Do you have one or more loose teeth? This can be a frightening experience. You’re not sure if the tooth is going to come out or if there’s a way to save it. Usually, a loose tooth is a sign of underlying gum disease (periodontitis). As this condition progresses, it causes recession of the gums and destruction of underlying jawbone. Without these structures to hold the tooth in place, the root becomes loose in the socket. Eventually, the tooth can fall out. In fact, gum disease is the No. 1 cause of adult tooth loss.

Can Loose Teeth Caused by Gum Disease Be Fixed?

This depends on the stage of the disease. A very early case of periodontitis (one that hasn’t progressed past the gingivitis stage) may be curable in the sense that the gum tissue can potentially heal fully. As it does, the gum tissue becomes firmer and can once again support the tooth and keep it from wiggling so much in the socket. Unfortunately, loose teeth are often a sign of gum disease that has progressed to the point where the primary treatment goal is simply to keep the condition from getting worse.

Later stages of periodontitis that involve both the gums and the underlying jaw bone are not necessarily reversible. Bone usually doesn’t regrow once it has been lost. Replacing lost bone volume may be possible with extensive restorative dental surgery such as bone grafting. Researchers are also experimenting with the use of a teriparatide drug called Forteo to regenerate jaw bone. However, there have been no large scale clinical trials yet to determine whether this treatment is safe and effective. Tooth loss may be unavoidable with advanced periodontitis. If that happens, a dental restoration such as dentures or blade-style dental implants may be the only fix.

The most important step you can take to prevent loose teeth and keep the condition from getting worse is to take very good care of your gums. Periodontitis is usually preventable with good oral hygiene and dietary habits.

What Other Factors Can Loosen My Teeth?

The following oral health issues can make teeth feel loose:

  • Trauma (hitting the tooth on something hard)
  • Abscess in the tooth and/or in the surrounding gum tissue
  • Hormonal changes that temporarily affect gum tissue (this condition will go away when hormone levels normalize such as after pregnancy)
  • Lack of proper nutrition (Vitamin C deficiency causing scurvy is not common in the United States, but it can occur if you have a very poor diet)

What Should I Do if a Tooth Feels Loose After Being Bumped?

If you play any kind of contact sport, it’s a very good idea to wear a mouth guard to protect your teeth from being knocked loose in the first place. However, many “bumped tooth” accidents happen when you least expect it (you might trip and fall, or you might bite down on something unexpectedly hard). Here’s what to do if that happens.

You may notice a loose tooth immediately after being struck in the face. Or, the tooth might start feeling loose and sensitive sometime after the initial trauma. In some cases, a loose tooth may tighten back up in the socket naturally if it is mainly the gums that were injured. However, there is also a chance that the nerve and/or the tooth root have been damaged by the impact. Your tooth may start changing color and go gray as the living pulp inside of the tooth dies. Even if it doesn’t fall out immediately, the tooth is weakened and vulnerable and may fail later. If you hit a tooth and it feels loose:

  • Avoid touching or wiggling the tooth since this may worsen the trauma and introduce infection
  • Don’t chew anything on that side of your mouth or otherwise put pressure on the loose tooth
  • Use a cold compress on the outside of your mouth for immediate pain relief
  • Contact your dentist immediately for an emergency evaluation

Your dentist will need to x-ray the tooth to check for root or nerve damage. If the loose tooth is basically OK, your dentist may simply give you a mouth splint to protect the tooth and hold it in place while it heals. If the tooth is damaged or if infection is affecting the tooth pulp, you may need a root canal to save the tooth.