Is it OK to skip implant after #18 extraction for 65 year old?

Hi:You definitely have the option of not replacing the tooth, as long as it does not effect your chewing and protecting the opposing tooth with a nightguard so it does not extrude due to lack of #18.  It’s always best to replace the teeth for more balance chewing and bite.Best,Dr. Maddahi

There is no right answer. Putting in an implant is a great way to give you more teeth to eat with. On the other hand, one can definitely live without that tooth. Studies would show that loosing just #18 would decrease you chewing capacity by 5%. Secondly replacing a second molar with an implant can be a difficult procedure for the surgeon and restoring dentist, as there may not be enough room for the implant or the instruments used to place it. Whatever decision you make, it will be the right one. Dr. Nick 

Implants work well, but are not required. If you do not have contact with the lower opposing tooth it may "over erupt" and move into the newly opened space. If there is contact between tooth 15 and 19, nothing will change.

Dear 3melch, I'm assuming that you have teeth #19, 20 and 21 as well as all the opposing upper teeth. Without tooth #18 you will lose function of the opposing tooth #15. These days second molars become the least important teeth next to the wisdom teeth (third molars). As long as you have all the rest of your teeth, not replacing #18 would not pose any major problems. It does not show in your smile and you have plenty of other teeth to support your bite/joints and with which to chew. However note that if you take care of yourself, exercise and eat right, you can live beyond 100. That's 35 more years. Dr. Neal