Why does my tooth feel loose?

What causes a loose tooth in adults?

A tooth is held in the jawbone by the gum and by tiny fibers that let it give very slightly when you bite. Anything that damages that support can loosen it:

• Gum disease, which slowly breaks down the bone that holds the teeth, usually without pain, so a loose tooth can be the first thing you notice.
• A knock. A fall, a sports injury or biting down hard on something can loosen a tooth or push it out of position, even when it looks fine.
• Grinding or clenching, which loads the teeth night after night, especially where the gums are already weak.
• An infection at the root. A dental abscess can destroy the bone around a tooth.
• A crown or bridge that has worked loose, rather than the tooth itself. See a lost filling or crown.

What to do until you are seen

Call first. Then:

• Leave it alone. Try not to wiggle it with your tongue or fingers.
• Chew on the other side, and stick to softer food.
• Keep brushing, gently, including around the loose tooth. Plaque left there makes the gum worse.
• After a knock, hold a cold compress against your cheek in short spells to ease the swelling.
• Take an over-the-counter pain reliever as the label directs, if it is safe for you to take.
• Do not try to pull it out. A tooth that feels lost can sometimes be kept.

How soon should you call?

As soon as you notice it, and right away if a knock loosened it or pushed it out of place, or if it hurts or the gum is swollen. Appointment scheduling is available 24/7, and treatment happens in the office, Monday to Friday, 8:00 AM to 5:00 PM. Tell whoever answers what has happened and they will get you seen.

If an adult tooth has been knocked out, minutes matter. Put it back in the socket if you can, or keep it in milk, and see what to do for a knocked-out tooth. During office hours, call us straight away. Outside those hours, go to the nearest hospital emergency room and take the tooth with you.

At any hour, go to a hospital emergency room first for any of these, then call us afterward and we will take care of the dental side:

• A hard blow to the head, or a suspected broken jaw.
• Swelling that is closing an eye or spreading down the neck.
• Difficulty breathing or swallowing.
• Bleeding that will not stop after firm pressure.

What happens at your visit

Here in Pearisburg, we start by finding out why the tooth is loose. We check how much it moves, measure the gum around it, look at your bite, and take a digital X-ray to see the root and the bone around it.

Treatment follows the cause, and we explain it, and what it costs, before anything is done:

• Gum disease: a deep cleaning under local anesthetic, then cleanings every 3 to 4 months. As the gum heals, a loose tooth can sometimes firm up a little.
• A knock: we check the tooth's position, adjust it if needed, and may hold it steady with a splint bonded to the teeth on either side while it settles. The nerve sometimes needs a root canal later, so we keep an eye on it.
• Grinding: a custom night guard, when it will help, to protect the teeth while you sleep.
• An infection: draining it, then a root canal or taking the tooth out.
• A tooth that cannot be kept: taking it out, then talking through what goes in its place, such as a dental implant, a bridge or a partial denture.

A loose baby tooth is usually normal

In children, a wobbly baby tooth is usually good news: the adult tooth underneath is pushing it out. Let it come out by itself. Gentle wiggling is fine, but pulling it early hurts and bleeds more. A little bleeding when it comes out is normal, and pressing clean gauze on the spot usually stops it.

Call if a fall or a knock loosened it, if there is pain or swelling, or if an adult tooth is coming in behind a baby tooth that has not budged. A knocked-out baby tooth is not put back, because that can damage the adult tooth underneath. We see children, and children's dentistry explains how we look after them.

Questions patients ask