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Impacted Tooth

Management Team

Impacted Tooth

Overview

An impacted tooth is one that remains trapped within the gums or jawbone (instead of erupting normally). While impaction usually affects wisdom teeth and canines (cuspids), other teeth may also be affected. Impaction is classified into three main types:

  • Soft-tissue impaction: The tooth erupts through the jawbone but does not break through the gums.
  • Partial bony impaction: Only a part of the tooth erupts through the jawbone; the tooth does not break through the gums.
  • Full bony impaction: The tooth remains completely trapped within the jawbone. 

The main causes of an impacted tooth are as follows: 

  • Twisted/crooked teeth that erupt sideways.
  • Overcrowding: this prevents the teeth from erupting normally.
  • Insufficient space in the jawbone: this may happen when the jaw is small or in the presence of extra (supernumerary) teeth.

The symptoms of impacted teeth may come and go or be persistent. These include the following:

  • Red, swollen, or bleeding gums
  • Pain and stiffness in the jaw (difficulty in opening the mouth)
  • Halitosis or dysgeusia
  • Headaches
  • Swollen lymph nodes in the neck

In some cases, impacted teeth can lead to one or more of the following oral health complications:

  • Tooth decay (cavity formation)
  • Tooth abscesses
  • Gum disease
  • Formation of cysts (fluid-filled sacs) under the gums
  • Pericoronitis
  • Malocclusion (bad bite)
  • Mandibular nerve damage (this is a large nerve in the lower jaw that controls important functions such as mastication and swallowing)

The diagnosis of impacted tooth usually involves the following:

  • Oral examination: Examination of the oral cavity for signs of inflammation, pericoronitis, swelling, or pus formation.
  • Dental X-ray: X-ray imaging to determine the location of the impacted teeth. Sometimes, cone beam CT is also used for determining the actual position of the impacted teeth and its proximity to vital nerves and vessels.

Patients with impacted teeth may not always experience symptoms; moreover, treatment is not always needed. However, if patients notice sudden and unexplained pain in the teeth or gums, they are advised to schedule a dental consultation. The severity and cause of the condition may reflect whether the symptoms will get better or worse; however, without proper care, the teeth will not heal and pain may persist.

Based on the symptoms, presentation, and severity of the condition, dentists decide whether treatment is required or not, and if it is, recommend the following treatments:

  • The “wait and see” approach: If an impacted tooth is detected but no symptoms are present, dentists may recommend that the affected region be monitored without further action (unless required), i.e., the tooth is frequently examined during routine dental checkups or cleaning sessions to ensure that it is healthy and does not cause any complications.
  • Impacted tooth removal: In cases where the impacted tooth causes oral health issues, such as pain, swelling, or infection, tooth extraction is recommended. This is an outpatient procedure performed under local anaesthesia or sedation.
  • Eruption aids: When a tooth does not erupt on its own, an eruption aid is applied to accelerate eruption. This treatment quite frequently performed among young patients (children and teenagers) with impacted canine teeth.
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Cochlear Implants

Management Team

Cochlear Implants

Overview

Cochlear implants are a remarkable solution that has transformed the lives of individuals with severe profound hearing loss. These hearing loss treatments have restored sound sensation for individuals fitted with them and serve as voice disorder treatments by helping them vocalise better.

Cochlear implants are sophisticated electronic devices that provide a sense of sound to individuals with profound hearing impairment. In stark contrast to traditional hearing aids based on amplifying sounds, cochlear implants work on the paradigm of directly stimulating the auditory nerve.

Cochlear implants are suitable for individuals with severe to profound hearing loss, for whom regular hearing aids may not work with the best efficiency. Ideal candidates include adults and children who do not benefit significantly from hearing aids or other medical interventions.

Our skilled team of specialists, who provide some of the best audiology services, will guide you through the implantation process, which involves a surgical procedure to implant the device under the skin behind the ear. After surgery, a rehabilitation period is crucial to help users adapt to and maximise the benefits of their new auditory experience, including speech therapy.

Cochlear implants have been instrumental in restoring the joy of sound for countless individuals. Common outcomes include improved speech perception, enhanced communication skills, and increased quality of life. The device evolves continuously, providing users with more natural and nuanced hearing experiences.

