Loose Teeth & Bite Problems
You may remember how difficult it was to chew when you were young and had one or more loose baby teeth; it was difficult to avoid chewing with that area, but if you accidentally did put pressure on your loose tooth, it was painful – or maybe it provided the extra push your tooth needed to detach and fall out completely. Losing a baby tooth is normal and expected, but losing a permanent tooth is not, and biting and chewing on a permanent tooth that is loose could cause the tooth to fall out prematurely and painfully (or lead to the need for extraction). Any permanent tooth that is loose faces the risk of falling out completely, but with prompt dental attention, the likelihood of saving the loose tooth increases. Just like loose baby teeth, however, loose permanent teeth cause bite problems, and it’s imperative to bite, chew, and otherwise proceed with caution if you have a loose permanent tooth and are awaiting a trip to the dentist.
The most common cause of loose permanent teeth is advanced gum disease, which is also called periodontitis or periodontal disease. Periodontitis is an infection caused by the proliferation of bacteria in the mouth. Bacteria is present in the plaque that forms when saliva and food debris combine, and when bacterial plaque is allowed to remain on the surfaces of the teeth and other oral surfaces, it causes inflammation and infection in the tissues of the oral cavity. Plaque can be removed with regular brushing and flossing, but even the best oral hygiene can leave some bacteria behind. When residual plaque remains on the teeth, it calcifies and turns into dental calculus, which can only be removed by a dental professional in a clinical setting. As dental calculus and plaque accumulate in the absence of effective oral hygiene, infection continues to progress. The gum tissue gradually detaches from the teeth and the bone that supports the teeth begins to deteriorate. The steady loss of gum tissue, ligaments, and bone causes the teeth to loosen and become ineffective at withstanding everyday biting forces and to eventually detach completely and fall out of the mouth.
Gum disease can be reversed when it is intercepted in its early stages, but as it advances, its treatment becomes more complex. Treatment begins with a deep cleaning of the teeth and gums, including the surfaces of the roots of the teeth below the gum line. Your dentist will use clinical tools to scrape dental calculus from the tooth root and smooth out the root’s surface, which will encourage the reattachment of the gum tissue to the tooth. You will also get thorough instructions for your home hygiene routine. For many patients, this periodontal treatment is sufficient to restore the gums to health; when treatment is unsuccessful, more invasive surgical procedures may be recommended.
Loose teeth can also arise because of bite problems, like bruxism, which is the habitual grinding or clenching of the teeth. The excessive forces of clenching or grinding can strain the ligaments that attach to the teeth to the bone and cause the teeth to loosen. If a tooth is misshapen and makes abnormal contact with the opposite row of teeth while biting and chewing, this can also apply imbalanced pressure to the teeth and compromise their security in the jaw. These bite problems can also cause pain in the jaw and excessive wear on the teeth, and they can hasten the loss of bone in the jaw. For patients with bruxism, dentists usually recommend using a bite guard while sleeping or in times of increased stress or anxiety, cushioning the force of the bite and protecting the teeth and oral tissues. When other bite problems threaten the integrity of a tooth, dentists may artfully and meticulously reshape tiny areas of tooth enamel to modify the way the upper and lower rows of teeth make contact with one another, redistributing force more evenly and reducing damage to the affected tooth. Dentists can also modify a patient’s bite by replacing or repairing broken fillings and reshaping or reconstructing worn-down teeth, and dentists can use adjacent, healthy teeth to splint loose teeth into a stable position so the ligaments that hold them in place can recover from injury or trauma. Splinting the teeth together also helps redistribute force more evenly across a greater number of teeth, thereby reducing the amount of force any single tooth must bear.