Expert: Jeff Dalin DDS - 11/3/2005

Question
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Followup To
Question -
I have a cracked tooth, a 1/4 of which has already broken off. It is towards the back of my mouth (#36) and I am happy simply to have it extracted and to leave a gap. My dentist has recommended extraction + bone preservation + implant, an expensive procedure. Will there be any dire consequences if i simply have it extracted and leave a gap there? I am 28 years old, and cannot presently afford fancy dental work. If I have it intially extracted, can I fill the gap at a later date?
Answer -
Cassy,
If only 1/4 is gone, why not try a filling or a crown first? This could save the tooth and prevent you from making any further decisions. I am not seeing the tooth so I do not know why this was not given to you as an option.

As far as extractions and leaving the space, here is what I tell my patients. It is the least expensive way to go. But you run the risk of having teeth drifting. There is also the esthetic look...do you mind seeing a space? And there might be some chewing inefficiencies.

My first choice is save the tooth. See if this is an option. If not, I hope you now know what the pluses and minuses are of leaving the space open.

Jeff Dalin, DDS

Thanks very much for your answer, Jeff.
The tooth cannot be restored unfortunately, so extraction is a must.
What are the risks associated with my teeth drifting? Purely aesthtic (which doesn't bother me) or leading to other expensive complications?
Also, if I have it extracted only now, can I get an implant at a later date? How long would be too long to leave it open if so?

Answer
Cassy,
Drifting can vary from person to person...situation to situation. Most often with only 1 tooth missing, it is not such a big deal. Most people just do not like the esthetics of a missing tooth. You have to ask your dentist to evaluate the way your teeth hit to see if this will be an issue. But let me tell you this...drifting does not take place right away. It is a slow, gradual occurrence.

So yes, you can have the tooth out now and wait a year, two years, whatever and then get the implant. There is no time period too long.

Good luck with everything.

Jeff Dalin, DDS