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Pericoronitis

Management Team

Pericoronitis

Overview

Pericoronitis refers to the inflammation of the gum tissues around the wisdom teeth, the last set of adult teeth that erupt; this usually happens during the late teens or early 20s. Typically, pericoronitis may occur when one or more wisdom teeth are still partially impacted (trapped) under the gum tissues. This condition is more likely to develop around the wisdom teeth in the lower jaw than in those in the upper jaw. Pericoronitis may be mild (lasting a few days) or severe (lasting several weeks).

Partial tooth impaction, i.e., the partial trapping of a tooth within the gums, which often results in the growth of bacteria and ultimately, infection and inflammation, is the main cause of pericoronitis.

The symptoms of acute pericoronitis symptoms may include:

  • Severe pain around the back teeth
  • Redness and swelling of the gums
  • Difficulty swallowing
  • Trismus (lockjaw, i.e., restricted mouth opening)
  • Facial swelling
  • Pus or drainage
  • Fever
  • Swollen lymph nodes in the neck

The symptoms of chronic pericoronitis may include:

  • Mild pain (often, temporary) near the back teeth
  • Halitosis (bad breath)
  • Dysgeusia (bad taste in the mouth)

The diagnosis involves the following:

  • Oral examination: The dentist reviews the medical history, symptoms, and presentation, examines the wisdom teeth, and checks for excess gum tissues.
  • Dental X-ray: The dentist may perform dental X-ray to rule out other conditions, such as tooth decay, and examine the health of the roots.

If patients develop pericoronitis-associated symptoms, such as bleeding gums, tooth pain, and related fever, they are advised to schedule a dentist appointment right away. The dentists often prescribe antibiotics to treat infections, if any, and ascertain the requirement for further treatments. If pericoronitis is not treated promptly, it may exert a domino effect, i.e., lead to the deterioration of oral and overall health.

The severity of the pericoronitis-associated inflammation influences the course of treatment recommended for each patient; the dentist may recommend normal or deep cleaning, treatment with antibiotics and/or antibacterial mouthwash, and in some cases, wisdom teeth removal.

  • Dental cleaning: The affected area is irrigated to wash out bacteria, food particles, or other debris. The use of antibiotics or an antibacterial mouthwash may also be recommended.
  • Antibiotics: Oral antibiotics may be prescribed to clear the pericoronitis-associated infection.
  • Pericoronitis mouthwash: A prescription mouthwash that contains chlorhexidine, a topical antiseptic, is recommended to kill harmful bacteria in the oral cavity.
  • Pericoronitis removal surgery: In many cases, removal of the gum flap (operculum), which is a short oral surgery procedure, is recommended; sedation during this procedure is often unnecessary. Typically, with local anaesthesia, this procedure is completed within an hour.
  • Wisdom tooth removal: If the wisdom teeth continue to cause problems or recurrent pericoronitis, removing them may be necessary. This procedure is often performed by an oral surgeon or periodontist with or without sedation.
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Hyperdontia

Management Team

Hyperdontia

Overview

Hyperdontia refers to the presence of extra or supernumerary teeth. People with this condition may have one or many extra teeth, which may be visible or hidden (impacted), on one or both the jaws. Anyone can have hyperdontia, given that it affects both primary (baby) and permanent (adult) teeth.

Although the exact underlying causes of hyperdontia remain unclear, several factors that can may cause this condition have been identified:

  • Hyperactivity of the cells in the dental lamina (the cells responsible for tooth development)
  • Certain health conditions associated with hyperdontia, such as cleft lip and cleft palate, cleidocranial dysplasia, Fabry disease, Gardner syndrome, Down syndrome, and Ehlers-Danlos syndrome.
  • Atavism, i.e., the reappearance of an ancestral genetic trait. It is possible that our ancestors needed extra teeth to grind raw nuts and plants in their primitive diet.

