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Dentistry/2nd molar - does it need to be replaced

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Question
Hi Dr Tieg

I had a wisdom tooth out about 4 months ago and now I am having problems with the tooth that was next to it (2nd molar lower left) and I either need a root canal or to have it pulled.  I'm leaning towards pulling it as I have had a fairly unsuccessful root canal in another tooth previously that causes ongoing problems and I'm not keen on repeating the experience.  I feel like all the specialists I see are trying to "sell" me an option - be it root canal, implant to replace or pulling alone and no-one will really discuss the disadvantages of what they are selling but will tell me how horrible the other options are.

i think I can get an honest opinion from you as you have nothing to gain?  If I pull the tooth and don't replace it could there really be any ongoing problems? The only other teeth I have missing are all my wisdom teeth - the top 2 were pulled in my mid 30's as they had super-erupted due to the lower ones being impacted.  Apparently I have very good teeth otherwise with stong roots.  Could the removal of this 2nd molar really cause my other teeth to shift (lower teeth are a little overcrowded but not significantly ) and my face to sag? Will my chewing be significantly impacted? Does the tooth really need to be replaced?  I am 50 years old in good health with good teeth otherwise.

Thank you so much for your help.
Sandra

Answer
Sandra-the main problem with extracting the lower second molar is a probable over eruption of the upper second one molar.  I know this situation well since I lost my lower see one molar when I was sixteen.  I began an over eruption of the upper second molar.  The cur for my situation has lasted many years without a complication.  The last two upper teeth, the first and second and molars were fused together by a crown made on each that were soldered together.  In this time a implant would be placed, but either is good option. The most important factor the the surgery cess of either is a very good  leaning daily.  If not, both will fail.

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Joel S. Teig, DMD, Diplomate ABOMS, retired

Expertise

I am a board certified oral and maxillofacial surgeon and I am available to answer questions related to tooth extractions, implant insertion, facial recontruction, facial and oral tumor removal, TMJ dysfunction and various successful treatments, including surgery if all else fails, and occlusal discrepancy requiring orthognathic or jaw surgery.

Experience

Board Certified Oral and Maxillofacial Surgeon practicine for over 20 years. Assistant Clincal Professor and State University School of Dentistry.

Organizations
American Dental Association, American Association of Oral and Maxillofacial Surgeons, American Board of Oral and Maxillofacial Surgeons

Education/Credentials
BA -University of Connecticut DMD - University of Pennsylvania School of Dental Medicine

Awards and Honors
National Honor Society (OKU), Philadelphia County Dental Society, Mosby Book Award, Oral Surgery Honors, Summa Cum Laude

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