surgery, all pain should be absent. Bone grafting on existing implant is difficult and unpredictable. This condition is called peri-implantitis. If the implant does not working, you should remove it and replace it

      Very Respectfully,

      Ramsey A. Amin, D.D.S.
      Diplomate of the American Board of Oral Implantology /Implant Dentistry
      Fellow-American Academy of Implant Dentistry

  62. Hi doc,

    My dentist says I need to have my molars removed due to periodontal disease or it will continue to ruin my bottom teeth. Both my remaining molars have up-rooted on one side. I asked if an implant could be possible but my dentist says I’ve lost too much bone. He says, if he chops my molars in half and does a root and crown them that will stop my periodontal disease and salvage my teeth. Is that true? What can I do? Would love to get a second opinion. Thanks.

    Jeff

    1. Hello Jeff,

      The procedure you are talking about is called a hemisection. It is a very old procedure that is not done very often anymore. It does not have the highest success rate unless your existing roots are very long. I’m assuming that your nerve is very close on the bottom jaw and that is why your dentist is tearing you away from implants. I would suggest you get a second opinion. The hemisection tooth with a root canal and crown is not likely to give you the same longevity as dental implants. You will only be going through all of this tooth extracted in the future.

      If you end up having very short implants that I would suggest that you connect them to each other for strength and durability.

      Good luck,

      Ramsey A. Amin, D.D.S.
      Diplomate of the American Board of Oral Implantology /Implant Dentistry
      Fellow-American Academy of Implant Dentistry

  63. I’m almost 31 and my #19 tooth chipped and got infected. I need to have it removed but was told I need to wait until 6 months after extraction to get the implant placed. Is this correct? I’m worried that my teeth will separate during this waiting period. Concerned I’ve been given incorrect information.

    1. 4-6 months after extraction would be considered a standard waiting time. I am assuming you had a socket bone graft to preserve the bone? Timeline can be speeded up with products made from your own blood such as L PRF.

      If you’re concerned about shifting teeth, you can make a temporary removable tooth to fill the space and prevent adjacent teeth from shifting. Generally speaking, within the first year the teeth do not move. If you were to leave this tooth out for several years, all of the teeth and that side would move.
      Good luck,

      Ramsey A. Amin, D.D.S.
      Diplomate of the American Board of Oral Implantology /Implant Dentistry
      Fellow-American Academy of Implant Dentistry

  64. im 14 years old and my one of my front teeth never grew. will it still grow at this age? I havent gone to the dentist in about 3 years, because I dont have medicaid, and I really want my tooth to grow. what can I do?

    1. you need to see an orthodontist ASAP. If you are missing a tooth and your other teeth grow around it, it is going to cause the rest of your teeth to become crooked. You may need a dental implant when you’re about 18-20 years old at the youngest

      Ramsey Amin DDS

  65. Hi doc,
    So i need to get a root canal on my last molar before my wisdom tooth. would it be possible to pull the tooth out instead and then get braces (because they are needed anyways) and pull the wisdom tooth in its place instead. I read a few articles where it says it is possible but just want a confirmation first.

    Thank you.

  66. I am 53 years old. My teeth have been yellow. I daily brush and clean them two times a day. I want to change these teeth and fix a new teeth which may be capable in eating fruit, bread, & other all foods. May it be possible and how? Kindly suggest me.

    R.B. Pandey

    1. Not enough information to answer.

      You need to see a very good dentist to asses you properly. Your own natural teeth are the best. implants are a close second place!!

  67. I keep getting caries in my top front teeth, why is that and I have some teeth that overlap each other, was wondering if I pulled one will my teeth straighten out some. Plz help

    1. That is likely a bad idea. You need to see an orthodontist….do not just pull teeth out to make the other straight. You’ll end up having a lot more problems in the future

    1. Yes absolutely. This dental implant would be a second molar.

      the second molar dental implant can be complex on the lower jaw due to the nerve below it in can be complicated on the upper by the sinus. It is important and I would say critical to have a 3-D CBCT scan done to properly place this implant. It is also important that you wisdom tooth is absolutely healthy. If a dental implant is placed next to an unhealthy wisdom tooth, it will be doomed.

      Second molar dental implants are extremely common in my office…. This tooth should be designed to be extremely strong with ideally a wide diameter implant and a monolithic zirconia crown. Make sure to choose somebody very skilled and experienced and dental implants. Second molars are more challenging than most teeth.

      Very respectfully,

      Ramsey Amin DDS

  68. Hi Dr. Amin,

    I was wondering if you could tell me if removal of the wisdom teeth affect facial structure? And if so, do you recommend getting getting implants?

    Thanks so much,

    Victoria

    1. Hi Victoria,

      If you have a full complement of teeth, removing wisdom teeth would not cause any issue at all. Many people including myself, did not have room for wisdom teeth and they cause a lot of problems. I would not ever consider reimplanting your wisdom teeth.

      Ramsey A. Amin, D.D.S.
      Diplomate of the American Board of Oral Implantology /Implant Dentistry
      Fellow-American Academy of Implant Dentistry

  69. my teeth are horrible i have 7 fillings 1 root canal and 2 teeth missing (2nd premolar bottom and 1st molar) and i’m only 18. i think my teeth could’ve been saved but my old dentist only believed in pullings and fillings , so i decided to try a new dentist (where i had the root canal done) , i was wondering could i use braces to bring my back teeth forward i still have all my wisdom teeth so can they replace the missing one or should i just get implants when i’m older , Is it too late for my teeth , =(( this is depressing me seriously because i take care of my teeth brush twice a day (sometimes 3 ) & laid off the sweets

    1. Hi Vanessa,

      Don’t lose hope! Yes we cannot change the past, but we can move forward. You will not be able to move the molars into the empty space unless you are 12-13 years of age. It is very unpredictable. The teeth can be uprighted or extracted and dental implants placed in the missing areas. Oftentimes you need your wisdom teeth extracted also.

