An adult tooth (or molar) can be missing because it has been lost due to dental problems or an accident affecting the tooth or surrounding area. However, this is usually because one or more of those teeth were never generated by the body; this occurs in 5% of people. 

Often, the baby teeth then remain functional for a given period, but only 1 in 30 people in their 40s have baby teeth without an adult tooth. Sometimes the choice is made to close the ‘gap’ at the site of the missing primary tooth or molar by moving the adjacent teeth, ‘the neighbours’, towards each other. Sometimes, however, it may be better not to close these spaces and to opt for ‘filling’ the open space.The space can be ‘filled’ by having the dentist place a bridge.

 A disadvantage of this is that part of the enamel has to be ground away. Nowadays it is therefore preferred, if possible, to place an implant on which a crown is made. An implant has a 95-98% chance of growing into place. The costs are similar to that of a bridge (+/- €1,500), if a bone structure is necessary in order to place the implant, this will be at least €500 more. Bone is then sometimes harvested from the area next to the wisdom teeth, but more often from the chin or hip.

There are some disadvantages to an implant with a crown on it, namely that:

  • The implant can usually only be placed at the age of 22 (girls) or 25 (boys) (because you have to be ‘fully grown’), so you will have an open space between the teeth for a while or a temporary solution to this; 
  • An implant is fixed in the bone and therefore cannot grow any further, while the natural teeth grow at least 0.1 mm/year throughout life. This means that in time there will be visible height differences between the cut edges of the own teeth and those of the crown on the implant;
  •  on average, a crown on an implant needs to be replaced every 20 years

One way of ‘filling in’ the gaps without the above-mentioned disadvantages is auto transplantation; the careful transfer of one’s own tooth to the place of the missing tooth. Just like an implant, an auto transplantation has a 95-98% chance of growing into place. It is important that this ‘removal’ takes place when the root of the tooth is 2/3 to 3/4 of the way down.

An autotransplantation can also be carried out on a decayed root, but a root canal treatment is then necessary, and the chances of successful bonding are five per cent lower. An auto transplantation is carried out under local anaesthetic by a periodontist or oral surgeon. Six to ten weeks after the auto transplantation, light pressure is applied to the tooth with braces.

An auto transplantation in adults (unless additionally insured for dentistry) may not be reimbursed by the health insurance company: applicable costs €1,355 – €2,028