These are very personal decisions. Dentists almost always prefer saving teeth, because dentists are aware of the benefit of having a full complement of teeth. They also are aware of all of the consequences of losing teeth. It is often hard to predict who will have complications. The fact that you are in your late 60s and have not had gaps develop after other extractions does not mean that gaps won’t develop after this one. But, if your jaw bone is healthy and strong, there is a good chance that the neighboring teeth will NOT shift dramatically after an extraction.
I am optimistic about your age. The average 65-year-old should live until about 85. That is 20 years! That is a lot of chewing, smiling, talking and presenting oneself in public. Oral health and a well-functioning mouth are important as a person ages.
Dentistry can be expensive and time consuming, and this is where the personal choices come into play. You actually have five options. From least to most expensive, your options are:
- Extract and do nothing else
- Extract and replace with removable prosthesis
- Root canal and new crown (this is very close to the cost of option 2)
- Extract and place a fixed bridge
- Extract and place a dental implant
If you are concerned about costs and need immediate treatment, the extraction option may be the most preferable. After the extraction, you and your dentist could talk about whether a replacement tooth is necessary and how to replace it. If this is what you decide, however, don't wait too long to discuss replacement options. It can become more complicated to replace the tooth if the other teeth have already shifted.
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