      It is not too late, but you need to have a plan in place to restore your entire mouth. Just going tooth by tooth is not going to cut it. If you do it this way, you only have continuous problems. You need to see a dentist who can handle full mouth rehabilitation including dental implants. I would suggest you see a total solution provider who can do all procedures by single person. Do your due diligence and research.

      How to Choose an Implant Dentist

      Ramsey A. Amin, D.D.S.
      Diplomate of the American Board of Oral Implantology /Implant Dentistry
      Fellow-American Academy of Implant Dentistry

  70. Hello,
    Im 57, and have very brittle teeth, and only have 1 back tooth on lower left hand side, as had 2 teeth removed 30 years ago. Recently my nhs dentist removed another loose tooth which has made the gap more noticeable. Asked my dentist about bridge, but he says the back tooth isnt very stable, and side bridges arent very good, and that no one will be able to see the gap, but i feel very conscious. Please could you advise me of my options?

    1. Hi Suexx,

      It sounds like you know the answer already…. You are ready for dental implants!! Do not make a bridge to a weak tooth. You might as well throw money in the trash if someone does that for you.

      In the lower part of the jaw, there is a nerve present. This nerve should be measured by 3-D scan to be sure that you have room for the implants. 3-D scan technology will allow you to virtually see your teeth before you ever even have surgery done.

      3d Scans

      Very Respectfully,

      Ramsey A. Amin, D.D.S.
      Diplomate of the American Board of Oral Implantology /Implant Dentistry
      Fellow-American Academy of Implant Dentistry

  71. Dear DR,

    I need your help, I had my upper right wisdom & molar removed due to my dentist not knowing it was jaw pain he thought I was having tooth pain but later found it was my jaw & then cause my jaw to lock.
    It was 8 years ago but now my a crown molar keeps falling out & my bite are imbalance, I really need your expert advice as now I worried about losing more teeth & am sick of the imbalance bite I have such a big gap at front that I can’t bite bacon etc.
    Thank you so much & look forward to your help

    1. Cheri,

      You should see an orthodontist first before considering a dental implant to replace your missing tooth. replacing a tooth is generally not going to solve jaw pain and a bite that is not balanced.

      Very respectfully,

      Ramsey A. Amin, D.D.S.
      Diplomate of the American Board of Oral Implantology /Implant Dentistry
      Fellow-American Academy of Implant Dentistry

  72. Hi. I’m a 30 year old female. I actually just got back from my first dentist appointment in 3 years. I waited so long because I did not have insurance. At the dentist I was told I need three teeth remove. Two molars on my bottom right side and another tooth on my bottom left side closer to my front teeth. Even though I have insurance now the cost of dental work is still pretty high. So I was told I should get bone grafts for all three teeth so later on a can get implants. But the cost of the bone grafts is not covered by my insurance. So my question is, what will happen if I don’t get the bone grafts right after the teeth are pulled? Could I get bone grafts done later without any significant problems? Implants are also very expensive, if I do get bone grafts i prob won’t be able to get the implants for a few years anyway because of the cost. Will it cause problems if I wait to get the implants?

    1. Hi Jean,

      Unfortunately dental insurance hardly does anything anymore. It has a yearly maximum that has a ceiling of usually $1500 per year. It has not changed and almost 40 years!!!! It is so behind the times.

      The longer you wait, the more expensive and complicated it will get. Even if you have bone grafting done, the jawbone may still shrink from disuse atrophy. This means if you don’t use that you will lose it. Also, your bite will shift in your other teeth will move…. These are all definites…. For some they have been much more quickly than others.

      I truly understand that finances are a huge concern, but somehow tried to make this happen…. It will save you a ton of money in the long-term.

      Bone Loss
      Does Insurance Cover Dental Implants? – Burbank Implant Dentist Advice

      Respectfully,

      Ramsey A. Amin, D.D.S.
      Diplomate of the American Board of Oral Implantology /Implant Dentistry
      Fellow-American Academy of Implant Dentistry

  73. Hi,
    I have lost my lower left ist molar teeth very long time ago and because of that other two molars have been tilted. Now i want to correct my buck teeth but the orthodontics says that ist molar teeth is needed and plays a crucial role in buck teeth treatment after the extraction of four teeth. so i desperately need your expert advice on this.
    Thank you.

    1. Orthodontic Dental Implants…They Help With Braces Too!

      You likely need to upright your molars. My guess is they are tilted and in the way. It will take some time for you to regain the space can reimplant the molars but I agree they are crucial to your orthodontic outcome.

      Ramsey A. Amin, D.D.S.
      Diplomate of the American Board of Oral Implantology /Implant Dentistry
      Fellow-American Academy of Implant Dentistry

  74. Hi. I am 19 years old and have been missing my bottom back right molar for about 4 years now. At the time my dentist gave me the option to put an implant in or just leave it (he did not make me aware of the full implications of a missing tooth), and, being a teenager I did not think about the long term consequences of having a missing tooth. 4 years later the gap where my tooth was is near to closed up, but, I now notice that the right side of my face is slightly less defined and that the jaw near my ear clicks and occasionally aches when I eat tough foods. I want to know if there is any treatment that can help now? (given that the gap has closed). or whether the issue will resolve itself? or any other implications that may arise.

    Any suggestions?

    1. Hi Daniel,

      It sounds like you have bone loss in the area where the tooth is missing and the molar behind it has tipped forward into the space. The most ideal treatment is to having orthodontist tilt and upright the molar behind the space. After that is done, bone grafting can be completed to widen the bone in order to have an implant.
      This is a collapsed bite situation and it is common to develop symptoms in your jaw joints because of it. This is one of the main reasons I counseled patients to replace teeth as soon as possible.

