Loose Teeth
An adult tooth that moves has lost some of the bone or ligament holding it. The most common cause is advanced gum disease; grinding and injury are next. Many loose teeth can be stabilized, and the sooner they are seen the more options there are.
“My two lower bicuspids became loose because there wasn’t sufficient bone to keep them stable. Dr Verrett assessed the situation and described two options. … His work was excellent as was the outcome. All of the staff are efficient and friendly.”
“Dr. Verrett treated me for periodontal disease. Went in for second opinion and chose to treat with him. He does not overtreat, but spends the time needed to evaluate the problem. Staff is excellent and available.”
What It Usually Means
Teeth are held by bone and a ligament. Periodontitis destroys both from the top down, and by the time a tooth feels loose, half or more of its support may be gone. The American Academy of Periodontology describes how the tissues and bone supporting the teeth are broken down in periodontitis until teeth become loose and may fall out or need to be removed, and the CDC lists periodontitis and tooth decay as the two leading causes of tooth loss. Grinding and clenching stretch the ligament and can make a tooth mobile even with good bone. Injury can do the same suddenly.
When to See a Periodontist
- Any adult tooth that moves when you push it with your tongue or finger.
- A tooth that has shifted position, or a new gap.
- Looseness with bleeding, bad breath, or pus.
- A partial denture or bridge that has become loose.
What We’d Do
For the longer answer to whether a loose tooth can be kept, read Can a loose tooth be saved?
A full exam with X-rays and, often, a cone-beam CT to see the bone around the tooth in three dimensions. Then one of three paths: treat the gum disease and let the tooth stabilize; regenerate lost bone where the defect allows and splint the tooth while it heals; or, when the tooth cannot be saved, remove it with the socket preserved for an implant. The American Academy of Periodontology describes regenerative procedures as using membranes, bone grafts, or tissue-stimulating proteins to encourage the body’s own ability to regenerate lost bone and tissue.
The long view is better than a loose tooth feels. Hirschfeld and Wasserman re-examined 600 treated periodontal patients an average of 22 years after their active treatment and found that half of them had lost no teeth at all to periodontal disease, and that of 2,139 teeth judged questionable at the outset, 1,473 were still in the mouth. Lindhe and Nyman followed 61 patients treated for extremely advanced disease for 14 years and found probing depths, attachment levels, and bone height essentially unchanged in most patients and sites, as long as maintenance visits continued. Gum disease treatment · Dental implants.
A tooth that loosens suddenly, rather than gradually, should be looked at promptly. Call the office, and we will try to get you seen as soon as possible.
How we treat it: Gum Disease Treatment, or request a consult.
Frequently Asked Questions
Can a loose tooth tighten up again?
Sometimes. If the looseness is from inflammation and grinding rather than severe bone loss, treating the infection and protecting the tooth from clenching lets the ligament recover and the tooth firm up. Teeth that have lost most of their bone do not.
How do you decide whether to save it?
By how much bone remains, whether the bone loss is in a shape that can be regenerated, whether the tooth is important to your bite, and what it would cost to keep versus replace. We show you the X-rays and give you a prognosis for each tooth in writing.
What if it's from an injury?
A tooth loosened by a blow may need splinting to the neighbors for a few weeks while the ligament heals, and a check of the nerve. See us or your dentist promptly.