So your dentist just told you that your tooth number 15 is non-restorable, meaning it is beyond repair and needs a tooth extraction. In addition to the bad news, they also presented to you a replacement option which you need to make a decision on before you can take it out.
However, the cost of a dental implant to replace the missing tooth seems awfully expensive. The price is a legitimate cause for hesitation.
We can imagine the questions that are running through your mind:
Do I even need that tooth?
What are the pros and cons to having it?
Is it worth it?
How would it affect the quality of my life without it?
We're going to review all of your available options as well as the consequences for each of the choices. That way you can make the best decision that is right for you. After all, health decisions are personalized.
Do I need tooth number 15?
Need is a rather strong word for the fate of tooth number 15. We prefer to say that tooth 15 is a welcomed addition to the tooth family in your mouth rather than it is necessary.
It's definitely incorrect to say that it is necessary because technically none of your teeth are even necessary. Think about the people who are edentulous and have no teeth at all. They still live on with their lives because they find other types of foods to eat such as soup and soft foods.
However it is certainly a luxury to have teeth because they permit you to eat a wider variety of food and obtain more nutrients. With teeth you can eat chewy chicken, steak, and whatever you can think of. Being able to eat all types of foods and not just soft ones will give you a more diverse diet and a richer life experience.
Therefore tooth number 15 is not necessary but it is nice to have. Although losing it will affect your ability to chew.
Which one is tooth number 15?
To be clear, your tooth that is numbered 15 is your upper left second molar. It is the tooth that is behind the first molar but in front of the third molar (wisdom tooth).
The pano x-ray above is to show you where said tooth is located.
Pros and Cons
As with all decisions, listing out the pros and cons to having a tooth number 15 will help you in making a decision.
Benefits of having tooth 15:
Complete set of dentition, you're not missing any teeth.
More efficient chewing.
Prevents tooth 18 from supraeruption.
Disadvantage of not having tooth 15:
Less efficient chewing due to missing one tooth.
Tooth number 18 may supraerupt into the place of tooth 15.
You may need to take out tooth 18 in the future.
Is it worth replacing it?
If finances weren't an issue, we would say yes it is worth it to replace the missing back tooth with an implant after it's been removed. However, dentistry isn't free and the procedure will cost you even if you have dental insurance.
The average total cost of an implant with the crown is $4773.46 without insurance.
The average cost of a dental implant is $2141.41 without insurance.
The average cost of the implant crown is $2632.05 without insurance.
If you have insurance, they typically will cover about 50% or roughly half of the cost. You do have to take into consideration what your annual maximum benefit is. The cost may exceed it and you'd be responsible for the difference.
Therefore, whether or not it is worth it would depend on if your finances are okay with it.
Consequences of not replacing it
If the cost for replacing tooth 15 is not to your liking, you may decide to leave it missing. That is your choice but we just wish to let you know of the consequences of doing so.
Consequences:
Decreased chewing efficiency. The second molar adds about an extra 10% chewing power. While you may still eat properly, it'll be slightly more cumbersome to chew.
Teeth shifting. The wisdom teeth may drift forward or teeth may drift backwards. This happens because there is now a space and your teeth can move into it.
May lose opposing tooth. The opposing tooth number 18 on the bottom left may try to drift upwards. It can try to grow up into the space where tooth 15 was, this phenomenon is called supraeruption.
More expensive to replace later. After the tooth has been removed but not replaced, you'll slowly start losing bone in the socket. After a long enough period of time, you may not have enough bone to do an implant if you change your mind later. You'd require a bone graft if you wanted to replace it and that is an additional cost.
Supraeruption of opposing tooth
Supraeruption is a condition where the opposing tooth tries to drift upwards or downwards into the space of the missing tooth. Teeth that oppose each other actually hold each other in place and prevents this from happening.
Upper teeth hold the lower teeth down.
Lower teeth hold the upper teeth above.
Once you remove a tooth, the opposing one will start supraerupting. If it drifts too much, you may need to extract the opposing tooth as well. When it erupts too much, more of the root surface shows and it starts to become sensitive. That makes it prone to cavities and other tooth problems.
The photo above shows a diagnostic stone model of one of our patients. As you can see, the top tooth has started supraerupting downwards. It is much further down than the adjacent tooth on the left.
In summary, if you get number 15 removed, number 18 may start to supraerupt and encroach upon the space of where 15 was.
What should I do?
If you tooth number 18 is intact and finances are not an issue, we would recommend replacing tooth 15 with an implant after an extraction. Doing so will allow you to maintain a full set of dentition and chewing power. It will certainly improve the quality of your life.
If finances are an issue, you may not have a choice but to extract it and leave it missing. We would advise to save up money in the meantime and still attempt to get an implant. It'll prevent complications later on such as not having enough bone and also the opposing tooth from supraerupting.