      Burbank Dental Implants – Correcting a Collapsing Bite Problem

      Very Respectfully,

      Ramsey A. Amin, D.D.S.
      Diplomate of the American Board of Oral Implantology /Implant Dentistry
      Fellow-American Academy of Implant Dentistry

  75. I recently had my last two left molars extracted and my wisdom tooth is peeking out already idk what I could do I really can’t afford Any work done what so you suggest

    1. Dear Lee,

      Try to make it happen to replace at least one “first molar.” Without 1 molar in every quadrant of your mouth your likely to end up with substantial bone loss and more importantly a collapsing bite. You need your back teeth to maintain the longevity of your front teeth. Just go very slow and try to get it done… It will cost you so much less in the long-term.

      Correcting a Collapsing Bite Problem

      Very Respectfully,

      Ramsey A. Amin, D.D.S.
      Diplomate of the American Board of Oral Implantology /Implant Dentistry
      Fellow-American Academy of Implant Dentistry

  76. please i need advice i hv lost two tooth within de period of four months one on September de lower last teeth and just dis November i removed de upper last tooth an just yasterday i started filling pains in the teeth dat is beside de first tooth that was first extracted i Dnt want to lose another tooth again what do i do doc.

    1. Losing teeth is mostly preventable. You likely have severe gum disease, a problem with extensive decay, and/or a problem with your bite. You need to see a very skilled dentist for a comprehensive examination with a complete set of x-rays. Once you establish a diagnosis, then treatment can be initiated to help to prevent further tooth loss.

      Your education is key. The more you know about maintaining oral health, the better you will be. Without you, even the best dentistry in the world will fail and you will continue to lose teeth. Be sure to understand a link between diet and oral hygiene. Of course smoking and recreational drugs never helps.

      Very respectfully,

      Ramsey A. Amin, D.D.S.
      Diplomate of the American Board of Oral Implantology /Implant Dentistry
      Fellow-American Academy of Implant Dentistry

  77. Hi,
    I have been to the dentist 2 days this week and had some of my teeth sealed.
    My second lower premolar is really damaged. Like its dark and it looks like something that has decayed and its getting close to the gum. I told my dentist that I want it cleaned and sealed but he recommended that I have it removed. Now am not sure because I have done some research and learned that having teeth removed can cause some changes like you upper premolar growing longer to occupy the space and stuff and I don’t think I’ll be able to get it replaced coz it’s really expensive. so I badly need your advice on what to do. Oh and by the way am 17 years old. Thank you

    1. Hello Sophia,

      First off, your parents need to help you with these decisions. If the tooth absolutely needs to be removed, you are probably too young to have a dental implant.

      If you have to have the tooth removed, I would suggest a socket bone graft to preserve the extraction site from shrinking so that you can have a dental implant in the future. This will prevent the bone from shrinking. In order to prevent the other teeth from moving because of a missing tooth, you can have a spacer made and cemented in so that your bite does not collapse from 1 missing tooth.

      If it is possible and predictable to save you tooth with a root canal and crown, you should consider doing this.

      Socket Bone Grafting….Do I Need It for My Dental Implant? Ramsey Amin DDS Reviews

      Burbank Implant Dentist on Extraction Defects…Relation to Dental Implants and Bone Grafts

      Very respectfully,

      Ramsey A. Amin, D.D.S.
      Diplomate of the American Board of Oral Implantology /Implant Dentistry
      Fellow-American Academy of Implant Dentistry

  78. Hi, I’ve been reading about implants. I have one scheduled for Jan. 6 with a good surgeon for the upper right hole where the 3rd tooth from the back was. (My wisdom teeth were pulled about 40 yrs ago). I’m having 2nd thoughts about titanium & resultant metal interaction. I have 6 gold crowns (2 underneath the hole & one next to the hole) & 4 silver/mercury amalgams in other teeth. The tooth was removed because of a 14 yr old root canal on that tooth that cracked in half and the porcelain crown kept coming loose & xray showed some bone loss there. I don’t care if my teeth shift a wee bit. I don’t want to lose any more teeth. What is the rate of bone loss, if any, of the neighboring teeth in terms of time? What are the long term consequences of doing nothing? I’m 63 & retired. Can I leave this for the next 20+ years? Other than peas getting stuck in the hole, I have no problems now. Thanks!
    Kathy

    1. Hi Kathy,

      Ultimately it is going to be your choice of what to do. Without seeing the full detail of your entire mouth by clinical and x-ray evaluation, there is no way for me to be able to tell you what to do.

      Teeth need other teeth.

      Once you lose one, you tend to lose more.

      Disadvantages of Dental Implants: The Cons

      Very Respectfully,

      Ramsey A. Amin, D.D.S.
      Diplomate of the American Board of Oral Implantology /Implant Dentistry
      Fellow-American Academy of Implant Dentistry

    1. This blog website is intended for dental implant and bone graft reconstruction questions. I will direct you to another link on my website for wisdom tooth information that may help you. 😉

      Of course I remove many wisdom teeth…. But they don’t all need to be extracted!

      Related links for you:
      Wisdom Teeth Extractions

      Good luck,

      Ramsey A. Amin, D.D.S.
      Diplomate of the American Board of Oral Implantology /Implant Dentistry
      Fellow-American Academy of Implant Dentistry

    1. Hello “Proud”

      Of course it is possible to put another one back in. You likely will need extensive bone grafting since the tooth may have been missing for all of these years and the bone has naturally gotten smaller.

      Get connected with an excellent dentist and consider having a dental implant. It is usually the best option!

      Dental Implant Procedures

      Very respectfully,

      Ramsey Amin DDS
      Diplomate of the American Board of Oral Implantology/Implant Dentistry
      Fellow of the American Academy of Implant Dentistry
      Burbank, California

  79. I 24 YEARS OLD AND I HAVE TO HAVE A TOOTH PULLED NEXT WEEK. AMD I WAS WONDERING IF I REALLY ACTUALLY NEED A BRIDGE. ITS MY BOTTOME RIGHT MOLAR.. ITS TOO EXPENSIVE BUT IF I HAVE TO I WILL PAY IT.. PLEASE HELP DOC!!!!