The hallmark of hyperdontia is the presence of one or more extra teeth. Although this condition does not cause discomfort in most cases, the following symptoms may appear if the extra teeth put excessive pressure on the jaws or gums:

  • Pain, swelling, and/or tenderness in the gums and/or jaws
  • Overcrowding of teeth
  • Tooth infection

Depending on where the extra teeth are present, the following symptoms may also be noted:

  • Tooth impaction (the partial or complete trapping of a tooth within the jawbone).
  • Overcrowding of teeth
  • Crooked teeth
  • Difficulties with biting and chewing
  • Malocclusion (a bad bite)
  • Cavity formation, i.e., tooth decay
  • Gum disease
  • Formation of noncancerous oral cysts

Hyperdontia is often diagnosed during a routine examination. Dentists run X-ray or CT scans to ascertain the presence of impacted supernumerary teeth.

If supernumerary teeth are detected, the dentists examine whether they are causing any issues.

Timely diagnosis and treatment can greatly help reduce the risk of any long-term complications.

Although treatment for hyperdontia is not always needed, if the extra teeth interfere with the functioning and health of the oral cavity, removing them is advised. Dentists often recommend a tooth extraction under the following conditions: 

  • Pain or discomfort
  • Difficulty in chewing, eating, brushing, or flossing
  • The extra teeth make the patient conscious
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H

Obstructive Sleep Apnoea

Management Team

Obstructive Sleep Apnoea

Overview

Sleep apnoea is a serious sleep disorder; the patient’s breathing stops repeatedly during the course of sleep. Loud snoring during sleep and fatigue despite getting a full night's sleep may be indicative of sleep apnoea.

Obstructive sleep apnoea is a consequence of the excessive relaxing of the muscles in the back of the throat; while the relaxation of these muscles enables proper breathing, excessive relaxation may cause the airways to narrow or close as air is breathed in. This, in turn, can cause the oxygen level in the blood to plummet and a buildup of carbon dioxide. As the brain senses this impairment in breathing, it briefly rouses the body during the sleep so that the airway can be reopened. This awakening is so brief that usually, patients do not remember it. Throughout the night, this pattern is repeated 5 to 30 times or more per hour. Because these disruptions prevent patients from attaining the deep, restful phases of sleep, they often feel sleepy during the waking hours. While obstructive sleep apnoea can affect any individual, certain factors are associated with an increased risk for developing this condition:

  • Excess weight: Fat deposits surrounding the upper airway can obstruct breathing.
  • Older age: the risk of developing this condition increases with ageing; however, this risk appears to level off after the 60s and 70s.
  • Narrowed airway: a naturally narrow airway is a hereditary trait. Moreover, the enlargement of the tonsils or adenoids could also cause airway blockage.
  • Hypertension and/or diabetes: This condition has been reported to be more common in patients with high blood pressure and/or diabetes.
  • Chronic nasal congestion: The incidence of this condition has been reported to be two times higher in people who have consistent nasal congestion (than in those who do not) at night, regardless of the cause.
  • Smoking: Smokers are more likely to have this condition.
  • Asthma: Asthma has been found to serve as a risk factor for obstructive sleep apnoea.
  • Male sex: Men may be twice or thrice as likely to develop obstructive sleep apnoea than premenopausal women. However, menopause has been reported to increase the risk of developing this condition in women.
  • Family history: Having family members this condition may be associated with an increased risk of developing this condition.

  • Loud snoring
  • Episodes of apnoea, i.e., the stoppage of breathing, during sleep (usually reported by another person)
  • Gasping for air during sleep
  • Insomnia, i.e., difficulty staying asleep
  • Waking up with xerostomia, i.e., dry mouth
  • Morning headaches
  • Irritability and/or inattention while awake
  • Hypersomnia, i.e., excessive sleepiness during the day

The diagnosis of sleep apnoea involves the following steps:

  • Physical examination: The back of the nose, mouth, and throat of the patient are examined. The patient’s neck and waist circumference and blood pressure may also be measured. Further evaluations are performed by sleep specialists, who can diagnose the condition and ascertain its severity and accordingly, plan the treatment. These evaluations often involve monitoring the breathing and other body functions of the patients overnight while they are asleep.
  • Tests: The following tests can help detect obstructive sleep apnoea:
    • Polysomnography (sleep study): Devices and sensors that monitor the brain, heart, and lung activities and breathing patterns are attached to the patients while they sleep. These devices also measure the blood oxygen levels and arm and leg movements. The patients are monitored for the entirety or a specific duration of the night.
    • Home sleep apnoea testing: In certain cases, at-home polysomnography kits may be used to diagnose this condition; however, using these kits, only a limited set of apnoea-related variables can be analysed during sleep.

