August 6, 2020
Oral health during Covid-19 lockdown.
Teeth have some degree of mobility when placed under pressure such as chewing or grinding teeth against each other. But loose adult teeth with noticeable movement when chewing is not normal.
Some movement of teeth within the jaw bone is acceptable because mother nature has created a shock absorption system to protect teeth from breaking. If teeth were held rigidly in place and we apply too much force the tooth will fracture. The ligaments attached to the root surface and surrounding bone help dissipate these forces to prolong the life of the tooth.
Common causes include:
Trauma– when a tooth receives a hard knock the tooth loosens. This loosening effect aids in preventing the tooth from breaking under high physical loads.
Loss of supporting bone– this happens when a more severe form of gum disease called periodontitis causes bone to breakdown. The loss of bone can also be associated with the position and alignment of the tooth. Wisdom teeth pressing against the adjacent tooth at an awkward angle will lead to bone loss between the two teeth.
Orthodontics– teeth placed under certain forces using braces will loosen. This loosening process is necessary for teeth to move. Orthodontist use this natural physiological process to effectively re align teeth.
Infection– when a tooth becomes infected on the inside it leads to the infection trekking out of the tooth at the tip of the root. This leads to bone loss and the formation of an abcess at the tip of the root (see figure below). This causes pain and swelling if left unattended. Root canal treatment or extraction is the only option of management at this stage.
Acute gum infection– the gum can become inflamed when foreign matter lodges between tooth and gum. In situations where the inflammation is significant enough the tooth can become loose. Some pain on pressure is also experienced. This results from the ligaments becoming inflamed.
Bruxism– teeth grinding during the day or night will lead to teeth loosening. This is one way the body tries to help preserve teeth under extreme prolonged pressure.
Less common causes of bone loss include the presence of cyst, tumors, and bone disease.
Any adult tooth becoming loose should be attended to immediately. The cause must be identified and managed. In the case of bone loss, early intervention will prevent too much bone breakdown. This will improve the long term prospects for that tooth.
Infections in the mouth can lead to significant medical emergencies if left untreated. Early intervention is very important.
Teeth which have received a blow from a fall or sporting accident need to be splinted to allow the tooth to recover. And in extreme cases underlying bone can fracture. The teeth affected will need to be splinted together for the area to heal avoiding long term problems.