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Dentistry/Do I really need to replace my extracted tooth?

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Expert: - 11/9/2008


Question
About a month ago I had my #19 tooth extracted.  It seems
to be completely healed, no pain or swelling.  However
there is still a hole in my gum.  Will this eventually fill
in?  Also, I had bone grafting done at the time of
extraction since I was planning on having an implant.  I
have a date scheduled for the implant, but am wondering.  
Since my insurance will not pay for it and it is quite
expensive, would it be possible to just leave the empty
spot?  It doesn't effect my appearance at all and I seem to
be able to eat fine without it.  Thank you so much for your
advice.

Answer
The problem with leaving the space unrestored is that it can very well lead to posterior bite collapse.  This occurs when the teeth on either side of the healed extraction space tip and drift into the space.  In doing so they no longer provide vertical support for the bite.  This places additional stress on the other teeth...especially the front teeth...and this can cause additional stress and trauma to the remaining dentition resulting in bone loss and ultimately compromise to the dentition.  It's a cascading effect with problem compounding problem as the health of the mouth deteriorates over time.  There is great value in preserving the health and integrity of the oral cavity and all its structures.  You are on the right track with plans for that implant.

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Dr. Randolph Myerson

Expertise

Please limit your inquiry to questions about orthodontics (braces) and children's dentistry. I am both an Orthodontist and a Pediatric Dentist, having been trained in both of these dental specialty fields. Orthodontics is the dental specialty that treats problems of tooth, bite and jaw alignment using braces and removable appliances. Pediatric Dentistry is the dental specialty also known as dentistry for children, which deals specifically with the dental problems of this special age group from infants to adolescents. I am also experienced in Forensic Dentistry, the application of dentistry to law enforcement and identification using dental records.

Experience

I have been in the private practice of orthodontics and pediatric dentistry for over 20 years. Prior to that I served for three years on the Cleft Palate and Cranio-facial Reconstruction team at Children''s Hospital of Philadelphia and was an Assistant Professor of Dentistry at University of Pennsylvania School of Dental Medicine. I also served as a dentist in the U.S.Air Force, stationed at Andrews AFB in Washington, DC.

Organizations
I am a Fellow in the American Academy of Pediatric Dentistry, and a member of the American Association of Orthodontics, as well as a member of the American Dental Association and the Dental Society of the State of New York.

Education/Credentials
I received my BA in Biology from Frankin & Marshall College in 1969, and my dental degree from University of Pennsylvania School of Dental Medicine in 1973. In 1978 I received both my Certificate in Orthodontics from University of Pennsylvania School of Dental Medicine, and my Certificate in Pediatric Dentistry from Children''s Hospital of Philadelphia after completing a three year Teaching Fellowship in Orthodontics and Pediatric Dentistry in 1978.

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