    1. Hello Kiesha,

      God designed you with all of these teeth for reason. I would highly suggest you to replace this tooth. Every tooth depends on another for strength and support. It begins a chain reaction of tooth loss once you lose one important molar.

      Dental Implant Procedures

      Very respectfully,

      Ramsey Amin DDS
      Diplomate of the American Board of Oral Implantology/Implant Dentistry
      Fellow of the American Academy of Implant Dentistry
      Burbank, California

  80. Hello.
    Right now I have only my back molar on the bottom right side remaining and it is in bad shape and giving me fits. the two teeth in front of this one have already been extracted. I am really leaning on getting that last bottom tooth extracted and want to know what the true negatives of this besides the typical alignment issues and stuff. I am growing tired of brushing the cavity hole and food getting caught in there. It is way past crown and root canal opportunities. If it means that the pain will go away and I can chew on my left side, that is what I truly want. I can worry about dentures or implants later, just need to know what to expected with my back 3 teeth on the lower right being removed.

    Thanks

    1. Hello Joe,

      Your pain will go away once the tooth was extracted.

      The more teeth you lose, the more bone you will lose. This will make wearing dentures almost impossible as you get older and will make the dental implant bone grafting process much more costly and lengthy. Especially in the lower jaw when bone is lost, wearing any type of partial or denture will become very difficult in a few years.

      Whatever you don’t use, you’ll lose. Your bone will naturally shrink away because it is not being used anymore. As that occurs your facial muscles will weaken and you will look much older than you are prematurely.

      There are so many reasons to replace your teeth.

      Bone Loss

      Respectfully,

      Ramsey A. Amin, D.D.S.
      Diplomate of the American Board of Oral Implantology /Implant Dentistry
      Fellow-American Academy of Implant Dentistry

  81. Hello.

    thanks for posting so much helpful information. Here’s my question, I’ve had perfectly straight upper teeth all my life, no gaps or anything. Then I had a molar removed on one side when I was younger. Now that I’m in my mid 30s my two front teeth are gaping. If I get an implant now, will I still need braces or some other procedure to close this gap?
    Also, I had a 2 large fillings done on the bottom molars and never had them crowned. What are the risks of leaving them as is?

    Thank you so much for your time!

    1. Hello Misty,

      If you are noticing gaps developing between your teeth you may have underlying periodontal disease which is also known as gum disease. This is due to a progressive loss of bone usually occurs very quietly and without the patient knowing. I would strongly suggest he see a dentist and have a full series of x-rays done and probing of all the gum pockets. The other reason why teeth space out is due to a bite problem. Both of these need to be evaluated by a professional.

      Types of Periodontal Disease

      This should be evaluated before you have braces or a dental implant.

      Molar teeth that have root canals need to have protection on top to prevent them from splitting in half. It is extremely common for me to remove broken root canal teeth that patients never had a crown put on top. Some front teeth do not need crowns over root canals but almost all back teeth do. Root canals make teeth dehydrated and thus more susceptible to breakage and fracture. For a molar tooth, I would suggest a monolithic zirconia crown.

      Ramsey Amin DDS Reviews Solid Zirconia Custom Dental Implant Crowns and Abutments Instead of Metal

      Very Respectfully,

      Ramsey A. Amin, D.D.S.
      Diplomate of the American Board of Oral Implantology /Implant Dentistry
      Fellow-American Academy of Implant Dentistry
      Burbank, CA

  82. Namaste
    I recently extracted my upper molar teeth due to not properly filling in root canal by doctor and now could u suggest me what should i do to refill it back here in our country(Nepal) i am little confused about doctors so how do i know which doctor is good as cost how much can it be for replacement of one tooth

    Thank You
    Waiting for the Advice
    Dolkar

    1. Hello Dolkar,

      Greetings from the USA.

      I don’t have enough information to be able to help you here. Just go ahead and see an excellent dentist with a good reputation for an evaluation and x-ray series. Then and only then can a diagnosis and treatment plan be made specific to you.

      How to Choose an Implant Dentist

      Respectfully,

      Ramsey A. Amin, D.D.S.
      Diplomate of the American Board of Oral Implantology /Implant Dentistry
      Fellow-American Academy of Implant Dentistry

  83. Namaste
    I recently extracted my upper molar teeth due to not properly filling in root canal by doctor and now could u suggest me what should i do to refill it back though u have written about one teeth root canal filling but here in our country(Nepal) i am little confused about doctors so how do i know which doctor is good as cost how much can it be for replacement of one tooth

    Thank You
    Waiting for the Advice
    Dolkar

    1. Hello Dolkar,

      Greetings from the USA.

      I don’t have enough information to be able to help you here. Just go ahead and see an excellent dentist with a good reputation for an evaluation and x-ray series. Then and only then can a diagnosis and treatment plan be made specific to you.

      How to Choose an Implant Dentist

      Respectfully,

      Ramsey A. Amin, D.D.S.
      Diplomate of the American Board of Oral Implantology /Implant Dentistry
      Fellow-American Academy of Implant Dentistry

  84. Hi,

    I got my bottom first molar teeth removed when I was in my teen years. I was wondering if I do get implants, will it keep my face from collapsing?

    Also, my second molars are shifting so how will the dentist put implants in if there’s not much gap as before?

    My wisdom teeth are vertically impacted, will it be possible to keep it or will I need to remove it?

    Thank you!

    1. Hello Lacey,
      It sounds like you have tilted molars. Your molars can be uprighted using braces. Because your first molars have been missing for many years you will likely also require bone grafting in the areas were the teeth use to be.

      It is best to create the ideal space first using orthodontics, then placed dental implants. It should always be done in this order. Your wisdom teeth need to be evaluated via panoramic x-ray in order to determine whether or not they should stay or go.

      Your lower first molar is an extremely important tooth. Nature gives you this tooth when you turn 6 years old. It is one of the cornerstones of the mouth like the canines are. I would highly suggest you replace it properly in order to maintain bite on your back teeth which in the long-term will reduce your chance of facial collapse.

