The document discusses three main causes of tooth mobility: 1. Gum disease, which results in loss of alveolar bone and periodontal ligament support for the tooth. Splinting or treating the underlying gum disease can sometimes reduce mobility. 2. Trauma from occlusion, such as from excessive biting forces, fillings, or grinding. This causes inflammation in the periodontium and loosens the tooth. Removing the source of trauma may help. 3. Periapical infections from dead or infected teeth, which cause inflammation and loosen the tooth. Treating the infection, such as with root canal therapy, can reduce mobility.

1. Why Is My Tooth Loose — Part 2
CAUSES OF TOOTH MOBILITY
There are several reasons for why your tooth or teeth have become loose
or more mobile. In severe cases, it is possible to actually grip your tooth
with your fingers and pull it out. I have even seen cases where a patient
has said that their tooth came out by itself during chewing something.
So let’s look at the reasons.
1. Gum disease
2. Trauma from occlusion
3. A periapical infection
There are also other less common reasons but we will just focus on the
above in turn.
1. Gum disease
If you have a loose tooth or teeth, the chances are that it is affected by
gum disease. There are other signs of gum or periodontal disease which
you can find in the link on Gum disease.
Gum disease results in the periodontium of the tooth being affected and
therefore the tooth has less support. Alveolar bone is lost, there is
gingival recession and loss of the periodontal ligament together with
inflammation. It is important to realize that lost alveolar bone can never
grow back or be replaced. However, often, once the correct gum
treatment has been carried out, there can be an improvement in the
mobility and the teeth seem to have tightened up. This is because the
inflammation is reduced. Another treatment which is sometimes carried

2. out during periodontal therapy is that of “splinting”. A mobile tooth will
not tighten if it is disturbed each time you eat. The constant moving does
not allow the periodontal ligament to heal. Splinting a tooth prevents
this movement so that the periodontium can recover. Obviously, the
underlying periodontal disease must be still treated. If a tooth or teeth
are splinted, it is important that the occlusion is favorable, otherwise the
same problem will reoccur. It is important to point out that, if the gum
disease and alveolar bone loss has progressed beyond a certain point,
then nothing will salvage your tooth. As a general rule, once bone
beyond 50% has been lost, the patient should be advised to let the tooth
go. This is because the prognosis is now very poor and any further bone
loss will make future treatment with either implants or dentures, much
more problematic or even impossible. A favorable result from dentures
or implants is much better if there is sufficient remaining bone.
2. Trauma from occlusion

3. Teeth during normal chewing are subjected to quite heavy forces.
Normally, this is not a problem because the periodontal attachment
fibers are able to accommodate and cushion these forces into the
surrounding alveolar bone. However, if repeated occlusal forces become
too great, then the periodontium can be affected. The periodontium
undergoes changes in order to adapt and respond. These changes affect
the alveolar bone. The periodontal ligament becomes inflammed and
that’s why your tooth becomes painful or tender. This inflammation also
causes the tooth or teeth to become loose. The only way to remedy the
situation is to remove the occlusal trauma. This could be for example,
removing a high spot from a recent new filling. In cases of parafunction
such as clenching or grinding, an occlusal splint will provide a shield
against the excessive biting forces on the teeth.
There is a situation where even normal biting forces can cause a tooth or
teeth to become loose. If a tooth already has compromised support, any
amount of normal forces will cause movement because the tooth has
limited adaptive capability. A tooth will sometimes move to a position
where the occlusal forces are less and then it will start to tighten back up

4. in this new position.
The adaptive capability of the periodontium is utilized during
orthodontic treatment. During orthodontic treatment, gentle forces are
applied to the teeth. These forces result in alveolar bone resorption and
deposition until a tooth has been moved into a new different position. In
orthodontics, damage can occur such as root resorption if the
orthodontist inadvertently applied too greater a force.
3. A periapical infection
An apical infection from an infected and dead tooth causes bacteria
within the pulp chamber to elicit an inflammatory response in the
periapical tissues. The inflammation with or without bone loss, will
result in an increased tooth mobility. In these cases, once the cause of
the periapical infection is treated, the mobility then returns to normal

5. levels. A treatment could be Root canal treatment.
References
Journal of Periodontology 1997;68:166–71
Damping characteristics of teeth with periodontal breakdown:
Correlation of mobility meter values with bone and attachment loss.
Damirel K, Gur H, Meric H, Sevuk C.
Essentials of Preventive and Community Dentistry
Indices used in Dental Epidemiology. Peter S.
Carranza’s Clinical Periodontology
Epidemiology of gingival and periodontal diseases.
Journal of Periodontal
A method for quantitative measurements of Tooth mobility.
Beck J, Arbes S. Pameijer CH, Stallard RE.
Patient-Centered Perspectives and Understanding of Peri-Implantitis
Angel Insua, Alberto Monje, Hom-Lay Wang and Marita Inglehart
Journal of Periodontology November 2017, Vol. 88, №11: 1153–1162.
Soft Tissue Changes Around Immediately Placed Implants: A Systematic
Review and Meta-Analyses With at Least 12 Months of Follow-Up After
Functional Loading

6. Bassam M. Kinaia, Filip Ambrosio, Monica Lamble, Kristyn Hope,
Maanas Shah and Anthony L. Neely
Journal of Periodontology September 2017, Vol. 88, №9: 876–886.
2017–03. Periodontitis and incident type-2 diabetes: a
prospective cohort study
Lewis Winning, Christopher Patterson, Charlotte Neville, Frank Kee,
Gerard Linden
J Clin Periodontol. March 2017: 44; 3; 266–274
British Society of Periodontology
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Tagged in Dentistry, Dr Muzzafar Zaman, Gum Disease, Trauma From Occlusion, Periapical Infection
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Exported from Medium on May 11, 2018.