Maybe one of the dentists will address this question...

I think it may depend on your individual case. It might serve you to
get a 2nd opinion from another oral surgeon or dentist in your area,
maybe one at a University who will give you the straight story, with
no vested interest.

On 2nd thought, I may be mistaken: It may have been #1 which they said
I did not need, and so they are only going to implant #2 (not as far
back as #1). In any case, if you have a tooth back behind #18 (#17),
it may be more necessary to implant it. Again I am only speculating
here, and in fact I think I may be in over my head and maybe I should
not be saying anything.

I do know that many times dentists want to implant teeth or do
bridgework in order to keep the other teeth from SHIFTING, over time.
Shifting can cause problems, and by putting in a bridge or implant it
can be prevented. That may be why they want to implant #18 for you.

I would certainly discuss this with your dentist and let him know if
the expenditure is a hardship for you and you don't want to do it
unless it is really NECESSARY for the health of your mouth.

And yes, I think SOMETIMES dentists/oral surgeons are more interested
in making a good profit than anything else and don't mind giving you
treatment you don't really need, especially if they can justify it by
saying "It IS the BEST (that is, most ideal) treatment plan."
Sometimes we cannot afford the "best" treatment plan and sometimes a
more budget-conscious (YOUR budget, not his!) dentist might say, "I'm
not sure you really NEED an implant there..."

Hope I have not caused you unnecessary confusion. IF it were me, I
think I'd get a 2nd opinion from an impartial dentist, one who stands
to gain nothing. In fact, I would tell the 2nd opinion dentist, up
front, "I am not going to have any work done by you, I only want your
opinion" so that he remains impartial. I would also try not to give
the name of the dentist you are having the work done by, so as not to
prejudice his opinion in case he knows the dentist/surgeon.

I am dismayed and confused to hear this because both of the dentists I
consulted said that I I needed an implant or bridge. I was seriously
considering doing nothing as I do not seem to be having any problems
after the extraction. But after consulting with them and hearing about
the problems with movement, I set aside money for FSA to pay for
implant.

Do you think that because they have a vested interest in selling
implants that they  will not give you the straight advice you received
from the university dentist?

I wish I had known this earlier.

Dr. Abu, I was also going to mention about maybe not NEEDING an
implant for #18, but since I'm not a doctor I declined to say it. Now
that you've said it, I will add that one of my dentists at the
University told me that I really did not NEED the implants in the
back, as in #18, that really one does not need those in most cases.
For some reason, they ended up doing one there anyway, but I think
they added it once they got "in there" for some reason.

I also had a powder type bone graft done when #18 was pulled about 6
months previous.

A question, did you have socket grafting done after the extraction of #18?
If not, was it mentioned as an option? The reason I ask, is that socket
grafting done just after extraction, can minimize the loss of bone that
occurs after extraction.

However, I am curious why you would want an implant for #18 at all.  I
rarely place implants in this area unless there is a specific reason.  If
all your other teeth are present, then the only major consideration is to
watch for extrusion of tooth #2 into the space for #18.  Last study I read
mentioned it only happens in about 19% of the general population.

Can you provide more details?

And, as JimSoCal says, EXPERIENCE is the best indicator of competency.  Just
look the Doc straight in the eye and ask him how many of these he has done,
and what your chances of success are with this procedure.  And yes, NO
surgery is routine......

Dr Abu

================================================

I had tooth #18 extracted and am scheduled for evaluation in a month
with the  oral surgeon to see how the bone has healed. If there is bone
loss, bone graft will be required (I am not sure if the oral surgeon
does bone grafts -- I will need to go to periodontist -- but I will
have to check on that).

But I do know that both the oral surgeon and the periodontist that
previously treated my infection, perform implants.

In the case that I go for implant, does it make much difference which
one of them I select?

Is experience very important or are implants a routine procedure that
any experienced dentist could do?