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Root Canal Doctor
Root Canal Doctor, Dentist (DDS or equivalent)
Category: Dental
Satisfied Customers: 1752
Experience:  Endodontist (DDS,MS)-50 years of practice, Endodontics Assoc. Professor at Loyola University School of Dentistry, Air Force Veteran
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My problem is that i have two loose upper front teeth but

Customer Question

Hi. My problem is that i have two loose upper front teeth but they are not wiggling. I had a previous case of gum disease but am taking the necessary precautions brushing twice a day and flossing. Also, due to bad bites my dentist has refered me to an orthodentist. Will putting brackets on the 2 loose teeth result in making them even looser where ill have to extract them?
Submitted: 2 months ago.
Category: Dental
Expert:  Root Canal Doctor replied 2 months ago.

Hi, the amount of bone loss around these teeth will determine if a passive bracket will be used which is most likely the case. This means that a bracket can be used but there will be no force applied to these two teeth so they will not be affected by any orthodontics. Another option is to use brackets as a splint which actually helps hold the two teeth in position and strengthens their position as well which will prevent any movement from destroying more bone.

The orthodontist will be using Xrays and will determine the extent of the bone loss and will try to mitigate any possible injury to these two teeth. If you have Xrays that I could see I would be better able to give you a more directed opinion.

Does all this make sense to you?

Customer: replied 2 months ago.
Basically the 2 upper right front teeth are loose. And as i have misaligned teeth, both of them will need to be corrected. Please consider my pics for reference. I have no xrays with me
Expert:  Root Canal Doctor replied 2 months ago.

Thanks for the photo. When teeth are moved there is bone loss in one direction (direction moved) and bone growth behind which stabilizes the tooth in its new position. Since your teeth are loose it will be very easy to move the teeth to the desired position and then when stabilized and no more movement is involved the teeth will then have bone growth around them to keep them in their new position. However, if the current bone loss is extensive and there is not enough bone height now to support any movement or repositioning of the teeth then they will not be able to sustain their new position without some sort of splinting to keep them in the new position and avoid any further movement.

The orthodontist will be able to tell you if moving these two teeth is possible or if moving them will speed their loss but stabilizing them with brackets will not cause them to be lost. The brackets are used as a splinting technique and when completed the splinting will be on the inside of the teeth so that they will not be seen and will be permanent as well.

Does this help answer your question?

If you need more information please do not hesitate to ask. Thanks.

Expert:  Root Canal Doctor replied 2 months ago.

Hi, do you need more help with this?

Customer: replied 2 months ago.
The two teeth only make clicking sound frequently mainly after eating and brushing but when i try to look at them in the mirror there is no movement. The dentist told me that the clicking sound is mainly due to the fact that my teeth are crooked but he did no perform any x ray on those teeth. The fact that the teeth are not wiggling means there is still extensive bone loss? And the splinting does it save the teeth for life or only a brief period?
Expert:  Root Canal Doctor replied 2 months ago.

When teeth are clicking it means that the bite is off and the misalignment of the teeth is the cause.

When teeth do not "wiggle" it usually does mean that there is still adequate bone support and that orthodontics can be of help.

However, X-rays must be taken in order to prepare a treatment plan for the orthodontics. Without X-rays the whole process is a guess and should NOT be done. So please do be sure that X-rays are taken before any work is contemplated.

The chances of extensive bone loss with teeth that are firm and not wiggling is rare which is why X-rays are needed to confirm the current bone levels.

Splinting can actually keep wiggling and loose teeth in for a lifetime unless disease sets in from other causes. Periodontists use splinting all the time to help retain teeth!!!

Expert:  Root Canal Doctor replied 2 months ago.

Just to let you know about splinting: My daughter is now 50 years old and has had permanent upper and lower front teeth splints since she was 17! This ensures no movement and keeps the teeth in the correct position.

So, YES it does work!!

