A loose primary (“baby”) tooth is often a cause for celebration. A loose permanent tooth, however, is a cause for concern. A permanent tooth shouldn't even wiggle.
If you have a loose tooth, it's likely you have a deeper dental problem. Here are the top underlying causes for loose teeth.
Gum disease. Teeth are held in place by an elastic tissue called the periodontal ligament. But advanced periodontal (gum) disease, a bacterial infection usually caused by film buildup on teeth called dental plaque, can damage the ligament and cause it to detach. If it's not treated, it could lead to tooth loss.
Bite-related trauma. A normal bite helps balance out the forces generated when we chew so they don't damage the teeth. But if a misaligned tooth protrudes higher from the jaw, the opposing tooth will likely create more downward pressure on it while chewing. This can stress the tooth's supporting ligament to the point of looseness.
Self-inflicted trauma. While they may be trendy, tongue jewelry can cause dental damage. A wearer who clicks the “barbell” of a tongue stud against their teeth could be creating conditions conducive for gum damage and bone loss, which can cause tooth looseness. Similarly, taking orthodontics into your own hands could also damage your teeth, especially if you have undiagnosed gum disease.
Genetics. Although you can't prevent it, the type of resistance or susceptibility you inherited from your parents (as well as your dental anatomy) can cause you dental problems. Thinner gum tissues, especially around the roots, can make you more susceptible to gum disease or dental trauma, which in turn could contribute to tooth looseness.
There are things you can do to lessen your chance of loose teeth. Brush and floss every day to remove disease-causing bacterial plaque and see a dentist regularly for cleanings to reduce your risk of gum disease. If you have any misaligned teeth, consult with an orthodontist about possible treatment. And avoid oral jewelry and DIY orthodontics.
If you do notice a loose tooth, see us as soon as possible. We'll need to diagnose the underlying cause and create a treatment plan for it. We may also need to splint the tooth to its neighbors to stabilize it and reduce your risk of losing it permanently.
If you would like more information on tooth mobility, 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 “When Permanent Teeth Become Loose.”
Moving teeth through orthodontics may involve more than simply wearing braces. There are many bite conditions that require extra measures before, during or after traditional orthodontic treatment to improve the outcome.
One such measure is extracting one or more teeth. Whether or not we should will depend on the causes behind a patient's poor dental bite.
Here, then, are 4 situations where tooth extraction before orthodontics might be necessary.
Crowding. This happens when the jaw isn't large enough to accommodate all the teeth coming in. As a result, later erupting teeth could erupt out of position. We can often prevent this in younger children with space maintainers or a palatal expander, a device which helps widen the jaw. Where crowding has already occurred, though, it may be necessary to remove selected teeth first to open up jaw space for desired tooth movement.
Impacted teeth. Sometimes an incoming tooth becomes blocked and remains partially or fully submerged beneath the gums. Special orthodontic hardware can often be used to pull an impacted tooth down where it should be, but not always. It may be better to remove the impacted tooth completely, as well as its matching tooth on the other side of the jaw to maintain smile balance before orthodontically correcting the bite.
Front teeth protrusion. This bite problem involves front teeth that stick out at a more horizontal angle. Orthodontics can return the teeth to their proper alignment, but other teeth may be blocking that movement. To open up space for movement, it may be necessary to remove one or more of these obstructing teeth.
Congenitally missing teeth. The absence of permanent teeth that failed to develop can disrupt dental appearance and function, especially if they're near the front of the mouth. They're often replaced with a dental implant or other type of restoration. If only one tooth is missing, though, another option would be to remove the similar tooth on the other side of the jaw, and then close any resulting gaps with braces.
Extracting teeth in these and other situations can help improve the chances of a successful orthodontic outcome. The key is to accurately assess the bite condition and plan accordingly.
If you would like more information on orthodontic options, 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 “Removing Teeth for Orthodontic Treatment.”
Five minutes a day: That’s all it takes to do something that could change your life. It may not seem like a lot of time, but it’s one of the most profound things you can do for your well-being.
So, what is this life-changing activity? Daily oral hygiene—good, old-fashioned brushing and flossing, just like your mom made you do. Along with regular dental visits, daily hygiene is crucial to keeping your teeth healthy. And healthy teeth are key to a healthy life.
Part of the magic is “showing up every day.” The main driver for tooth decay and periodontal (gum) disease is dental plaque, a thin film of bacteria and food particles that accumulates on teeth. Clearing away this daily buildup with brushing and flossing drastically reduces the likelihood of disease.
The real advantage, though, is in brushing and flossing effectively. Plaque can cling stubbornly to teeth, especially around the gum line and other hard to reach surfaces. What’s left behind interacts with saliva to form a hardened, calcified form called calculus (also known as tartar) that could increase your risk for disease. And it can’t be removed by brushing and flossing.
