Background Information:

What are the other Names for the Procedure?

• Autogenous Tooth Transplantation
• Transplantation of Tooth

What is the Tooth Transplantation procedure?

Tooth Transplantation is a procedure that involves replacing a damaged or disease tooth (usually the first or second molar) with the wisdom tooth (third molar).

What part of the Body does the Procedure involve?

A Tooth Transplantation procedure involves the teeth, gums, and mouth.

Why is the Tooth Transplantation procedure Performed?

Tooth Transplantation is performed to restore normal function of a tooth.

What are some Alternative Choices for the Procedure?

Dental implants with replacements for the roots may be possible in some individuals.

What are the Recent Advances in the Procedure?

There are no recent advances to a Tooth Transplantation procedure.

What is the Cost of performing the Tooth Transplantation procedure?

The cost of Tooth Replantation procedure depends on a variety of factors, such as the type of your health insurance, annual deductibles, co-pay requirements, out-of-network and in-network of your healthcare providers and healthcare facilities.

In many cases, an estimate may be provided before the procedure. The final amount depends upon the findings during the surgery/procedure and post-operative care that is necessary.

When do you need a Second Opinion, prior to the Procedure?

• It is normal for a patient to feel uncomfortable and confused by the information regarding Tooth Replantation procedure and on what needs to be done
• If the patient needs further reassurance or a second opinion, a physician will almost always assist and also recommend another physician, if required
• Also, if the procedure involves multiple surgeries or has many alternatives, the patient may take a second opinion to understand and choose the best one. They can also choose to approach another physician independently

What are some Helpful Resources?

Complete Guide to Symptoms, Illness & Surgery; Written by H Winter Griffith, M.D.; Revised and updated by Stephen Moore, M.D. and Kenneth Yoder, M.D.; The Berkley Publishing Group, 5^th Edition, New York, 2006

https://www.cda-adc.ca/jcda/vol-67/issue-2/92.html (accessed on 05/16/2015)

Prior to Tooth Transplantation Procedure:

How is the Tooth Transplantation procedure Performed?

• The Tooth Transplantation procedure is usually performed under local anesthesia with or without sedation.
• The dental surgeon removes the diseased/damaged tooth and prepares the socket for the transplant procedure
• A suitable donor tooth is then extracted carefully with minimal damage to the surrounding ligamentous tissue (periodontal ligament)
• The donor tooth is placed in the prepared recipient socket and kept in place using a suture splint. This is maintained for one to two weeks
• Further treatment occurs one month after the procedure with clearing of the canal of the transplanted tooth and replacement with a filling material

Where is the Procedure Performed?

The Tooth Transplantation procedure is usually performed in an out-patient surgery center facility, a dentist or oral surgeon’s clinic/office, or a hospital.

Who Performs the Procedure?

A dentist or an oral surgeon performs the Tooth Transplantation procedure.

How long will the Procedure take?

Depending on the number of teeth transplanted, it may take anywhere from 30 minutes to multiple hours.

What do you need to tell your Physician before the Procedure?

It is very important to provide the following information to your healthcare provider. This enables your healthcare provider in assessing the risks for the Tooth Replantation procedure and helps avoid unnecessary complications.

• Provide a complete list of medications you are currently taking to your physician. This information is useful for a variety of reasons. For example, it can help your healthcare provider prevent complications due to a drug interaction
• If you are allergic to any specific medication or food items
• If you are taking blood thinners such as aspirin, warfarin, herbal supplements, or any other such medications
• If you or your family members have a history of bleeding disorders, or if there is a tendency to bleed more than normal
• If you have diabetes, high blood pressure, chest pains, or have previously suffered from a heart attack
• If you have ever been diagnosed with blood clots in your leg (deep vein thrombosis) or lung (embolism of lung)
• If you have a history of frequent bone fractures (this may affect bone-healing if bones are involved as part of your procedure)
• A list of all previous surgical procedures you have undergone, for example: Removal of appendix, gallbladder, or any other part, of your body; surgical repair of any body part, such as hernia repair, perforation of bowel wall, etc.

What Preparations are needed, prior to the Procedure?

• The physician may evaluate the individual’s medical history to gain a comprehensive knowledge of the overall health status of the patient including information related to the medications that are currently being taken
• Some medications increase a person’s chances of bleeding and it may be recommended to discontinue them for a period of time before the procedure is performed
• Blood tests may be performed to determine if there is a bleeding tendency or any other medical conditions that prevents the person from undergoing the procedure
• Inform the physician if you are allergic to any local anesthetics, lidocaine, etc.
• Avoid application of any cosmetics, deodorant, or topical medicines on the area prior to the procedure
• It is advisable to quit smoking and the use of any nicotine based products for a while before the surgery
• Consumption of alcoholic drinks must also be avoided for a period of time, as instructed
• The patient must avoid eating or drinking at least 8 hours prior to the surgical procedure, depending on when the procedure is arranged
• For individuals suffering from diabetes, it is important that the blood sugar stays within the normal range; if not, their diabetologist may have to control blood sugar by recommending insulin and/or a combination of oral medicines

What is the Consent Process before the Procedure?

• A physician will request your consent for Tooth Replantation procedure using an Informed Consent Form.
• Consent for the Procedure: A “consent” is your approval to undergo a procedure. A consent form is signed after the risks and benefits of the procedure, and alternative treatment options, are discussed. This process is called informed consent.
• You must sign the forms only after you are totally satisfied by the answers to your questions. In case of minors and individuals unable to personally give their consent, the individual’s legal guardian or next of kin, shall give their consent for the procedure

What Tests are needed, before the Tooth Transplantation procedure?

