Are Implants Necessary To Replace both Teeth #18 and #19?

Since the majority of your chewing occurs from the first molar forward, it is not always necessary to replace the second molars with a dental implant. The small benefit in function you may or may not gain by replacing the second molar with an implant, will not out weight the cost and possible surgical risk of placing the implant.

Hi, 

Are you comfortable with missing teeth 18 and 19? How's eating? When you eat are you feeling pain or irritation?

With every tooth lost there is a 10% loss of  ability to chew. I would recommend replacing tooth number #19 if not both. With this you will regain 10%  of chewing ability as well as decrease the loss of bone in the rear jaw area. 

If there is no tooth that will oppose #18,  it is not necessary to place an implant in the #18 area as it will not give any functional occlusion(ability to chew in the 2nd molar area).   Many people function well with just 1st molar occlusion.  When a tooth is lost, the jawbone is no longer stimulated and the bone will gradually resorb  and shrink.  Placing an implant in an area stimulates bone similar to how a natural tooth does.  So although not necessary to place an implant in the #18 area, there is a benefit to doing so.   This also will give you the option of placing an implant in the # 15 area in the future, which would then provide you with 2nd molar occlusion and more chewing power on your left side.  

Hi:Normally replacing missing teeth with implants is the best option, however opposing teeth and bite has an effect on the final decision.  If there is absolutely no opposing tooth contacting tooth #18 you most likely can get away by doing just tooth  #19.  However, if there is even a little contact with #18, doing an implant in both #18 and #19 will give you a better bite and will stablize the joint better.  Keep in mind the longer you wait to do #18, there will be more bone resorption which might complicate implant placement in the future.Best,Dr. Maddahi