Dental Education Lecture: Loose Tooth

Mr. Wang has severe gum disease.  One of his bottom teeth is very loose.  It moves when his tongue touches it (Fig.4 as compared to Fig.3). He cannot eat or even brushes his teeth because of the looseness and pain.

The best option is to extract the loose tooth and place an implant.  But Mr. Wang wants to keep the tooth as long as possible.  First of all, we need to get rid of the cause.  Gum disease is caused by accumulation of tartar (Fig.1 arrowhead) under the gums.  Asterisk (star *) points to the loose tooth.  Deep cleaning removes the tartar (compare Fig.2 vs. 1).  The loose tooth has also root tip infection (denoted by white line in Fig.1).

To fix the loose tooth, we bend a piece of wire and attach it to the tongue side of the bottom six teeth with white filling (Fig.5).  Fig.5 photo is taken with the help of a mirror to show both the front and back views of the bottom teeth.  This method of fixation is called splinting, the same way the surgeon fix our broken arm with a splint.  

To fix the root tip infection and pain, we do root canal (not shown).

A week later, the patient returns to the office for upper tooth deep cleaning.   He is pleased with the result of splinting and root canal.  We cannot see the wire from the front (Fig.6).  Splinting in fact is a temporary method.  It may become loose.  We hope that root canal cures the root tip infection and bone will fill the space as shown by white line in Fig.1.  Once the tooth becomes stable, we may remove the splint.  

Splinting makes it difficult for local oral hygiene.  We need to use small brush, threader or superfloss for cleaning.

Xin Wei, DDS, PhD, MS 1st edition 11/08/2009, last revision 04/09/2010