Customer: replied 2 months ago.
The orthodontist has already taken an xray but has made no comments about the bone support nor for my front teeth. Instead he has directly prescribed the other teeth that have to be extracted. Shall i assume everything is okay and proceed to putting braces?
Customer: replied 2 months ago.
do general dentist provide splinting services?
Customer: replied 2 months ago.
Cause there is no periodontist in my country
Expert:  Root Canal Doctor replied 2 months ago.

Great to hear that the orthodontist has looked at X-rays!!!!! Good news!

I would now assume that everything is ok to go forward with the ortho treatment. YES!

The orthodontist will place the splints for you after all the work is completed and not your general dentist even though he is capable of doing it as well. Better to have the splints done by the Orthodontist!!

I only mentioned Periodontists because they deal with very loose teeth all the time and use splinting to maintain the teeth to prevent their removal.

Expert:  Root Canal Doctor replied 2 months ago.

Are you still there?

Customer: replied 2 months ago.
Thanks for your reply. I hope that the orthodontist will proceed exactly as you have explained. If he exerts the same amount of pressure on all teeth during the orthodontic treatment, will the two other ones become loser than the remaining teeth?
Expert:  Root Canal Doctor replied 2 months ago.

You are very welcome.

When teeth are being moved they become loose while being moved and then tighten and become rigid and fixed into the new position as new bone grows and supports them. Ultimately all the teeth will be the same when biting and chewing once the new bone has stabilized them.

Expert:  Root Canal Doctor replied 2 months ago.

Hello??? Do you have more questions or are we ok??

Expert:  Root Canal Doctor replied 2 months ago.

If we are ok then please rate our interaction.

And if you need more help just just let me know.

Thanks and have a great day (evening)!! :):)

Expert:  Root Canal Doctor replied 2 months ago.

Are you still there?

Customer: replied 2 months ago.
I will send you my xray by tomorrow. Would you be able to give an opinion about the amount of bone loss?
Expert:  Root Canal Doctor replied 2 months ago.

Absolutely!! Will keep an eye out for your X-ray! :)

Customer: replied 2 months ago.
Today am feeling a sudden pressure on my 2 right upper front teeth while biting, as if it will fall out if i bite something hard and i'm feeling one of them have pulled down slightly, hindering the ability for me to talk.
Expert:  Root Canal Doctor replied 2 months ago.

You most likely just clenched your teeth and caused more pressure than usual which could explain your current feeling.

Wait until I see your X-rays and then I can give you more help.

I will be away from my computer for a few hours and if you have more questions I will answer when I return!! :):)

Customer: replied 2 months ago.
Hi there.
I have got the xray.
Could you please give an opinion about the bone structure.
Expert:  Root Canal Doctor replied 2 months ago.

Hi, thanks for the X-rays. They are dark and a little blurred but I can see that you only have moderate bone loss on the anterior teeth which means you will be just fine after the orthodontics! You have plenty of bone left to work with! The teeth can be easily stabilized and with proper home care you can avoid further loss of bone. I suggest you get a water pik device and use it every evening as the last thing you do before going to sleep. It will flush out any remaining debris that if not removed can ferment over night and cause both bone loss and tooth decay. :):)

Customer: replied 2 months ago.
Thanks and will the bone level change after i have done orthodontic treatment?
Expert:  Root Canal Doctor replied 2 months ago.

You're welcome!

The bone level should remain at the same level it is now providing you employ good home care as I suggested earlier. If you do that you should be just fine and have no more worries about loose teeth or bone loss!

Customer: replied 2 months ago.
will high intake of calcium increase the bone level in my jaw?
Expert:  Root Canal Doctor replied 2 months ago.
Sorry, no, nothing you can take or do will increase the bone level. Once it is lost it is lost forever. The bone that is in the rest of your body is very different then the jaw bone that holds the teeth in place. This is why home care is so important fir everyone!
Expert:  Root Canal Doctor replied 2 months ago.

Hi, have I answered all of your concerns?

Expert:  Root Canal Doctor replied 2 months ago.