      Braces, Orthodontics and Front Teeth Missing From Birth…What You Need To Know Before Having A Dental Implant

      Rationale and Costs –Immediate Same Day Extraction and Back Tooth Molar Implant vs.Waiting

      I hope this helps you,

      Ramsey A. Amin, D.D.S.
      Diplomate of the American Board of Oral Implantology /Implant Dentistry
      Fellow-American Academy of Implant Dentistry
      Burbank, California

      1. Hello,
        I spoke to my orthodontist and she suggested that I get braces to move my two bottom second molars into where my first bottom molars use to be at. Do you think that would work? Since my bottom wisdom teeth is erupting, I am think of keeping it as my second molars.
        Let me know what you think.

        Thank you,
        Lacey

        1. Hello Lacey,

          This is really going to depend on your age. It is a difficult orthodontic movement to be able to move second molars into first molar position and keep them up rights without tipping them forward. It is easy to move them forward but difficult to keep them standing straight upright without being tilted towards the front of your mouth. Oftentimes I have to upright second molars in order to place dental implants in the first molar position.

          If you are really young perhaps between 11 and 19 years of age it is a possibility.

          Braces, Orthodontics and Front Teeth Missing From Birth…What You Need To Know Before Having A Dental Implant

          Orthodontic Dental Implants…They Help With Braces Too!

          Ramsey A. Amin, D.D.S.
          Diplomate of the American Board of Oral Implantology /Implant Dentistry
          Fellow-American Academy of Implant Dentistry

  85. Hi I have read your comments above. I seem to have a very conservative dentist. On my right side I have to a lower first molar removed due to an absess and after a few infections the wisdom tooth finally calmed.
    Unfortunately on the other side the wisdom tooth grew into and cracked my second molar so it had to be removed, fairly dramatic- wound wouldn’t heal, stitches x 2 etc! So that was two years ago and now my wisdom tooth has come through but kind of rotated and at times cuts into my gum causing concerns of other problems, cancer etc.
    My long winded question is it really necessary to have this wisdom tooth out after all to prevent cheek problems but would it be important to get an implant maybe in place of the second molar so I don’t have a huge obvious gap? Thanks

    1. Hi Sarah,
      Wisdom teeth for 90% of us are useless and in fact are often the origin of gum disease and cavities that continue through life. Both gum disease and cavities are both caused by bacteria. So you can spread disease from one tooth to others. Having a healthy mouth and all of your teeth healthy is extremely important.

      Depending on the way your teeth come together, replacing your second molars with dental implants may be very important or it may not be important and all. For instance if you have a strong overbite or underbite, sometimes it makes your second molars either completely nonfunctional or, extremely functional and in fact distribute a bite over 2 teeth on the other jaw.

      Burbank Dental Implants – Correcting a Collapsing Bite Problem

      Very respectfully,

      Ramsey A. Amin, D.D.S.
      Diplomate of the American Board of Oral Implantology /Implant Dentistry
      Fellow-American Academy of Implant Dentistry

  86. My sister n I had our premolars extracted by ourselves and so some pieces are still remaining coz some came out by breaking off, it’s become hard to approach our parents about it coz they’ll ask why we delayed reporting , but in my case I must visit a dentist because the gap is way too big n embarrassing, is it possible to get dental replacement maybe after extracting the remains of the breakages its really making me uncomfortable please help

    1. Hi Mary,

      Are you really being serious or are you kidding?

      Very respectfully,

      Ramsey A. Amin, D.D.S.
      Diplomate of the American Board of Oral Implantology /Implant Dentistry
      Fellow-American Academy of Implant Dentistry

  87. Magnificent web site. Plenty of useful info here. I’m sending it to a few buddies ans additionally sharing
    in delicious. And certainly, thanks for your sweat and time!

  88. I have a fixed Hybrid with a very sunken look. My dentist says its boneloss. How can I fix this. its my maxilla and I have 5 implants

    1. Hi Anitha,

      There is only so much that a fixed dental implant restoration can do if you have extreme bone loss. That being said, most of the time I can make the teeth in such a position that does not give you a collapsed facial profiles. I personally deliver temporaries on almost every single case I do for a full mouth upper or lower dental implant reconstruction. This allows you and I to test drive what the teeth will look like before we finish. This allows for modifications of the facial profiles.

      I am not a fan of a fixed hybrid as they’ve routinely break because they are made of plastic denture teeth. If I were you I would upgrade to a Prettau, monolithic zirconia dental implant restoration.

      Here are some links for you to look at:
      Prettau Dental Implant Full Mouth Bridge

      Respectfully,

      Ramsey A. Amin, D.D.S.
      Diplomate of the American Board of Oral Implantology /Implant Dentistry
      Fellow-American Academy of Implant Dentistry
      Burbank, California

  89. Hi I’ve had a rootcanal on my third molar from the back its been 1 year I chipped my molar..one dentist told me I have to do my rootcanal again another one said I should put a crown on it and others say I should pull it out im so confused whats your opinion please help

    1. Hi Suzanne,

      Root canal and crown versus a dental implant is a common consideration. Attached is a link that may help you. Ultimately you want to choose the procedure that has the most predictable outcome for your unique situation. A crown a root canal may function very well for many years!!

      Dental Implant or Root Canal – Cost and Value Comparison

      Respectfully,

      Ramsey A. Amin, D.D.S.
      Diplomate of the American Board of Oral Implantology /Implant Dentistry
      Fellow-American Academy of Implant Dentistry
      Burbank, California

  90. Hiya, ive looked through your website. I really really need advice. My two front top teeth have shifted to the left, and ive looked it up and its said that when i was younger, perhaps i lost a tooth on the left which hasnt grown back, hence why my teeth have shifted. The number of teeth on either side is unequal. I feel very self conscious and unable to smile showing my teeth. 🙁 Is there anything i can do? At the moment, i have no space between my back teeth to replace it. I could really do with thorough advice, please. Thank you.

