Our teeth are not set in stone, as it were. In other words, they are not solidly set into the jaw bone but rather are suspended in their sockets by means of an encircling network of fibres between the root surface and the interior of the bony socket in which they sit.
This network of strong fibres is called the periodontal ligament. This serves as a kind of shock absorber during eating and chewing and allows for a certain amount of “give”, so that teeth aren’t damaged during heavy loading, and chewing can put quite a load on them.
Thus a small degree of mobility in a tooth is natural and normal; but if it moves to the extent that it is visibly noticeable then it’s a sign that something is wrong.
This article will summarise the most common causes of a loose tooth, and discuss how to prevent and treat such occurrences.
Traumatic Injury – External Forces
Occasionally a person may bite into something hard or bring a tooth into collision, perhaps with an olive stone in a pizza, for example, and then they feel the tooth has become mobile. It may perhaps have been pushed in the socket beyond its normal limits, but if so it usually tightens itself again in time, provided it is treated carefully.
Sometimes, however, what appears to be a loose tooth is not in fact a whole tooth moving, but one which has fractured and left part of the root firmly fixed, but the remainder just held in by the soft tissues (the ‘gum’). In this event, the loose piece usually has to be removed and a decision made as to whether the remaining portion of the crown is salvageable.
An obvious way in which a tooth becomes loose is due to a knock or blow.
Accidental trauma can occur during sports such as football, rugby, or cricket if appropriate care is not taken to protect the teeth. If a tooth is loosened and actually knocked completely out of the mouth it is important to try to save it. Hold it in the mouth or put it into milk, before getting to the dentist as quickly as possible, since it may be able to be replanted, splinted, and eventually become functional again.
Even if the tooth is not completely knocked out but only dislodged or loosened in its socket it’s important to see your dentist immediately. This is so that the damage can be assessed and probably a splint applied to give support to the traumatised tooth, from one or more others adjacent. A tooth that has been loosened, but which is immediately treated, usually firms up again within a couple of weeks or so if treated gently. The nerve is at high risk of being damaged however, so more often than not root canal treatment is needed.
If, unfortunately, a tooth is lost then of course there is usually a need to restore the space left with some form of artificial replacement. This may involve a denture, a bridge, or an implant. The precise form of restoration depends on several factors and the dentist will help a patient come to the best decision regarding choice.
Grinding – Internal Forces
Teeth may also be loosened by heaving dental grinding, a habit called bruxism, which is often related to anxiety and occurs mostly during sleep.
The continuous, excessive loading of opposing sets of teeth can eventually tend to loosen some. These types of cases may be treated by means of a night guard which protects the dental arches and avoids them grinding together.
Sometimes a tooth can be made mobile because of an abscess forming underneath it, from infection within the tooth. The infection can travel down the roots and build up fluid underneath it which is trapped in the bony socket, with the effect of pushing the tooth out somewhat and making it loose.
Gum Disease – The Most Common Cause
The most common cause of teeth loosening is, however, probably chronic gum disease.
This is present in many adults as a result of genetic tendencies combined with inadequate oral hygiene over a long period of time, allowing bacteria in the sticky plaque on teeth surfaces to irritate and damage the gums.
The gums tend to shrink as a result, and the actual bone holding teeth can also be lost resulting in the support for the roots being severely reduced. This means that the teeth become more mobile, and without treatment will tend to gradually loosen further to the point where they can no longer function properly and have to be extracted.
If gum disease is spotted early enough it is treatable and loose teeth can be encouraged to tighten up again. Provided that the patient brushes and flosses adequately from then on, the teeth can still give many years of service.
Read much more in our gum disease section starting here.
Thus the two main causes of a loose tooth or teeth are acute trauma and chronic periodontal, or gum, disease. The former can be due to an accident which could happen to anyone, but the latter is avoidable by careful attention to proper oral hygiene, and we all should take note of that.