Advised to Get an Implant to Replace a Decayed Tooth. My Mouth is Crowded. Braces?

As seen in the photo, on the right, bottom, second from the back is the tooth in question. My teeth, are always crowded on the bottom. Here's the story, I had a root canal, the tooth is now decayed to the point it needs removal. Dentist recommended an implant. I'm wondering if I wouldn't be better to have them remove it and get braces, giving myself some room. I'm 44 and have no concern of length of time to fix things or cost, just looking for the overall best solution.

Doctor Answers 4

Implant? Braces? Best solution is...

The best solution may be exactly as you are suggesting... have the hopeless tooth removed, get braces to straighten the teeth, and then a future implant.   That will give you the best results long term for a great looking smile and a stable bite (occlusion).  Since the lower teeth look crowded, and some teeth looked tipped in toward your tongue, you would benefit from orthodontic treatment.  Your orthodontic treatment could hopefully be done without extracting other teeth.  

Implant or space closure for missing back tooth?

IN general it is better to maintain all the teeth because the bite is most stable and healthy when there are equal numbers of functioning  teeth (from top to bottom and left to right) which bite correctly.  Sometimes, depending on the bite and on the degree of crowding, extraction of permanent teeth may be indicated.  If this is the case it may be possible to use the extracted molar as the "tooth to remove" on the lower right, while bicuspids may be removed elsewhere in the mouth.  Notice the terms "depending on", "may be" and "sometimes" -- this is an indication that every case is unique and you really need to seek the opinion of an orthodontist to get definitive answers to your particular case.

Brian Povolny, DDS, PhD
Seattle Orthodontist
5.0 out of 5 stars 2 reviews

Implants, Braces and Missing Teeth...

It sounds like you're asking if it would be possible to use the space in the back of your mouth from the tooth that needs to be extracted to gain space in the front of your mouth to uncrowd your lower front teeth. GREAT idea in theory but in practice it wouldn't work well. Your teeth need to be as symetric as possible. You can't simply regard the teeth as pearls on a string so as if you lose a pearl you can slide all the other pearls around to fill in the missing gap. Teeth are each designed for a specific purpose and symetry is important. It might be possible to move your wisdom tooth forward to fill in the missing space but that is a very difficult and unpredictable movement. Your lower front teeth no doubt are crowded and should be properly aligned for not only a better esthetic appearance but better long-term health. There are effective ways to gain needed space without extracting teeth. If I were you, I would extract the tooth, straighten the teeth and place an implant to replace the missing molar.

Good luck!

Brad Lockhart, DDS
Tustin Dentist
5.0 out of 5 stars 13 reviews

Remove incisor?

As always, it depends, but often we do extract a lower incisor for crowding in adults so it may be possible.  Another option if there is too little crowding it to extract the tooth and spread the other three incisors out then have them bonded/veneered to fully take up all of the extra space.  This would allow you to avoid the cost and problems associated with an implant

Robert Waxler, DMD, MS
Saint Louis Orthodontist

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.