    1. Hi Teekay,

      It sounds like you need a great orthodontist. When you lose a tooth and your bite shifts, oftentimes your midline will be off center making your smile look crooked. After the orthodontist corrects your shifting teeth, they may or may not create space for the teeth that were lost which can be later replaced with dental implants. You need to be seen in comprehensive manner. If you don’t do anything, things are likely to get worse over time

      Ramsey A. Amin, D.D.S.
      Diplomate of the American Board of Oral Implantology /Implant Dentistry
      Fellow-American Academy of Implant Dentistry
      Burbank, California

    2. Hi. I have a total of 22 teeth left and I’m only 24 years old. I became agoraphobic and couldn’t go to a dentist. I need one more out. The front teeth are black and I can fit my tongue in the gap on one tooth. Is there any way for it to be saved at all?! I’m really really scared and I’m getting agorophobic again because of my teeth. I’m embarrassed and I mumble when I talk. I have both back molars but on the left side, I have a space where 5 teeth have gone. I’m really really really worried. Would a part denture help? My brother has a few teeth on a wire to fill the spaces. I cannot afford implants since they are around £250 per tooth in the UK. Thank you.

      1. Hello “Scared and worried”,

        If you cannot afford dental implants consider other types of replacement such as a fixed bridge. It is important to replace all teeth that are missing besides the wisdom teeth in most people’s mouth

        The bigger issue is anxiety. Find a dentist who specializes in treatment for patients who have anxiety. This should be able to sedate you before you evening get to the office and then do IV sedation when you get there. All treatment can be performed while you are asleep whether it is a dental implant and bone graft, a routine cleaning or filling.

        Fear may cripple you from ever having dental work done. This would lead to a downward spiral of your dental health. I have several patients that come into my office just to have her teeth cleaned by our hygienist while I sedate them under IV. Sometimes that is what it takes to keep your teeth forever. Of course excellent oral hygiene and your diet is critical also.

        Details of Sedation

        Very respectfully,

        Ramsey Amin DDS
        Diplomate of the American Board of Oral Implantology/Implant Dentistry
        Fellow of the American Academy of Implant Dentistry
        Burbank, California

  91. I have no front below tooth by birth,,, dentist told me that the new artificial teeth can be placed by shorting your present teeth both side of ‘the teeth which is to be placed in vacant space’,,,
    sir,
    i want to know that the artificial tooth can be placed without interupt my present teeth or not,,,

    1. Hi Sank,

      It sounds like you’re being recommended bridge. This means that the teeth on either side of the space are going to be ground down into pegs and a bridge will connect those teeth together and fill in the gap.

      In order to be evaluated for a dental implant, you would need to have an examination and x-ray (preferably a 3-D scan) to see if a dental implant can work in this position.

      If it can be avoided, a dental implant is better than a bridge. This is the case probably 90% of the time.
      Missing Several Teeth

      Ramsey A. Amin, D.D.S.
      Diplomate of the American Board of Oral Implantology /Implant Dentistry
      Fellow-American Academy of Implant Dentistry
      Burbank, California

  92. I have no my front below teeth,,,is there any way to grow up it,,,i m 22 years old,,,i want to know that the space can be filled by artificial teeth or not,,,
    plz,,,tell me

    1. Hello Sank,

      Your question is really broad. There is always a way to replace your teeth whether it be using dental implants, some type of fixed bridge our last resort using some type of removable teeth. You will need to visit a dentist and have diagnostic x-rays and then examination done in order to determine what is best for you within your budget.

      Ramsey A. Amin, D.D.S.
      Diplomate of the American Board of Oral Implantology /Implant Dentistry
      Fellow-American Academy of Implant Dentistry

  93. I have one teeth lose on upper left. Will it be ok for me to just have denture or implants? Will it cost facial collapse?

    1. Hi Peggy,

      Your question is a bit unclear. Is only one tooth loose or are all of them loose? Generally speaking when he tooth is loose it means you have some type of gum disease which may be present and other areas of your mouth. I would highly suggest you see a dentist to evaluate your entire mouth and not just focus on this one area.

      What is Periodontal (Gum) Disease?

      If you lose enough teeth it will cause the bone shrinks which does cause collapse of the face.

      Good luck!

      Ramsey A. Amin, D.D.S.
      Diplomate of the American Board of Oral Implantology /Implant Dentistry
      Fellow-American Academy of Implant Dentistry

  94. Im 28 years old. I got a tooth extracted last year and. Unfortunately did nothing about it, this year again looks like am going to loose a second tooth!!!!! Whats causing this problem?! Im a heavy drinker, can this be the main problem? I need an answer please , thank you!!!

    1. Hello Nallely,

      Losing just one tooth especially in the back, sets up a domino effect of further tooth loss. Many people think that they can get away without replacing one single tooth but the reality is it has long-term detrimental effects.

      Expect for your other teeth to move and shift in addition to bone loss in the area where the tooth was extracted. Your bite will place pressure on other teeth into an unbalanced nature and can cause excessive force to be placed on other teeth.

      Using alcohol on a daily basis doesn’t help. Alcohol breaks down to sugar and causes cavities. It also dries out the mouth and leads to poor healing after extractions, bone grafts and dental implants. 1-2 drinks a night is considered excessive if you want your teeth to be healthy for a lifetime.

      I hope this helps you. I’m not trying to tell you how to run your life, but you might want to make some lifestyle changes. Obviously brushing twice a day for 3-5 minutes with an electric toothbrush and flossing correctly once daily is going to help tremendously. You need to see a dentist at least 1-2 times a year for overall dental health and prevention.

      Dental Implants: A Patient Testimonial

      Respectfully,

      Ramsey A. Amin, D.D.S.
      Diplomate of the American Board of Oral Implantology /Implant Dentistry
      Fellow-American Academy of Implant Dentistry
      Burbank, California

  95. Im 28 years old i got a tooth extracted last year and it looks like im going to loose a second tooth once again!!! Whats going on ??! Im a heavy drinker… does it have anything to do with my problem? Help i need an answer please!!!!

