Question: Why has one of my adult teeth become loose?
Explanation: A loose permanent tooth is never normal and always warrants investigation. Causes include advanced periodontal disease with bone loss, trauma causing luxation, a periapical or periodontal abscess, excessive occlusal forces from grinding or a high restoration, root fracture, and rarely a cyst or tumour undermining the bone. The degree of mobility is graded clinically, and radiographs assess the remaining bone support. Some causes, such as an abscess or occlusal overload, are reversible. Advanced periodontal bone loss is not.
Related Questions:
Can a loose tooth tighten up again?
It depends on the cause. Mobility from inflammation, an abscess, or occlusal trauma often resolves once the cause is treated. Mobility caused by permanent loss of supporting bone from periodontal disease does not, though it may be stabilised by splinting and by arresting further bone loss.
How is tooth mobility measured?
Clinically, using two instrument handles to rock the tooth. Grade one is up to one millimetre of horizontal movement. Grade two exceeds one millimetre horizontally. Grade three includes vertical movement, or depressibility, which carries a poor prognosis.
Is a loose tooth an emergency?
It is urgent rather than an emergency, unless it follows trauma or is accompanied by swelling, fever, or severe pain. A tooth loosened by trauma needs same-day assessment for repositioning and splinting. A tooth loosened gradually by gum disease needs prompt periodontal assessment.
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