My bottom right first molar is decayed and does not have a second molar behind it. My dentist wants to try to save it with a root canal, and if that does not work, she recommends a dental implant. The tooth is far enough back that I wonder if removing it and doing something like a half snap-on smile would work. I work from home, so I would only need to wear artificial teeth when I socialize. My dentist says that if I want an extraction, I need to find another dentist. She hates removing teeth. Do you mind offering your opinion? Thank you. Tytus from GA

Tytus,

Thank you for your question.

If you have already lost your second molar, removing the first molar would leave you without any lower right molars. We want to help you understand the effects of removing your first molar.

Effect of Lacking Molar Teeth on One Side

If you have no molar teeth on one side of your mouth, it will affect you in these ways:

• Chewing – You will not be able to chew on that side of your mouth. And you will add stress to the teeth on the other side of your mouth. As molar teeth on the left side of your mouth wear, you will eventually need to eat soft foods that do not require a lot of chewing unless you get some form of long-lasting tooth replacement.
• Temporary replacement teeth – A Snap-on Smile and similar products do not replace the function of molar teeth. Even if you wear it for socializing, it is not durable. You will need to replace it repeatedly.
• Tooth misalignment – When one tooth is missing, nearby and opposing teeth begin to drift into the space. Without molars on the lower right side of your mouth, your teeth will start to move, detract from your smile, and create orthodontic issues.

Treatment Options for a Decayed First Molar Tooth

If your molar tooth is damaged, your treatment options likely include:

• Root canal treatment – Your dentist can try to save your tooth with root canal treatment and a dental crown. Saving the tooth will prevent surrounding and opposing teeth from shifting. Root canal treatment is less expensive than extraction and a dental implant or dentures.
• Dental implant – If root canal treatment fails and your dentist cannot save the tooth, a dental implant can replace it without damaging your oral health. An implant has an artificial root and a crown. It will function as a healthy natural tooth.
• Partial denture – Although a partial denture can replace a missing tooth, it must attach to other teeth to stay in place. Over time, the pressure from the clasps of a partial denture weakens healthy teeth.

We recommend talking to your dentist about your concerns with root canal treatment. If your tooth is healthy enough, root canal treatment is the best way to save it and avoid a series of temporary solutions that require replacement.

Best wishes.

 

Duane Delaune, DDS, a cosmetic dentist of Metairie, New Orleans, sponsors this post.