Expert: Joel S. Teig, DMD, Diplomate ABOMS, retired - 12/6/2009

Question
My 23 yr old son needs help deciding what to do. His #2 molar has had 2 infections so we have seen a root canal specialist and an extraction specialist. He is without a job after recently graduating from college, so we owe for that as well. His dentist slipped a few years ago and created a larger hole than he meant to, so my son has had 5 fillings on this tooth. I am worried that a root canal will not last since there appears to be a probable crack, yet we cannot afford an implant. His wisdom teeth have been removed, so if he has the #2 tooth extracted, i it likely to shift and cause even more problems? Thanks.  

Answer
Susan - I have to tell you, if your son has to lose a tooth and he doesn't want his teeth to shift, the best one would be the upper second molar (#2).  Teeth throughout life have a tendency to erupt and to move forward to the front of the mouth.  If a tooth is touching a tooth on the opposite arch (upper jaw tooth touching lower jaw tooth)then that tooth cannot continue to erupt.  Such is the usual situation with the loss of #2.  The lower second molar, if you check into his mouth, should be touching,even slightly the upper first molar.  If so, the lower second molar will not erupt.  The upper 1st molar will not drift backwards.  

So if the situation is as I have described, your son can lose #2 without causing any drifting of teeth.  Ideally, it is always best to try to save teeth, but with the financial situation your son is in, having to lose #2 will not create major problems.  If he can afford to have that tooth replaced at a future date with an implant, having the tooth removed now should not cause any major problems.  If you have additional questions, feel free to contact me again.