Healthy Smile: “My Tooth Has Been Loose Since Last Year”

by Jeffrey Gross, DDS, FAGD of The Healthy Smile

I met a new patient yesterday who was ready to begin treating his mouth. But, unfortunately, his right front tooth was quite loose. So his visit focused on that tooth. Adjacent to that loose tooth was a dental implant, and he was ready to do the same procedure on his loose tooth. When I questioned him about how long he noticed the looseness, he responded that the situation extended back to last year. I assume that the pandemic prevented him from making an appointment. As with all of my colleagues, we used a high level of sanitation and sterilization, and our office was open. Unfortunately, some patients were frightened, and I understand that concern. No matter the reason for not coming in before this week, the fact remains that the loose tooth did not receive a diagnosis or treatment.

This week the level of looseness progressed to the point where there was a concern for the tooth falling out. My patient felt that now was the time for treatment. Before I go any further, let me explain why a tooth becomes loose. As we have mentioned before in this column, bone anchors teeth to the jaw. Gum tissue covers the bone and is anchored firmly to that bone. Together, the bone and gums comprise the anchoring complex of the mouth and, more specifically, the teeth.

The more bone that is present around a tooth, the firmer the tooth is in the mouth. Just as important as the quantity of bone is the quality of bone. Denser bone adds additional stability to the teeth. To chew dense and hard food, we use our jaws to create a tremendous amount of force in the eating process. Our teeth act as mini-grinders to get food to the consistency that we can swallow.

Teeth require a firm anchor to the jaw to perform this task well. They can not move around or break. Imagine gripping down on an object with a pair of pliers where the ends shatter and come loose. In short, the pliers will not function properly. Similarly, in the mouth, lack of stability on the working end, which is the teeth complex, will prevent proper chewing. In short, you can’t chew if your teeth are loose.

Our patient lost bone around his front tooth. The longer a tooth is loose, the more bone destruction occurs. This phenomenon is due to the constant movement of the tooth against whatever bone is there. The pressure from movement accelerates bone loss. When I remove the tooth, I will find a large void present. It is impossible to place and anchor a dental implant in a large opening. The implant requires some bone in which to anchor for it to be successful. I will need to add bone to the area, and this bone will take time to become part of the body. A short treatment will turn into a lengthy one in this situation.

The bone loss that occurs over time with a loose tooth requires immediate attention. If you feel a tooth is loose, call your dentist or us and make an appointment as soon as possible. First of all, we may be able to stop the loosening process. If not, then replacement should be a quick procedure. Sometimes adding and growing bone may be easy, but other times, it is a challenge for all concerned. As in all areas of medicine, prevention or acting quickly to correct a problem is a proper approach.

If this situation is in your mouth, please call 440-892-1810 and let’s make an appointment for you as soon as possible. I look forward to meeting you.

Jeffrey Gross, DDS, FAGD is an Ohio licensed general dentist and is on the staff of Case Western Reserve School of Dental Medicine.

The Healthy Smile • 27239 Wolf Road, Bay Village, OH 44140 • 440-892-1810 • www.jeffreygrossdds.com