Posts for: September, 2014
A loose permanent tooth isn’t normal — it represents a serious threat to the tooth’s survival. There may be a chance to save the tooth, however, if we can determine the cause of the looseness and treat it appropriately.
Teeth are normally held securely in place by the periodontal ligament, an elastic tissue that attaches to both the teeth and the bone. Certain conditions, however, can disrupt this attachment. The most common is advanced periodontal (gum) disease, an infectious condition caused by bacterial plaque. It can severely inflame and damage the surrounding gum tissues resulting in bone loss. As the bone is lost, the periodontal ligament is lost as they detach from the teeth. In fact, tooth looseness may be a fairly late sign of the disease.
Another major cause is teeth grinding (bruxism) and clenching habits that result in excessive biting forces. Usually stress-related, teeth grinding and clenching generate forces on the teeth outside of their normal range. As a result the periodontal ligament can become stretched, inducing tooth looseness.
Our treatment approach depends on which condition is causing the looseness, best assessed with a thorough dental examination. If gum disease is the culprit, the main treatment is to remove as much bacterial plaque and calculus (tartar) as possible using various techniques such as scaling or root planing (accessing and cleaning root surfaces). It’s also imperative for you the patient to start and maintain an effective hygiene regimen of daily brushing and flossing, along with professional cleanings every three to six months depending on your degree of vulnerability to gum disease. Subsequent healing will stimulate tissue reattachment to the teeth.
In the case of excessive biting forces, we primarily want to reduce their effect on the teeth. Treatment can include muscle relaxants or anti-inflammatory drugs, or a custom-fitted bite guard to minimize biting forces from teeth grinding during sleep. In some cases we may opt to reshape the biting surfaces of teeth through removal of small amounts of surface enamel: this will reduce the biting force by altering how the upper and lower teeth contact. It’s also possible to splint loose teeth to more stable teeth, joining them like pickets in a fence. This helps relieve the biting force on teeth with significant loss of bone support.
If you notice a loose tooth, you should make an exam appointment with us as soon as possible. The sooner we can diagnose the cause and begin treatment, the less chance you’ll lose your tooth.
If you would like more information on loose teeth, 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 “Loose Teeth.”
What would it take to get you to give up tobacco? For major league baseball player Addison Reed, it took the death of his former coach, Tony Gwynn. Gwynn, a Hall-of-Famer who played for the San Diego Padres in addition to coaching at San Diego State, was just 54 years old when he died of oral cancer. As soon as Reed heard the sad news, the Arizona Diamondbacks’ relief pitcher says he knew what he needed to do: He took every can of smokeless tobacco he owned and dumped them all in the trash.
“It’s just become a habit, a really bad habit,” Reed told an interviewer at MLB.com. “It was something I always told myself I would quit.” But quitting took him many years — in fact, Reed admitted that he first started using smokeless tobacco as a junior in high school.
People begin using tobacco — in the form of cigarettes, cigars, pipes, or smokeless types (snuff, chewing tobacco, or dip) — for a variety of reasons. One major draw is that they see others doing it. And, while smoking is prohibited in most all Major League venues, the use of smokeless tobacco has remained fairly widespread.
Smokeless tobacco isn’t a safe alternative to cigarettes. According to the National Cancer Institute, it contains 28 carcinogenic agents. It increases the risk not only for oral and pancreatic cancer, but also for heart disease, gum disease, and many other oral problems. It’s also addictive, containing anywhere from 3.4 to 39.7 milligrams of nicotine per gram of tobacco — and its use has been on the rise among young adults.
But now the tide may be turning. After Addison Reed’s announcement, his former college teammate Stephen Strasburg (now a pitcher for the Washington Nationals) resolved that he, too, would give up tobacco. “[The] bottom line is, I want to be around for my family,” said Strasburg. Mets left-hander Josh Edgin has vowed to try quitting as well. It’s even possible that Major League Baseball will further restrict the use of smokeless tobacco at games.
What does this mean for you? It may just be the opportunity you’ve been waiting for… to stop using tobacco. Dentists have seen how quickly oral cancer can do its devastating work — and we can help you when you’re ready to quit. The next time you come in for a checkup, ask us how. Your teeth and gums will thank you — and your family will too.