Dr. Cohen’s Implant Dentistry Blog

I have advanced gum disease and had a root planing/scaling, osseous surgery, and bone grafting done on tooth #10. However, I still have a little gum disease around that tooth. As a result, now my tooth is slightly mobile and moving out of its socket towards the back of my mouth. Recently, I got a veneers put on to close the gaps and to shape it up a little and it doesnt seem to help. Its still moving. Today, I got a dental splint with just the white composites (no wires) and my concern is if that tooth continues to move out of the socket, will it also pull the 2 surrounding teeth with it or should the splint stabilize for some time? And please help, what’s causing it to move like that? My general dentist and periodontist cannot seem to figure out why. I’ve taken all kinds of antibiotics following the instructions and it doesnt seem to work. THANKS!!!
- May from California
May,

Gum disease is a long-term degenerative disease that can’t be cured with what we know now, it can only be controlled and slowed. And when the teeth begin to get loose, they also can begin to drift. So you have this one tooth that has begun to drift – that is a common occurrence with advanced gum disease.

One treatment is that the teeth can be splinted together. That will prevent the drifting, and it strengthens the weak tooth. Yes, there is a risk that the two teeth on the sides that are being used to support the weaker tooth in the middle will be stressed too much, and it can weaken those. But it’s a calculated risk based on your dentist’s assessment of the overall condition of your mouth.

The best weapon in your long-term battle with gum disease is your own home care. Floss every night, faithfully, without missing a night. With the teeth splinted together, you have to use a floss threader to get those areas clean – be sure you do this. The second best weapon is faithful professional care. Often, with serious gum disease, it is recommended that you have your teeth cleaned every three months. Don’t miss one of these appointments. And even though gum disease is an infection, antibiotics won’t stop it. It’s more complicated than that. Keeping the teeth clean is what you need to do.

Links:
Read about your options for replacing missing teeth. They can be replaced with dental implants or with removable partial dentures.

I am a diabetic and one of my front teeth is loose and one side tooth is loose. I want to know what I can do to get them back tight. I have a gap in the middle and I want to save my teeth.
- Ora from Texas

Ora,
It sounds like you have advanced periodontal disease (gum disease), and if your teeth are as loose as it seems, it may be too late to do anything to save them. When they start to wobble, the bone support is usually almost entirely gone. But you can check with your dentist and see what can be done. And if you have been going to the dentist regularly and he or she hasn’t told you about your serious gum disease, I would find a dentist who is more tuned in to this issue. This is a chronic disease that takes years to develop.

The other possibility for teeth that are very mobile is some kind of serious traumatic injury, like being hit in the face.

When you have diabetes, you are especially susceptible to gum disease. A conscientious dentist will carefully screen all patients for gum disease, and for the majority of patients over 40 who have some form of gum disease, will recommend some course of action to deal with it and help control it.

If you end up losing these teeth, you will need a carefully worked out treatment plan to replace them. Usually, when two teeth are as loose as you seem to be saying, the adjacent teeth are also quite weak. This limits your options for solving the problem. Bridgework or even removable partial dentures will put additional stress on the remaining teeth, which won’t help them. The sooner you start treatment, the better off you are.