The following treatments can be used for the management of sleep apnoea:

  • Mandibular advancement device (or mandibular repositioning device): This device temporarily moves the jaw and tongue forward, widening the airway space decreasing the degree of throat constriction; thus, it helps prevents sleep apnoea and snoring.
  • Transcutaneous electrical nerve stimulation (TENS): Small devices (TENS units) administer low-voltage electrical currents at or near the nerves; this blocks or alters pain perception, thereby providing pain relief.
  • Positive airway pressure (PAP): During sleep, air pressure is delivered by a machine through a small piece that is either fit into the nose or placed over the nose and mouth. PAP is helpful in reducing the frequency of apnoea episodes during sleep and mitigating daytime sleepiness; thus, it greatly improves the quality of life of patients. The most common method for administering PAP is continuous positive airway pressure (CPAP). This treatment stabilises breathing during sleep by continuously delivering air at a constant pressure; this pressure is slightly higher than the surrounding air pressure (hence, the term positive pressure) and is sufficient to ensure that the upper airway remains open. Thus, CPAP prevents obstructive sleep apnoea and notably reduces the intensity of snoring.
  • Surgical procedures: For patients with mild obstructive sleep apnoea, uvulopalatopharyngoplasty (UPPP; the removal of tissues from the throat) is recommended; tonsil and adenoid removal may also be advised. These procedures serve to widen the airways. For UPPP, which is usually performed in a hospital, a general anaesthetic is administered to induce a sleep-like state.
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Bruxism (Tooth Grinding or Clenching)

Management Team

Bruxism (Tooth Grinding or Clenching)

Overview

Bruxism refers to the clenching, grinding, or gnashing of teeth. It usually happens subconsciously, either during waking hours or during sleep.

A combination of psychological, physical, and genetic factors has been associated with bruxism.

  • Anger, frustration, stress, anxiety, or tension may cause awake bruxism, which serves as a coping mechanism for activities involving deep concentration.
  • Sleep-related chewing activities associated with arousals may cause sleep bruxism.

The following factors have been shown to increase the risk of bruxism:

  • Stress: Increased levels of anger, frustration, and anxiety can cause the grinding of teeth.
  • Age: While bruxism is common before and during early adolescence, it usually disappears by adulthood.
  • Personality type: People that are competitive, aggressive, or hyperactive may be at an increased risk of developing bruxism.
  • Family history: People with family members who have bruxism or a history of it may develop this condition.
  • Medications and other substances: Some psychiatric medications, such as antidepressants, are associated with uncommon side effects, such as bruxism. Consumption of caffeinated beverages or alcohol, recreational drug use, and smoking tobacco may increase the risk of developing bruxism.
  • Other disorders: Some neurological disorders, such as attention-deficit/hyperactivity disorder, epilepsy, and Parkinson's disease-related dementia, and sleep-related disorders, such as sleep apnoea and night terrors, have been associated with an increased risk of developing bruxism.

The symptoms of bruxism include:

  • Loud teeth grinding or clenching (that may awaken the sleep partner)
  • Enamel erosion, leading to the exposure of the deeper layers of the tooth
  • Fractured, chipped, flattened, or mobile teeth
  • Heightened tooth pain and/or sensitivity
  • Stiffness in the jaw muscles (difficulty in opening or closing the jaw completely)
  • Soreness or pain in the jaw, neck, or face
  • Sleep disruption
  • Dull headache originating in the temples
  • Pain that feels like, but is actually not, an earache

Bruxism is diagnosed based on the presence of the aforementioned signs during routine dental examinations.

