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Tooth mobility refers to the movement of loose teeth within their sockets. Primarily caused by gum disease and trauma, loose teeth are often an indicator of a larger dental problem. Treatment involves identifying and addressing the cause of tooth mobility. If caught early enough, loose teeth can be made firm again.
There are two types of tooth mobility. Physiologic mobility refers to the slight degree of movement that all teeth, even perfectly healthy ones, have when some force is applied. The amount of physiologic mobility varies from person to person, from tooth to tooth, and even varies by the time of day that the mobility is measured. Pathologic mobility refers to tooth movement caused by the progression of gum disease or trauma.
Dentists evaluate tooth mobility during routine examinations. Movement is usually measured by applying direct pressure to individual teeth with a finger or dental instrument. Another method involves placing a finger on the front surface of the tooth and feeling for movement while the patient grinds their teeth or chews. Tooth mobility is classified by assigning a score between zero and three to represent the amount of movement a tooth is capable of. A normal tooth that is not loose scores a zero, and a severely loose tooth that moves both horizontally and vertically scores a three.
Aside from the loss of baby teeth, gum disease is the most common cause of tooth mobility. Also called periodontal disease, it begins with a bacterial infection. If untreated, the inflammation eventually destroys gum tissue, spreads to the tissues between the teeth and bone, and ultimately destroys the bone itself. Gum disease attacks the entire foundation that normally holds teeth firm.
For mobility caused by gum disease, scaling and root planting procedures are frequently used to remove bacteria and encourage the growth of healthy gum tissue. If receding gums are an issue, a graft may be needed to secure wobbly teeth. The successful treatment of gum disease will firm up loose teeth. In the case of very advanced gum disease, however, there may be no other treatment option but to remove the tooth. A dentist may recommend dental implants or bridge work to replace the missing tooth.
The other major cause of tooth mobility is trauma to the tooth. Damage suffered as a result of an accident or a sporting event is one source of trauma. A loose tooth resulting from force will usually firm up on its own if the gum tissue is healthy. Chewing directly with the tooth should be avoided to allow the damaged tooth to rest. If the tooth is extremely loose, or if the mobility bothers the patient, the tooth can be splinted to firm, neighboring teeth with a thin wire.
Another source is chronic clenching or grinding of the teeth, called bruxism. Misalignment is another cause of mobile teeth. Also called malocclusion, this condition puts uneven pressure on certain teeth when chewing, and over time weakens the supporting bone and teeth. Teeth that are loose due to grinding or clenching are frequently protected with the use of a mouth guard. Orthodontic treatment might be necessary to correct tooth mobility caused by malocclusion.