  96. Hello Dr.

    I had one of my lower left Molar extracted due to infection. The Endodondist initially started the root canal,but after the first sitting I continued to have pain while chewing. They took a decision to extract it giving the reason there is no way to restore the tooth as they cannot put a crown.I am 30 years old and very depressed of not taking time to think about it further to save my tooth and having it extracted. On reading various blogs, web posts it seems like Dental implants is a very long procedure and one cannot be sure if it will be successful. I am also worried that this side is my preferred side and if I will ever be able to enjoy some of my favourite foods or if my looks/smile will change after this, Please help suggest me a solution.

    1. Hi confused and depressed,

      Most simple dental implants are not a long process and have an extremely high success rate. Replacing a single back tooth if the tooth was a recently extracted, would be considered a routine procedure.

      Once your dental implant is complete, you should feel like it is one of your own teeth.

      Ramsey A. Amin, D.D.S.
      Diplomate of the American Board of Oral Implantology /Implant Dentistry
      Fellow-American Academy of Implant Dentistry
      Burbank, California

  97. I’m 22 years old. I got my molar tooth pulled due to fractured tooth. And I was wondering if it’s possible to use my wisdom tooth as a replacement instead of getting a replacement done. And if so can I use braces to speed up the process of my wisdom tooth to come out. My wisdom tooth is already coming out and showing.

    1. Hello Nancy,

      Using a wisdom tooth to replace another tooth can be done in extremely unique situations. You have to be generally younger than 22 years of age. The wisdom tooth would have to be erupting and not really have too much of a root on it yet. This generally would only work for the second molar teeth.

      Is a clever idea that is used more in pediatric dentistry when a young child has to lose a second molar like tooth number 18 or 31. Sometimes the wisdom tooth will drift forward and replace it naturally.

      Sorry for the bad news.

      Ramsey A. Amin, D.D.S.
      Diplomate of the American Board of Oral Implantology /Implant Dentistry
      Fellow-American Academy of Implant Dentistry
      Burbank, California

      1. Hi Dr Amin, I’m 14 and I have the same problem as Nancy and I was just wondering how long it would take for my wisdom tooth to grow into the space where my molar was.

  98. I feel uncomfortable, am having kind of bad breathe, before when i breathe from mouth, it seem like somebody died inside my mouth, smelled like hell, then later i started taking care of it, and brushed my mouth night and morning, when i talk i dont notice my breathe smell again @ all, now am having swolen gum problem around just one of my teeth, please help

    1. The gum between two teeths, it grows out, makes it hard for me to make good word out, then later it will shrink into its position, and comes out again to give me headache, this is what am facing

    2. Hello Murphy,

      It sounds like you have an advanced case of periodontitis. This is gum disease which causes bone loss and is due generally to bacteria that remain on your teeth in the form of plaque. You need to get your hands into a good dentist ASAP. This is the number one leading cause of tooth loss in the world.

      http://www.burbankdentalimplants.com/what-is-periodontal-gum-disease/

      Ramsey A. Amin, D.D.S.
      Diplomate of the American Board of Oral Implantology /Implant Dentistry
      Fellow-American Academy of Implant Dentistry
      Burbank, California

  99. I would like to ask if this also happens when a third molar is removed. I regret having my perfectly healthy (tried hard to keep it clean) though not ‘so’ well positioned tooth extracted. I so angry I was not consulted about it and had assumed there was caries and it had to be extracted. I am 25 and i dont want facial tone loss. I want to remain attractive to my husband:(. Should i think about a dental implant? Is it normal to extract a healthy third molar instead of a second molar which needs a filling? What my dentist did makes no sense to me:(. And i payed so much for this, thing which will make me look old, i am so dissapointed and sad:(. It has been 30 hours since the extraction and i have kept the tooth in milk. Is it possible for it to be inserted and grow back? Shall I keep the other one, will it not cause a shift and assymetry of my face? Why do dentists pull the teeth out if they are healthy, only slightly malpositioned?! These can be kept for later when another molar has to be extracted to fill in the space, am i not right? No implant will then br needed? Thank you very very much for an answer! Please, please, give me some suggestion about the remaining third molars, plus the one i have kept(can anything be done?)

    1. Hi Lea,

      Wisdom teeth are generally problematic in a huge percentage of the population. I had problems with my own and personally have all 4 removed. My wife and father also had all 4 removed. Generally speaking wisdom tooth surgery is straightforward and predictable with minimal chances of complications especially at your age of 25. You should have a second consultation so that another dentist can give you their opinion. Make sure you have a panoramic x-ray for this evaluation.

      Attached is a link to my website. I do remove wisdom teeth on a routine basis when it is deemed necessary.

      http://www.burbankdentalimplants.com/wisdom-teeth-extractions/

      This blog is focused on dental implant surgery and restoration. That being said wisdom teeth are typically not reimplanted whether by natural tooth or by dental implant.

      Very respectfully

      Ramsey Amin DDS

      1. Hi just a quick question in relation to facial tone loss. I had root canal and my tooth was not strong enough to hold so the bottom broke so it looks like a gap in my smile where my first premolar is on the top. Anyway I lost facial tone on one side even though a little of the tooth is still there and I keep there cause maybe one day I will have an implant if I can’t afford it. But my question is I have partially erupted wisdom teeth they haven’t caused me problems I just feel one growing down now at 30 years of age. If I removed the broken tooth and let the wisdom stay would they push together and fill the gap. Also wouldn’t taking them out also change the shape of my face?
        Does a bridge change facial tone loss? Or ? will am implant at this late stage reverse it on the one side

        1. Hello Andrea,

          Most of facial tone is held by the muscles of the face. When people lose teeth, they lose the strength of their bites. Because they cannot bite as strong as they used to, the muscles are not exercised as well and therefore can lose muscle tone and begin to sag.

          That being said, several teeth have to be missing generally for this to occur. Missing only one tooth is not likely to create this but does begin a domino effect of further tooth loss. Once you lose the tooth, you’ll lose the bone from atrophy.