Treatment is not necessary in many cases, given that many bruxism disappears among many children without treatment and that in many adults, the teeth grinding or clenching is not severe enough to warrant therapeutic interventions. However, for cases of severe bruxism, dentists prescribe specific dental approaches, therapies/habits, and medications to prevent further tooth damage and provide relief from pain or discomfort:

  • Dental approaches: Dentists often suggest methods to prevent the wear and tear of the teeth or improving dental health; however, these may not be effective in stopping bruxism. These methods include:
    • Application of mouth guards and splints: These devices, often prepared using hard or soft acrylic materials, are fit onto the upper or lower teeth; thus, they help separate the teeth and prevent the damage caused by tooth grinding/clenching.
    • Dental correction: When the bruxism is severe, i.e., wear and tear of the tooth has led to heightened sensitivity or difficulties in chewing/eating, to repair the damage, the chewing surfaces may need to be reshaped, followed by the insertion of dental crowns.
  • Other approaches: Bruxism may also be treated using one or more of the following approaches:
    • Management of anxiety and stress: Adopting strategies that promote relaxation, such as meditation, and/or guidance from a licensed therapist or counsellor, may be effective if the bruxism is a result of psychological stress or anxiety.
    • Behavioural changes: The dentist may recommend appropriate jaw posturing/alignment and mouth and jaw exercises as behavioural changes to suppress teeth grinding/clenching.
    • Biofeedback: If changing behaviours/habits is difficult, biofeedback, i.e., the use of monitoring procedures and equipment to teach patients how they can control muscle activity in the jaw, may be effective.
  • Medications: Generally, treating bruxism using medications has not been shown to be effective; further research is needed to determine the efficacy of medications and develop effective medicines for this condition. The following medications may be used for treating bruxism:
    • Botox injections
    • Muscle relaxants
    • Anti-anxiety or anti-stress medications
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B

Dental Plaque

Management Team

Dental Plaque

Overview

Dental plaque is a sticky colourless film containing bacteria, saliva, and leftover food particles; constant plaque formation on the teeth is normal. However, regular non-removal of plaque can lead to the hardening of the dental plaque, forming tartar, which is the leading cause of gum disease. As tartar cannot be removed by brushing and flossing, tooth cleaning by a dental professional is required.

Initially, tartar appears off-white or yellow; later, it takes on the colour of the food or substances being consumed. Certain activities, including the consumption of tea, coffee, red wine, and chocolates, chewing tobacco, and smoking, cause the tartar to appear darker.

When bacteria in the oral cavity mouth interact with starchy or sugar-rich foods, such as chocolates, bread, pasta, fruits, milk, soft drinks, or juices, they release acids for metabolising the carbohydrates in these foodstuffs. Failing to brush teeth or delays in brushing teeth after the consumption of such foods can cause the combination of bacterial cells and acids and carbohydrates to accumulate; the resulting deposits appear as a sticky, colourless film, which is termed plaque.

The common symptoms of dental plaque formation include:

  • Fuzzy sensations on the teeth
  • Red, swollen gums
  • Bleeding gums, especially after brushing
  • Halitosis (bad breath) that does not go away

Severe dental plaque and tartar formation can lead to:

  • cavity formation
  • tooth infection and loss
  • gingivitis and other types of gum diseases

If the teeth appear or feel fuzzy, it is likely that plaque formation has occurred. For the maintenance of dental hygiene, scheduling an appointment with a dentist, who will examine the gums and teeth and prescribe appropriate treatments (if needed), is recommended.

Regular visits to the dentist for teeth cleaning are also recommended. While some people need to undergo tooth cleaning once every 6 months, in cases where plaque formation is severe, more frequent visits may be required. Dentists often recommend the type of cleaning schedule that best suits the patient’s needs.

Dentists use specialised instruments for the removal of plaque and tartar. The following treatments may also be recommended:

  • Application of dental sealants to prevent further plaque formation.
  • Fluoride-based treatments to inhibit the growth of plaque-causing bacteria and reduce the risk of tooth decay.
  • Application of prescribed toothpaste or antibacterial mouthwash.
  • Treatments to prevent dry mouth and increase saliva production.
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Hypodontia (Missing Teeth)

Management Team

Hypodontia (Missing Teeth)

Overview

Hypodontia is a type of dental agenesis, i.e., congenitally missing teeth. Specifically, hypodontia patients may have one to six missing teeth. About 2–8% of the general population has hypodontia. While hypodontia can occur in part of the oral cavity, the upper lateral incisors and the second and lower second premolars usually represent the most commonly missing teeth in patients with hypodontia.

