Treating Loose Teeth

 

Over time, a patient can have their teeth loosen up in their mouth, usually because of bone loss. Pathologic bone loss occurs when periodontal disease accelerates and bone is lost around the teeth.  Unfortunately, often the teeth cannot be saved and the patient has to face the reality of getting dental replacements.  The options are implants, fixed or removable partial dentures, or even complete dentures. This is the state of affairs we do not want to arrive at!

 

In less severe cases there are attempts to save the teeth, through procedures like deep scaling and root planing, or even gum surgery from the periodontist. The final result can be quite amazing and stable. Often a bite guard is recommended so that a hard bite or a bite with deflections is not moving the teeth. Sometimes the patient will receive an occlusal equilibration, which means adjusting the places the upper and lower teeth hit to achieve a more harmonious bite, avoiding more tooth erosion.

 

The lower front teeth are frequently jeopardized first. The roots are relatively small and the plaque and tartar growth in this area causes a more accelerated degeneration if hygiene has been lax and there is much bone loss. The loose teeth can be splinted with either filling material, a wire or a mesh so they can support each other. This procedure can buy time for the patient until that fails. If a patient loses one of the teeth, the crown of the extracted tooth can be cut off from the root and splinted in place. In the periodontally compromised case, this can buy the patient some time until a more permanent fix can be achieved.

I recently had a patient who had a different problem with one of his lower incisors, and he needed to have it extracted. He is fine periodontally. After the tooth was extracted I bonded the extracted tooth with the root cut off to the two adjacent teeth. This allowed him to avoid a flipper (removable 1 tooth denture) until his implant was placed and restored. It worked quite well.