          Bone Loss

          Whether or not your wisdom teeth will scoot into position is anybody’s guess at age 30. It is unlikely though. Should you decide to remove your wisdom teeth, they will not change the face since they do not do a lot of chewing.

          A bridge that is very large with limited number of teeth or implants could change facial tone if there are large spans in between that have no teeth or implants. In those large spans bone will shrink.

          Some people have thicker skin than others… No pun intended. People with thick skin don’t tend to show minor changes in their teeth. Females tend to have thinner builds and therefore thinner skin and accompanying bone. Females tend to show more facial tone loss from missing teeth.

          Very respectfully,

          Ramsey A. Amin, D.D.S.
          Diplomate of the American Board of Oral Implantology /Implant Dentistry
          Fellow-American Academy of Implant Dentistry

  100. Amazing web page. Many techniques listed here. I wished I lived closer to Burbank. My dentist is still learning dental implants and is not a dental implant specialist like you.

    thank you for the help

  101. Hi. I have just had a three unit bridge fixed. Two days after I put it in the porcelain chipped!!! I decided to go with a repair since a removal of the bridge might break the abutments since they are really weak and thin (with root canal treatment). This is not the only problem. The bridge (last three teeth on the upper right side does not touch at all the opposing teeth. So for the past three days I have had pain on the other side of my mouth since the pressure is much more I guess. Since a remake of the bridge is not an option what should I do? Can no contact between the bridge and the opposing teeth cause serious problems? What should I do? Please help as I feel desperate!

    Thanks a lot!

    1. Hello Ahmed,
      I feel so bad for you. Porcelain chipping can be caused by the way the dentist designed the teeth below, the laboratory design of your bridge, your bite and many many other factors.
      Porcelain is not easy to repair inside of the mouth. You may need to remake the bridge because your bite does not touch and the porcelain has chipped. I would suggest using a material called monolithic zirconia as long as it is in the back of the mouth. It is very strong and very chip resistant.

      Dr. Amin

  102. When I wa younger in Ecuador, I have a newbie as dentist. As every young girl, with the unkind hand of Mother Nature, I had crooked teeth; the logical step was to get braces. My teeth were improving so fast and it made me want to smile all day long. During the last stages of the braces, I was given elastic bands. I’m not quiet sure the man purpose of it but they were fun to have since I knew it was the first sign that I wa approaching the last weeks of braces. As I was playing with my other cousins, I got kneed int mouth. I felt a snap and the rubber band disapear. As soon as I could made my way to the dentist and told her of the issue. She tried to look for it but couldn’t find it. I went back home and I felt some uncomfortableness in my mouth. I went back to the dentist a few daya later and she said that she was going to open my gums and try to locate it. I was 10 years old with no adult a guidance and agreed to it. She cut open my gums and she was unable to find anything, she looked so long that I felt the anestisia wearing off and felt the needle go through my gums as she was closing up the wound. She did this 2 other times as I went back and told her that I felt something there. Nothing. Luckily that time I learned that I along with my brother were granted a visa and finally could see our parents. I came to the US and about 2 years of being in this country, I begged my parents to take me to the dentist. Since they didn’t have any health insurance, they saved as much money as they could, so I could go to the dentist. I depended on my older sister to try and make appointments since she was the only one that spoke English, after months nd months of begging and harrasing she made an appointment. My sister told them the issue and not even a minute of the dentist checking on me, he located the rubberband. I was shocked!!! The other dentist did 4 surgeries and could not locate it. The dentist told me that I lost bone structure in my gums and gave me instructions to take some pills. After a few months, made my way to the orthodontics and he told me that they have to remove my second middle tooth and shape my caninne into the second tooth and this has been my smile for over several years. I hate it. Hate it so badly. I want to know what my options are ?

    1. Hi Fernanda,

      Wow what a story! That is so unfortunate. I’m sorry this happened to you.

      I would really need to see you in person with x-rays to really diagnose you. Are you local to Burbank?

      Ramsey A. Amin, D.D.S.
      Diplomate of the American Board of Oral Implantology /Implant Dentistry
      Fellow-American Academy of Implant Dentistry

  103. Dear Dr. Amin,

    I came to this dental implant blog to get much needed information and found what I was looking for. Thank you for your time and effort.

  104. Hello, Im 2o and I lost a tooth on the upper side of my mouth and its not visible, 8 years ago, is it possible to get a tooth implant? would it cause me to have a gap tooth? Thank you

    1. Hi Sandra,

      At your young age, replacing the tooth is VERY important. A dental implant will be your best bet for the long term.

      Good Luck!

      Ramsey A. Amin, D.D.S.
      Diplomate of the American Board of Oral Implantology /Implant Dentistry
      Fellow-American Academy of Implant Dentistry

  105. Hi Aquarian,
    I suggest you get in the hands of a very skilled implant dentist.
    Follow the link on the upper left area of my blog to the American Board of Oral Implantology. You will find a very qualified dentist to help you get started.
    Respectfully,
    Dr. Amin

  106. Hi, I am a 22yr old young lady and i had was terrified of the dentist as a child as a result i am now missing a total of 10 teeth from my mouth.Molars on the bottom of each side of my mouth and also directly above the bottom teeth have all been extracted. I am very concerned with my face shrinking at such a young age.I dont socialize with friends much and i am currently dealing with severe depressing and anxiety. I also feel that my sinusus are damaged due to toothloss..Is the facial sagging reversable if i undergo implants? At this point i am totaly overwhelmed and i dont know where to begin to fix this problem..what do u suggest?

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About Ramsey A. Amin, DDS

Dr. Ramsey Amin has extensive experience in surgical and restorative implant dentistry. As one of only less than 400 Diplomates of the American Board of Oral Implantology/ Implant Dentistry (ABOI/ID) he is considered an expert, and board-certified in dental implants. He is a former instructor at the UCLA School of Dentistry.