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Towson, MD 21286
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Posts for tag: loose teeth

By Dr. Mark Shulman
July 22, 2016
Category: Oral Health
Tags: loose teeth  
LoosePermanentTeethisaProblem-takeActionNow

If you've noticed one of your teeth feeling loose, you're right to believe it's not a good thing. Loose permanent teeth are a sign of an underlying problem.

Periodontal (gum) disease is usually the culprit. Caused by bacterial plaque, a thin film of food particles, gum disease causes the tissues that support teeth to weaken and detach. While a tooth can become loose from too much biting force (primary occlusal trauma), it's more likely bone loss from gum disease has caused so much damage that even the forces from normal biting can trigger looseness.

A loose tooth must be treated or you may lose it altogether. If it's from gum disease, your treatment will have two phases.

In the first phase we need to stop the gum infection by removing plaque and calculus (hardened plaque deposits). Hand instruments known as scalers or ultrasonic equipment are usually sufficient for removing plaque and calculus around or just below the gum line. If the plaque extends deeper near or around the roots, we may need to consider surgical techniques to access these deeper deposits.

Once the infection is under control and the tissues have healed, we can then undertake the second phase: reducing biting forces by breaking clenching and grinding habits, doing a bite adjustment for advanced problems and securing loose teeth with splinting.

Although there are different types of splinting — both temporary and permanent — they all link loose teeth to adjacent secure teeth much like pickets in a fence. One way is to bond dental material to the outer enamel of all the teeth involved; a more permanent technique is to cut a small channel extending across all the teeth and bond a rigid metal splint within it.

To reduce biting forces on loose teeth, we might recommend wearing a bite guard to keep the teeth from generating excessive biting forces with each other. We may also recommend orthodontics to create a better bite or reshape the teeth's biting surfaces by grinding away small selected portions of tooth material so they generate less force.

Using the right combination of methods we can repair loose teeth and make them more secure. But time is of the essence: the sooner we begin treatment for a loose tooth, the better the outcome.

If you would like more information on treating loose teeth, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Treatment for Loose Teeth.”

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By Dr. Mark Shulman
December 19, 2014
Category: Oral Health
Tags: gum disease   loose teeth  
DeterminingtheCauseofToothLoosenessKeytoEffectiveTreatment

A loose permanent tooth isn’t normal — it represents a serious threat to the tooth’s survival. There may be a chance to save the tooth, however, if we can determine the cause of the looseness and treat it appropriately.

Teeth are normally held securely in place by the periodontal ligament, an elastic tissue that attaches to both the teeth and the bone. Certain conditions, however, can disrupt this attachment. The most common is advanced periodontal (gum) disease, an infectious condition caused by bacterial plaque. It can severely inflame and damage the surrounding gum tissues resulting in bone loss. As the bone is lost, the periodontal ligament is lost as they detach from the teeth. In fact, tooth looseness may be a fairly late sign of the disease.

Another major cause is teeth grinding (bruxism) and clenching habits that result in excessive biting forces. Usually stress-related, teeth grinding and clenching generate forces on the teeth outside of their normal range. As a result the periodontal ligament can become stretched, inducing tooth looseness.

Our treatment approach depends on which condition is causing the looseness, best assessed with a thorough dental examination. If gum disease is the culprit, the main treatment is to remove as much bacterial plaque and calculus (tartar) as possible using various techniques such as scaling or root planing (accessing and cleaning root surfaces). It’s also imperative for you the patient to start and maintain an effective hygiene regimen of daily brushing and flossing, along with professional cleanings every three to six months depending on your degree of vulnerability to gum disease. Subsequent healing will stimulate tissue reattachment to the teeth.

In the case of excessive biting forces, we primarily want to reduce their effect on the teeth. Treatment can include muscle relaxants or anti-inflammatory drugs, or a custom-fitted bite guard to minimize biting forces from teeth grinding during sleep. In some cases we may opt to reshape the biting surfaces of teeth through removal of small amounts of surface enamel: this will reduce the biting force by altering how the upper and lower teeth contact. It’s also possible to splint loose teeth to more stable teeth, joining them like pickets in a fence. This helps relieve the biting force on teeth with significant loss of bone support.

If you notice a loose tooth, you should make an exam appointment with us as soon as possible. The sooner we can diagnose the cause and begin treatment, the less chance you’ll lose your tooth.

If you would like more information on loose teeth, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Loose Teeth.”

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By Dr. Mark Shulman
June 26, 2013
Category: Oral Health
Tags: loose teeth  
TreatmentforLooseTeeth

There is nothing pleasant about having a loose tooth. It can be very unsettling to feel your tooth move around, and you may be worried about losing the tooth entirely. If you notice any looseness in your teeth, you should make an appointment with our office immediately, so that we can determine the underlying cause.

There are two reasons for loose teeth, and most often, this looseness is actually a late symptom of gum (periodontal) disease. If left untreated, this disease destroys the supporting structure of your teeth, including the bone. As bone loss progresses, teeth gradually become looser, and if you do not seek treatment, this can ultimately result in tooth loss.

Another less common reason for loose teeth is excessive biting forces, including clenching or grinding of the teeth. These biting forces are outside the normal range of functional pressures and can stretch the periodontal ligaments that join the teeth to the supporting bone, resulting in loose teeth.

In both cases, this condition can be classified as “occlusal (bite) trauma.” When we examine you, we will determine the type of occlusal trauma that you have.

  • If the amount of bone supporting your teeth is normal and excessive force is causing your loose teeth, it then is referred to as primary occlusal trauma. Our treatment approach will focus on reducing the biting forces. We may recommend minor bite adjustments and/or custom mouthguards.
  • Secondary occlusal trauma occurs when gum disease has caused excessive bone loss. In this instance, even normal biting forces can be damaging. We will work with you to treat the gum disease and improve your oral hygiene efficiency to heal your gums. Once the gum tissue heals and the inflammation is reduced, it is likely that there will be some tightening of the teeth. We will then adjust the biting surfaces of your teeth. This is accomplished by carefully reshaping (by drilling) small amounts of your tooth's surface enamel to change the way upper and lower teeth contact each other, thus redirecting forces. Secondary occlusal trauma may also require splinting or joining teeth together, so that they can handle biting pressures. The need for this additional procedure will be determined by your response to treatment and how much mobility of the teeth remains after the inflammation is resolved.

If you would like more information about loose teeth, please contact us or schedule an appointment for a consultation. You can also learn more by reading the Dear Doctor magazine article “Loose Teeth: Biting Forces Can Loosen Teeth.”

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