I Am Missing Molar #30. Molar #31 Needs Extraction but Still on with No Pain., What Are My Options?

It is difficult to decide on the best treatment option for you without looking at your xrays/ clinical pictures 

we need to rule out periodontal disease / infection which alot of times are silent / without any pain. 

If the tooth is healthy , then sure, you can keep it. But you made a comment that the tooth needs to be extracted. For what reason? If the gum is infected / bone loss on the site, it might compromise adjacent implant 

 

If the tooth needs to be extracted , it is always good to have both implants done at the same time. This way their crowns could be attached/ splinted. To provide better long term stability. 

Based upon your specific situation it may be preferable to extract the tooth that will not be receiving an implant at this time. There are several issues which lead me to this answer.

First off, there is obviously the chance that the tooth requiring extraction may flare up at an inopportune time. A toothache or abcess amy occur when you are not prepared financially and or physically to have the procedure performed. I am sure you would prefer to see a Dentist of your choice as opposed to an emergency room Doctor.

Secondly, the amount of bone in an implant site is critical to the stability and prognosis of the implant. By prolonging the extraction you are most likely losing bone in the area that the implant is to be placed. This may make the procedure less predictable and the esthetics compromised.

Overall the sooner you remove the tooth, the better your chances of avoiding an emergency situation and of providing a good site for Implant placement.

Tooth #30 needs an implant according to what you are conveying here on this forum.

You also mentioned tooth #31 needs extraction. As a general rule, we recommend extracting a tooth that is next to an implant site if it has a poor prognosis, so as to avoid having a neighboring tooth spread an infection to a new implant. Consider having the extraction site treated with an ND/YAG laser at the time of extraction. Faster and better healing.

Dear John: You are correct that most times implants are the best option. If you have good bone, there is no reason why you cannot have implant number 30 right away, and then get an implant to replace tooth number 31 in the future. However, waiting for tooth number 31 to hurt is not a good idea. Pain, is not a good sign, and often comes after the damage has already been done. Talk to your dentist or prosthodontist on having the implants placed in the right location and sequence properly. Best of luck.