  • Hypodontia is mostly a birth defect and passes down in the family. In patients with hypodontia, abnormalities in the dental lamina, i.e., the tissue underneath the gums where the teeth are formed, are observed.
  • Hypodontia may occur in association with certain syndromes. e.g., Crouzon syndrome, Williams syndrome, achondroplasia, orofaciodigital syndrome, and Rieger syndrome.
  • Hypodontia has also been observed alongside other conditions, such as low birth weight, genetic disorders (Down’s syndrome or ectodermal dysplasia), infectious diseases (candidiasis or rubella), or cleft palate/lip.
  • Hypodontia can also be caused by chemotherapy and radiation therapy.

  • Being born with one to six missing teeth at birth represents the most common symptom of this condition. Hypodontia can affect either the primary (baby) or permanent (adult) teeth anywhere within the oral cavity. The presence of peg-shaped teeth or teeth that are smaller than average can also been observed; patients may also present with gaps and spaces between the existing teeth.
  • Some hypodontia patients also display other symptoms characteristic of genetic disorders (such as ectodermal dysplasia), such as nail abnormalities, hair thinning, poor vision and hearing, and lack of sweat glands.
  • Difficulties in eating, chewing, and speaking are a common result of missing teeth.
  • Hypodontia may also damage the gums and impair the growth of the jawbone, which, in turn, can cause the jaw to be underdeveloped and appear smaller (than average).

Hypodontia can be diagnosed by the following:

  • Oral examination: Dentists may look for other symptoms of hypodontia (apart from missing teeth), such as the presence of gaps between existing teeth or peg-shaped teeth.
  • Dental X-rays: Dental X-rays may reveal the absence of tooth buds.

If a child’s primary teeth do not erupt by the age of 4 years or the permanent teeth do not appear by the age of 14, scheduling an appointment with a dentist is advised to address concerns about the child’s missing teeth.

Methods for treating hypodontia include: 

  • Application of orthodontic devices, such as braces.
  • Application of partial dentures (removable dental prostheses) for replacing missing teeth in the lower and/or upper jaw.
  • Application of dental bridges for replacing missing teeth by taking support from two adjacent teeth.
  • Application of dental implants (titanium-based screws) for replacing a missing tooth without any support from the adjacent teeth.

Until they are old enough to receive one or more of the aforementioned treatments, typically, children with hypodontia are advised to wear partial dentures.

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H

Heart Failure

Management Team

Heart Failure

  • It is a condition where the heart cannot not pump enough to move the blood forwards or it has trouble receiving blood
  • So, some parts of your body may not get enough blood and oxygen
  • Heart failure is a chronic problem. But it can be managed with medications to help improve symptoms

  • The heart has four chambers: two on its right side and two on its left
  • The right side of the heart receives blood from the whole body. This blood has a low oxygen and high carbon dioxide levels
  • The right side of the heart pumps this blood into the lungs for getting more oxygen and getting rid of excessive carbon dioxide
  • The purified blood comes to the left side of the heart and gets distributed in the whole body
  • This repeated pumping process is responsible for keeping us alive

  • High blood pressure
  • Heart problems
    • Valve defects
    • Rhythm disorder
    • Heart muscle defects
    • Other disorders of the heart
    • Coronary heart diseases
  • Lung problem
    • Poor blood supply to the lungs
    • Lung diseases like asthma, bronchitis, obstructed airways
    • High blood pressure in the lungs
  • Lifestyle
    • Failure to take preventive medication
    • Diet (excessive salt and fluid intake)
    • Alcohol and drug misuse
    • Smoking
  • Other medical conditions
    • Anaemia
    • Kidney diseases
    • Diabetes
    • Obesity
    • Thyroid