Before a Tooth Transplantation procedure, the patient has to undergo certain tests such as:

• Routine blood and urine analysis
• Other tests as directed by the healthcare provider

What are some Questions for your Physician?

Some of the basic questions that you might ask your physician are as follows:

• What is a Tooth Transplantation procedure?
• Why is this procedure necessary?  How will it help?
• How soon should I get it done? Is it an emergency?
• Who are the medical personnel involved in this procedure?
• Where is the procedure performed?
• What are the risks while performing the procedure?
• What are the complications that might take place during recovery?
• How long will it take to recover? When can I resume normal work?
• How many such procedures have you (the physician) performed?
• Are there any follow-up tests or periodic visits to the healthcare facility required, after the procedure?
• What are the costs involved?

During the Tooth Transplantation Procedure:

What kind of Anesthesia is given, during the Procedure?

Local anesthesia by injection and occasionally general anesthesia by injection and inhalation are administered for the procedure.

How much Blood will you lose, during the Procedure?

There is not much blood loss involved in an uncomplicated Tooth Transplantation procedure.

What are the possible Risks and Complications during Tooth Transplantation procedure?

There are general factors that increase the risk of getting complications during surgery and they include:

• Obesity: Generally, the greater the degree of obesity, the greater the surgical risk
• Smoking: The longer the smoking history (in pack years smoked), the greater the surgical risk
• Advancing age
• Poorly controlled diabetes, as evidenced by a high hemoglobin A1c and a high fasting glucose
• Poorly functioning kidney, as evidenced by increased BUN (blood urea nitrogen) and blood creatinine
• Poorly functioning liver, as evidenced by increased blood liver function tests
• Hypertension (increased blood pressure), especially if it is poorly controlled
• Poor nutritional status (malnutrition with mineral and vitamin deficiencies)
• Poor lung function, as evidenced by abnormal lung function tests
• History of bleeding disorders
• Longstanding illness, such as autoimmune disorders and chronic infections
• Poor immune system due to a variety of causes

The possible risks or complications that may arise during the Tooth Transplantation surgery are:

• Excessive bleeding
• Infection within the surgical wound
• Anesthetic complications

What Post-Operative Care is needed at the Healthcare Facility after Tooth Transplantation procedure?

At the healthcare facility, usually there is no requirement for any post-procedure care, unless any complications arise. 

After the Tooth Transplantation Procedure:

What are the possible Risks and Complications after Tooth Transplantation procedure?

The possible risks and complications that may arise after Tooth Transplantation are:

• Excessive bleeding
• Infection surrounding the surgical wound
• In rare cases, rejection of the transplanted tooth may occur

What is the Prognosis after the Surgery?

The prognosis after a Tooth Transplantation procedure is usually good.

When do you need to call your Physician?

Do contact your physician if you notice any of the following symptoms:

• Pain that worsens and swelling around the gums and teeth
• Bleeding or fluid drainage from the surgical wound
• The occurrence of any symptom that causes uneasiness such as nausea or vomiting
• Signs of an infection
• Headache, muscle aches
• Fever, feeling sick
• Dizziness
• Complications associated with prescription medications used in treatment

What Post-Operative Care is needed at Home after Tooth Transplantation procedure?

At home, the following post-operative care is recommended after a Tooth Transplantation procedure:

• Avoid rinsing your mouth, spiting, smoking, or using drinking straws for the first day after the procedure. Then proceed to rinse your mouth with warm salt-water every couple of hours
• Use a soft toothbrush to brush the teeth
• Avoid biting down on the affected tooth until it has completely healed. Eat soft, chewable foods for a couple of days after the procedure
• Complete the course of prescribed medication under advice of the physician
• Take antibiotic medication to help combat or prevent infection, per your physician’s advice
• Avoid taking nonprescription medications such as aspirin. However, individuals may take acetaminophen to relieve pain (per the physician’s advice)
• Avoid all activities that are physically strenuous for about 3 weeks after surgery
• Resuming normal daily food and fluid intake after the procedure will result in a faster healing process. If a normal daily diet seems difficult at first, attempting a high-protein liquid diet for a few days might help
• Avoid drinking alcoholic beverages until there is a complete healing

How long does it normally take to fully recover, from the Procedure?

Depending on the number of teeth transplanted, recovery may take a couple of days to a few weeks.

Additional Information:

What happens to tissue (if any), taken out during the Procedure?

The procedure does not involve the surgical removal of any tissue.

When should you expect results from the pathologist regarding tissue taken out, during the Procedure?

Since no tissue is removed during the procedure, a pathologist does not get involved in the care of the patient

Who will you receive a Bill from, after the Tooth Transplantation procedure?

It is important to note that the number of bills that the patient may receive depends on the arrangement the healthcare facility has with the physician and other healthcare providers.

Sometimes, the patient may get a single bill that includes the healthcare facility and the consultant physician charges. Sometimes, the patient might get multiple bills depending on the healthcare provider involved. For instance, the patient may get a bill from:

• An out-patient surgery center facility, a dentist or oral surgeon’s clinic/office, or a hospital.
• An anesthesiologist (if anesthesia was administered)
• Dentist or oral surgeon

The patient is advised to inquire and confirm the type of billing, before the Tooth Transplantation procedure is performed.

Thanks and Gratitude:

We sincerely acknowledge and thank Dr. Douglas J. Jones for reviewing the article. His valuable input and feedback has helped enrich the contents of this article.

Douglas J. Jones, MD FACS
Board Certified General Surgeon and Faculty Member
University of Illinois, College of Medicine at Urbana-Champaign
506 S. Mathews Ave., Urbana, IL 61801, USA