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When you are a child, your first loose tooth can be cause for celebration; when you are an adult, it definitely is not. Biting and chewing with a tooth that is not securely attached in its socket can be difficult or even painful — and any tooth that becomes loose is at risk of needing to be removed or, at worst, falling out. It’s often possible to prevent that from happening, but quick action is required.

Causes

The most common reason for tooth looseness is periodontal disease — a bacterial infection of the gum and/or bone tissues that surround and support your teeth. The infection results from bacterial plaque that sits on your teeth in the absence of effective oral hygiene. Over time, periodontal disease will cause gum tissue to detach from the teeth as plaque and tartar formation increases and tooth-supporting bone is lost. As more bone is lost, teeth gradually become loose and are unable to withstand normal biting forces. If severe periodontal disease remains untreated, loose teeth will eventually fall out.

Another common contributor to the loosening of teeth is a clenching or grinding habit that generates too much biting force. This force can stretch the periodontal ligaments that join the teeth to the supporting bone, making your teeth looser. These habits can accelerate bone loss and also cause jaw pain and excessive tooth wear.

Treatment

Just as the causes of loose teeth can be biological (disease) or mechanical (too much force) — or both — so, too, are the treatments. Let’s first take a look at the biological approach.

To control gum disease, a dental professional must thoroughly clean the teeth of plaque and harder deposits (tartar or calculus) in which bacteria thrive; this includes the tooth-root surfaces beneath the gum line. At the same visit, you will be instructed on effective oral hygiene techniques and products to use at home. Often this type of deep cleaning, combined with improved oral hygiene, will reduce inflammation and heal the gums enough to cause some tightening of the teeth.

The mechanical approach involves modifying the forces that are applied to the teeth. This can be achieved in a number of ways. For example, an occlusal (bite) adjustment can be performed by carefully reshaping minute amounts of tooth surface enamel. This changes the way upper and lower teeth contact each other, redirecting and lessening the force. Replacing broken fillings and restoring worn teeth is also sometimes needed to create a more balanced bite, even when teeth are not loose.

It is also possible to reduce stresses on teeth by temporarily or permanently splinting them together like fence pickets so that any biting force is distributed among groups of teeth rather than individual loosened teeth. The splint is a very small metal bracket bonded to the backs of or tops of the teeth.

If clenching or grinding habits are a problem, a custom-made bite guard (also called an occlusal splint) can be worn when needed. Placed in the mouth at night or in times of stress, it can protect the teeth from the consequences of too much biting force. This can also be helpful in preventing excessive tooth wear, and sometimes in relieving jaw pain.

Loose teeth can be successfully treated with both biological and mechanical techniques. A thorough examination will be needed to determine the best approach. So if you are experiencing tooth looseness, don’t wait — the sooner this problem is addressed, the more likely you are to keep your natural teeth.