It’s a disheartening shock to find movement in a perfectly good tooth.

Generally, the last experience of that was met with much excitement and just a week or two before the Tooth Fairy made it all worthwhile.

As an adult, there’s nothing comforting about it. Particularly when it’s not the result of some sudden impact to instantly explain it; like being clocked in the mouth by the thick skull of an excited dog. Or underestimating the proximity of a door jamb. Maybe even copping an elbow to the face during sport. (And wishing you’d worn a mouthguard.)

Either way, you know how it happened. You weren’t just unnervingly conscious of something that was so firmly and immovably fixed in your mouth having wiggle room one day.

Even worse, sometimes there’s more than one.

Not only is it physically and psychologically uncomfortable, the worst is that it’s something for which we are entirely responsible.

Often, it marks the progression of gum disease: the gingivitis we didn’t properly attend to, the regular dental appointments we didn’t make. Perhaps a deliberately jejune perspective on poor dietary choices, inadequate dental hygiene or the impact of smoking and drinking on good oral health.

Sometimes its a crown or filling that’s come unstuck that needs redoing or re-gluing. It can be genetics, or the side-effect of medication. Sadly, more often than not, neglect plays a greater role; and it’s not necessarily intentional. There’s the intrusion of life’s stresses and changes in the financial landscape. There’s the misapprehension that home remedies to treat though irregular bouts of swollen, tender or bleeding gums is all that needs to be done. After all, dental appointments are expensive. With no other pain or discomfort and brushing twice a day, that’s enough isn’t it?

Unfortunately and unsurprisingly, no. Were someone to assert to a crowd that washing their car completely negated ever having to take it to the mechanic, the ensuing ridicule would insist it’s justified.

Only a trained oral health professional has the knowledge and expertise to recognise the early stages of potentially more damaging issues, and devise the appropriate treatment. Only a dentist can properly remove the plaque, tartar and calculus that are responsible for periodontal disease and the point at which it can be remedied.

Otherwise, it’s incurable and can only be managed with a range of options. That’s why the first response to tooth sensitivity shouldn’t be to reach for the Sensodyne – it has to be to have a proper dental assessment.

The most recent change in therapy for periodontal disease is currently under development. With a few years to go before it’s approved, the research results are astounding. Unlike all other approaches to chronic gum disease, this gel and oral strips target and block succinate – a natural receptor molecule that becomes elevated in periodontal patients. Disabling it counteracts the soft tissue inflammation and bone loss, and effectively shuts down the disease.

The intention of gel and strips are home therapy; while a more concentrated version will be available only to dentists for professional application as part of a treatment plan.

Recently, narrow spectrum antibiotic FP-100 (hygromycin A) was found to do a specific job that’s taken almost a decade to find: it successfully eliminates Fusobacterium nucleatum. This is an opportunistic bacterium commonly found in the mouth. When left unchecked, it leads to severe gum disease, dental pulp infection, oral cancer and associated systemic diseases.
Impressively, it doesn’t harm healthy gut bacteria.

Since teeth are not simply fused to the jaw bone but connected to gum sockets by the periodontal ligament, they do have a degree of mobility: 0.25mm. This cleverly accommodates the force and decades of chewing without our teeth cracking or shattering in our mouth. Beyond this normal range of movement, it’s graded.

Grade 1 is less than 1mm of horizontal displacement; Grade 2 is anything greater than 1mm while remaining one directional. Grade 3 involves more than 1mm with significant vertical migration as well.

There are a number of causes for tooth mobility: accident, severe gingivitis, tooth infection, gum recession and periodontal disease. Periods of stress, where jaw clenching and bruxism (tooth grinding) commonly result in loose teeth. Sufferers are sometimes unaware of their new and damaging habit as it commonly occurs during sleep. A dental exam will quickly diagnose it, and often a custom-made splint will correct it..

Gum recession is a common issue that disrupts tooth anchoring.

Conventional solutions are dependent on severity, and extend from courses of antibiotics and antimicrobial mouthwashes, to gum grafting. This surgical procedure is performed by a periodontist with the missing soft tissue replaced either from the palate of the patient, or via substitute donor material.

As with all surgical procedures it comes with risks.

Pinhole gum surgery is a option that was developed in 2006. A minimally invasive process, it repairs receding gums without incisions or stitches. Special dental tools make a pinhole in the gum, and gently move the existing tissue to cover where the recession has occurred. There is limited discomfort and rapid healing with more natural looking results.

In 2019 researchers surgically implanted a thin, film-like membrane between an inflamed gum and tooth. The coated material blocked the infection, while simultaneously delivering medication and growth factors to the gum tissue. It was proved to inhibit bacteria growth, regenerate soft tissue and promote bone growth.

Another tremendous breakthrough giving great hope for the near future. In the meantime, it’s all about monitoring and managing loose teeth rather than magic.

In the early stages of gum recession – and after professional cleaning to remove plaque, tartar and calculus – aloe vera mouthwash, or gel, as well as salt water rinses, oil pulling, and the appropriate use of clove, basil and tea tree oils can help. All have anti-inflammatory qualities. Xylitol, an unfermentable sugar that bacteria can’t utilise for acid production has also been found to assist gum health, and remineralise teeth.

Dietary improvements to increase vitamin C intake will heal and rejuvenate gums. It synthesises collagen – the protein necessary for structure, support and strength to skin, muscle, bone and connective tissue. Specially formulated gels containing Vitamin C, hyaluronic acid and xylitol have shown to have positive effects on gingival fibroblasts and oral healing. Omega-3 fatty acids, zinc, Vitamin D3 and collagen supplements are recommended by holistic dentists; with eucalyptus oil said to seed gums and promote tissue growth.

A healthy and healing oral environment is alkaline rather than acidic. Along with understanding foods that help maintain that, it’s important to drink water: although curiously, not through frequent sipping as this disrupts saliva protection of tooth enamel.

Soft and ultra-soft toothbrushes don’t stimulate the gums enough, and good circulation is vital for repair. Switching to a medium brush, incorporating gum massage and re-education in brushing technique by a dental hygienist are highly useful.

Drinking green tea is also suggested, as it too contains antioxidant compounds. Most recently, groundbreaking research has found that matcha powder – the essence of green tea – is a promising ally against the bacterial onslaught of porphyromonas gingivalis, the pathogen of periodontitis.

Researchers at the Nihon University School of Dentistry in Japan published their findings in Microbiology Spectrum, an open-access journal of the American Society for Microbiology (ASM). The study involved a series of in vitro experiments with 16 oral bacterial species – three strains of which were P. gingivalis – to test the efficacy of a matcha solution.

Within 2 hours almost all the cultured anaerobic, rod-shaped P. gingivalis cells had been eradicated by the matcha extract. After 4 hours, all the cells were dead: proving matcha very beneficial in the prevention and treatment of periodontal disease.

It’s impossible to know whether a loose tooth can be saved until you consult a dentist.

Retaining loose teeth or an individual loose tooth is certainly more likely with early treatment, so making that appointment is key.

Waiting to see if it will ‘fix itself’ is a completely understandable panic response. What’s needed is a professional examination.

We don’t have the ability to turn back time. We can, however not turn our back to the time that there is. So make that dental appointment knowing you’re giving yourself the best opportunity to use, rather than lose that worrisome wiggly tooth.

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Note: All content and media on the Bacchus Marsh Dental House website and social media channels are created and published online for informational purposes only. It is not intended to be a substitute for professional medical advice and should not be relied on as health or personal advice.

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