There are 3 reasons for ligament damage, aside from an obvious traumatic blow to the face: excessive bite force, disease, or a combination of both.
Excessive bite force is considered “primary occlusal trauma.” It means that the tooth has experienced a prolonged excessive biting force beyond its tolerance. This is often a result of bruxism (habitual grinding) or clenching of the teeth. It can also result from tooth misalignment in which the positioning of a tooth is causing it to sustain more bite force than it’s meant to withstand.
Advanced periodontal disease results in extensive bone loss around a tooth, which in turn results in a condition referred to as “secondary occlusal trauma.” This kind of trauma occurs when normal forces are applied to the teeth but the ligaments are unable to withstand those forces because of so much bone loss. Disease is the most common cause of tooth looseness.
If you sustain a traumatic blow to the face, the reason for tooth looseness should be no mystery. Even so, it often requires professional help to allow the teeth to heal in proper position or to prevent further damage.
Treating the Problem
The approach to treating loose teeth is both biologic and mechanical.
The biologic approach involves treating periodontal disease so that the periodontal attachment can heal. This is vital before mechanical options can work.
The mechanical approach involves modifying forces applied to the teeth, treating the effects of the force on the periodontal ligament and/or modifying the amount of biting force generated by the jaw muscles and received by the teeth during bruxism, clenching or biting. The appropriate approach(es) will depend on the source and intensity of the bite force and the degree of tooth looseness:
Mouth Guard. In the case of bruxism — “parafunctional” (outside the norm) bite forces — a mouth guard may be used as a protective barrier between upper and lower teeth.
Occlusal Adjustment. This involves reshaping the biting surface of the tooth to reduce the amount of force it receives. In some situations orthodontic treatment may be used to move a tooth into improved alignment.
Splinting. This involves joining teeth together like fence pickets to distribute the bite force among them. There are temporary and permanent options depending on healing and the amount of bone loss.
If you’re experiencing tooth looseness, don’t ignore it. Chances are it will get worse. Visit your dentist promptly for a comprehensive assessment and diagnosis and a more detailed discussion of your treatment options.