Loosening of the teeth usually occurs as a result of an injury or inflammation and damage to the bone. As known the roots of teeth are strongly secured into the bone of the upper and lower jaw (alveolar bone). When this bone is healthy and reaches to the neck of the teeth, the teeth are firmly attached to it and immobile. If the bone height is decreasing, the tooth becomes looser.
In trauma the mobility of the teeth may be a result of a fracture of the tooth root at a different depth into the bone or a fracture of a portion of the alveolar bone itself, making it impossible to retain the tooth immobile.
In inflammatory diseases (periodontitis) the alveolar bone melts over time and the tooth roots become more and more visible which results in a gradual loosening of the tooth and even to spontaneous falling out. Both front (anterior) and back teeth (molars) can loosen. The loose tooth can be mobile to varying degrees.
There are three degrees of loose teeth.
First degree – mobility is only from the cheeks and lips towards the tongue.
Second degree – in addition to first degree there is mobility back and forth in direction of the adjacent teeth.
Third degree – there is vertical mobility – a tooth moves up and down in the gum.
Moving of the teeth may be associated with pain, gum inflammation or discomfort when eating.
When the movement is due to a hit or a trauma and there is one or several teeth which are loose, an X-ray picture should be done to determine whether there is a fracture of the root of the tooth or the bone. In milder injuries there may be only tooth luxation (moving of the tooth in the tooth socket without breaking).
In periodontitis loose teeth occur over time, because the process of melting of the bone is slow. This process can start inconspicuously, but in advanced stages problems during eating and speaking occur, and if no action is taken to treat the disease, it can lead to the spontaneous fall out of teeth. Loose teeth in periodontitis is a process which occurs by the principle of the vicious circle. This is due to the emerging mobility of the teeth in the alveolar bone which cannot recover, which in turn leads to increased mobility of the teeth. A treatment option is the use of teeth splints with which the teeth are immobilized and this creates an environment for the alveolar bone to recover.