Braces with missing teeth: your options

Page updated October 22, 2026.

You can get braces with missing teeth. Braces can either close the gap by moving the neighboring teeth into it, or open and hold the space so a dentist can later fill it with an implant or bridge (Cureus review). Which is better depends on your bite, your age and the teeth involved. Here is how orthodontists decide, what the research says about each approach, and what it means for cost and insurance.

Why teeth are missing

Some teeth never develop. The AAO describes congenitally missing teeth as a genetic occurrence in which permanent teeth don't form (AAO); the dental term is hypodontia. How common it is varies a lot by population: studies summarized in a 2024 review found it in about 2% to 13% of people, depending on the country, more often in females, and more often on both sides of the mouth than one (Cureus review). Other teeth are lost to injury, decay or gum disease, or removed as part of treatment.

Missing teeth are one of the problems the AAO says may benefit from early treatment (AAO), and an orthodontic check by age 7 can spot them on X-rays before they cause shifting (AAO).

Close the gap or keep it open?

The 2024 review in Cureus concluded that implants and tooth-supported replacements generally had poorer gum and appearance outcomes than space closure, and recommended closing the space whenever the case suits it (Cureus review). It also stresses that your expectations, the clinician's experience and cost all count (Cureus review). Bite type matters too: the choice depends on growth, the space available, the neighboring teeth and how the jaws meet (Cureus review).

Why implants wait until growth ends

An implant is fused to the jawbone and doesn't move with growth. Natural teeth keep erupting slightly, so in young adults an implant can gradually end up lower than the teeth beside it, a height difference that can worsen over time and continue through life (Cureus review). Other reported implant problems include gum inflammation around the implant, bone loss and gum discoloration (Cureus review). So when an implant is the plan for a teenager, the space is held until growth has finished; the review describes temporary false teeth anchored to small screws as one stopgap for growing patients (Cureus review).

Braces for adults with missing teeth

Adults can have braces too; the AAO notes adult teeth often take a little longer to move because they're more firmly set in the jaw (AAO). Your orthodontist and dentist plan this together, because the space has to suit the replacement.

What it costs

Costs come in two parts. The orthodontic part is a normal braces or aligner fee, typically $3,000 to $7,000 for metal braces and $4,000 to $7,000 for clear aligners before insurance (CareCredit). If you hold the space for a replacement, add the dentist's fee for the implant or bridge, which we don't price here. Over the long run, a study cited in the 2024 review found that closing the space cost more at the start but had significantly lower total costs to society over 12 years than implant treatment (Cureus review).

On insurance, the AAO's proposed criteria for medically necessary orthodontic care include congenitally missing teeth, excluding wisdom teeth, of at least one tooth per quadrant (AAO). These are proposals, not rules insurers must follow, so ask your plan how it treats missing teeth. Medicaid covers medically necessary care for children (Medicaid.gov); see does Medicaid cover braces.

Questions to ask

• Can the gap be closed, or does my bite need the space kept open?
• If we keep it open, when can an implant go in, and what fills the gap until then?
• How will you and my dentist share the plan?
• What's the total cost of each option, including the replacement tooth?

Many orthodontists offer the first consultation free (AAO); see free orthodontic consultations and closing gaps in teeth.