You can minimize calculus formation with proper brushing and flossing techniques. When brushing, for instance, use a circular motion and make sure you brush all tooth surfaces, including around the gum line (a thorough job takes about two minutes). And avoid aggressive brushing—you could damage your gums. Be gentle while you brush and let the toothpaste and brush bristles do the heavy lifting.
Don’t forget to floss to remove plaque from between teeth your brush can’t access. Wrap the ends of about 18 inches of floss thread around the middle finger of each hand. Using a combination of your index fingers and thumbs to maneuver it, work the floss between the teeth and then snug it to the tooth surface. Go up and down the sides of each tooth a few times until you hear a squeak (this only happens with unwaxed floss). Move then to the remaining teeth until you’re finished.
Focusing on these techniques will improve your ability to keep daily plaque accumulation low. And that means your teeth and gums have a better chance of staying disease-free and healthy.
If you would like more information on proper oral hygiene, 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 “Daily Oral Hygiene.”
Boston Bruins defenseman Zdeno Chara had a rough Stanley Cup final against the St. Louis Blues this past June. Not only did the Bruins ultimately lose the championship, but Chara took a deflected puck shot to the face in Game Four that broke his jaw.
With the NHL season now over, the 42-year-old Bruins captain continues to mend from his injury that required extensive treatment. His experience highlights how jaw fractures and related dental damage are an unfortunate hazard in hockey—not only for pros like Chara, but also for an estimated half million U.S. amateurs, many in youth leagues.
Ice hockey isn't the only sport with this injury potential: Basketball, football (now gearing up with summer training) and even baseball players are also at risk. That's why appropriate protective gear like helmets and face shields are key to preventing injury.
For any contact sport, that protection should also include a mouthguard to absorb hard contact forces that could damage the mouth, teeth and gums. The best guards (and the most comfortable fit) are custom-made by a dentist based on impressions made of the individual's mouth.
But even with adequate protection, an injury can still happen. Here's what you should do if your child has an injury to their jaw, mouth or teeth.
Recognize signs of a broken jaw. A broken jaw can result in severe pain, swelling, difficulty speaking, numbness in the chin or lower lip or the teeth not seeming to fit together properly. You may also notice bleeding in the mouth, as well as bruising under the tongue or a cut in the ear canal resulting from jawbone movement during the fracture. Get immediate medical attention if you notice any of these signs.
Take quick action for a knocked-out tooth. A tooth knocked completely out of its socket is a severe dental injury. But you may be able to ultimately save the tooth by promptly taking the following steps: (1) find the tooth and pick it up without touching the root end, (2) rinse it off, (3) place it back in its socket with firm pressure, and (4) see a dentist as soon as possible.
Seek dental care. Besides the injuries already mentioned, you should also see a dentist for any moderate to severe trauma to the mouth, teeth and gums. Leading the list: any injury that results in tooth chipping, looseness or movement out of alignment.
Even a top athlete like Zdeno Chara isn't immune to injury. Take steps then to protect your amateur athlete from a dental or facial injury.
If you would like more information about dealing with sports-related dental injuries, please contact us or schedule an appointment for a consultation. To learn more, read the Dear Doctor magazine articles “Athletic Mouthguards” and “The Field-Side Guide to Dental Injuries.”
If you’ve ever read online that root canal therapy causes cancer, don’t be alarmed—it doesn’t. What it does do is save a deeply decayed tooth that might otherwise be lost.
Tooth decay is caused by acid produced by bacteria, which dissolves enamel to create a hole or cavity. But it doesn’t stop there: decay can move on to infect the tooth’s innermost layer, the pulp filled with nerves and blood vessels. Unchecked, the resulting infection can travel through the root canals to eventually infect the bone.
A root canal treatment stops the infection before it goes this far. After administering a local anesthetic, we drill a small hole into the tooth to access the pulp chamber and root canals. We then remove all the diseased tissue, disinfect the space and then place a filling within the empty chamber and root canals to prevent further infection. We then seal the access hole and later crown the tooth to further protect and stabilize it.
It’s no exaggeration, then, to say that root canal treatments have saved millions of teeth. So, for all its beneficial effect, why is it considered by some to pose a health danger?
The germ for this notion comes from the early 20th Century when a dentist named Weston Price theorized that leaving a “dead” organ in place would harm the body. Since a root-canaled tooth with the pulp’s living tissue removed is technically no longer viable, it fit the category of “dead” tissue. Thus, according to this theory, maladies like cancer could arise because of the “dead” tooth.
Unfortunately, this theory has found a somewhat new life recently on the internet, even though it was thoroughly investigated and debunked in the 1950s. And as late as 2013, a study published in a journal of the American Medical Association found no increased cancer risk after root canal treatment, and even some evidence for a reduced risk.
So, if your dentist recommends root canal treatment, rest assured it’s needed to save your tooth. Rather than harm your health, it will improve it.
If you would like more information on root canal treatment, 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 “Root Canal Safety.”
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