  • Breathlessness, tiredness, and swelling in certain parts of your body, like the feet, legs, arms and stomach
  • Other less common symptoms include stomach fullness, nausea, vomiting, dizziness, confusion and blacking-out/fainting
  • These symptoms can occur during activity or rest or even sleep

  • Ejection fraction (EF) is a measure of the blood that the left side of the heart pumps out with each beat
  • A normal EF is between 55% and 70%

  • If left untreated, heart failure gets worse and the symptoms will also get worse, requiring hospital admission for IV medications
  • Eventually, it will make your daily activities (like dressing and bathing) more difficult
  • It may also make you too tired to do things like spending time with friends and family

So, treatment is necessary to help you feel better and help keep your condition from getting worse

  • Complete clinical history and clinical examination
  • ECG, echocardiography and certain blood tests
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H

Loose/Mobile Teeth

Management Team

Loose/Mobile Teeth

Overview

A tooth that sits loosely within its socket and wiggles is called a mobile tooth. As a child, having loose teeth is a part of development of dentition. However, the occurrence of mobile teeth in adults is never typical, and almost always, indicative of an underlying condition (disease or trauma).

In children, once the permanent (adult) teeth begin to break through the gums, the primary (baby/milk) teeth loosen and eventually, fall out. The factors causing loose teeth in adults include:

  • Periodontal (gum) disease. Periodontitis causes the degradation of the supporting ligaments, tissues, and bones that surround the teeth; globally, among adults, periodontitis is the most prominent cause of loose teeth (and tooth loss).
  • Dental trauma: Dental injuries, such as those caused by sport-related or vehicular accidents, may result in one or more teeth becoming mobile.
  • Teeth grinding (bruxism): Over time, constant tooth clenching or grinding can cause tooth mobility.
  • Pregnancy: Pregnancy-induced surges in the progesterone and oestrogen levels may cause the tissues that hold the teeth in place to loosen (albeit temporarily), a condition termed as pregnancy gingivitis. Usually, in women with this condition, the symptoms disappear after childbirth.

Apart from feeling strange, especially during common oral activities, such as chewing, eating, brushing, or flossing, wobbly teeth may be associated with the following symptoms:

  • Red, tender, bleeding, and/or swollen gums
  • Receding gums, i.e., when the gums wear or pull away, exposing the roots.
  • Tooth discoloration

Eventually, loose tooth may cause:

  • Difficulties with biting and chewing.
  • Excess contact and pressure on the neighbouring teeth.

A loose or mobile tooth can be easily identified as it can be felt with the tongue or finger. Moreover, how the upper teeth sit on the lower teeth may seem different than usual.

During a dental examination, the cause of loose teeth can be ascertained and accordingly, appropriate treatment plans may be recommended.

In general, regular dental examination and cleaning procedures are recommended (often, once every 6 months). However, if patients are prone to developing cavities or gum disease, more frequent visits to the dentist are recommended.

If patients develop loose teeth between visits, they are advised to schedule additional appointments with the dentist, who can begin treatment immediately to reduce the risk of further complications.

The severity and cause of mobile teeth determine the treatment method recommended by the dentist.

  • Treatment for trauma-induced formation of loose teeth:
    • Bite adjustment: A minute amount of enamel is scraped off from the loose and opposing tooth to alleviate the excess pressure from the bite; this helps promote the healing of the wobbly tooth.
    • Mouth guard: In patients with bruxism, this oral appliance shields the teeth from excessive damage and/or pressure.
    • Splinting: In cases where the loose tooth has not yet been pulled away from the gums, two neighbouring teeth are bonded together, so that the loose tooth has additional support and its movement is prevented during healing.
  • Gum disease-induced tooth mobility: The following surgical treatments are recommended:
    • Tooth scaling and root planing
    • Osseous surgery (flap or pocket reduction surgery): A procedure involving the thorough cleaning of the roots of the teeth to clear the bacterial infection, removal of infected tissues, and if necessary, reshaping the bones surrounding the teeth.
    • Application of dental bone and/or gum grafts

Sometimes, when a loose tooth is beyond saving, the dentist is likely to recommend tooth removal, followed by the application of a dental bridge or implant as a replacement for the extracted tooth.

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