Are you still there??

Customer: replied 2 months ago.
There is no natural treatment for increasing bone level in the jaw? The fact that you said the bone level is good, so what is the specific reason for the loose teeth?
Expert:  Root Canal Doctor replied 2 months ago.

Malocclusion. If the teeth are not in proper position they get improper forces applied which makes them loose.

Your bone loss is moderate but if the gums are inflamed, and I am sure yours are, because of the misalignment that is why why they feel loose to you. There is still time for you to correct the alignment and initiate correct oral hygiene to prevent both bone loss and gum inflammation.

Customer: replied 2 months ago.
the loose teeth will become stabilise and firm again after correcting the misalignment?
Customer: replied 2 months ago.
How to correct the inflamed gums?
Expert:  Root Canal Doctor replied 2 months ago.

Orthodontics helps reduce periodontal issues because of the proper alignment and the proper alignment reduces the impaction of food and debris. Much easier to maintain good oral health when teeth are spaced properly and touch adjacent teeth in the correct spot. This is why many adults have ortho work in order to improve their over all oral health.

What you need to do besides brushing and flossing is get a water pik device which you should use very evening as the last thing you put in your mouth before sleeping. This water lavage will flush out any remaining foods and debris that are still in your mouth and will prevent them from fermenting overnight and causing both decay and gum related issues.

You should also have regular hygiene appointments with a hygienist as well.

If you do all of this you will be good going forward!!

Customer: replied 2 months ago.
Will there be the need to do splinting on both teeth given i have moderate bone loss?
Expert:  Root Canal Doctor replied 2 months ago.

Once the ortho is completed many patients have their upper and lower front teeth splinted to prevent further movement from occurring as you age. It just helps keep them in the correct position because teeth are always in a dynamic movement toward the center line. If you do not splint you take the chance of there being a misalignment occurring as you age. This you can discuss with your ortho when you have finished the treatment. This is usually done with or without moderate bone loss.

Customer: replied 2 months ago.
Do my gums look inflamed?
Expert:  Root Canal Doctor replied 2 months ago.

The photo looks pretty normal. one way to tell is if there is any bleeding when the gums between the teeth are probed and if they bleed then there is inflammation. A pink color is desirable and any reddening indicates inflammation. If your teeth bleed when brushing then they are inflamed. If not, then you are good. When (gum) pocket depth is checked by a dentist and it exceeds 3mm then there is bone loss and it needs to be addressed or the bone loss will continue. 4-6mm pocket depth is moderate bone loss and it appears that the front teeth are in that range based on your Xrays. But actual probing needs to be done to tell for sure. But you can have bone loss with healthy looking gums which is why daily home care is so important and regular cleaning visits at a dentist's office are also advisable. Bone loss occurs innocuously meaning without symptoms!!

Customer: replied 2 months ago.
how many years does it take for the bone loss to progress?
Expert:  Root Canal Doctor replied 2 months ago.

There is no set amount of time because it varies from person to person but the process is slow and can take from several months to years depending on genetics, health, immune system, oral hygiene, etc. Many different factors account for bone loss but it is mitigated with good oral hygiene and teeth in the proper position in the arches!!

Customer: replied 2 months ago.
Am experiencing another problem. An havig throbbing pain behind my last molars mainly while touching, eating and drinking and the pain is on all 4 sides. On the 3 sides my wisdom teeth has not erupted. Thought maybe this could be the reason. But am experiencing pain mainly behind the wisdom tooth on the gums more specifically. I have already done filling there. What could be the underlying cause?
Expert:  Root Canal Doctor replied 2 months ago.

Sorry to hear you are having new problem. There are 2 probable reasons for this new issue.

However, you really need to initiate a new question for a new problem. To do this you will need to close and rate the current question and then if you want me to help you with the new question just request me with the new question and I will be very happy to help you. Thanks!! :)

Expert:  Root Canal Doctor replied 2 months ago.

The website has timed out your question so please rate the conversation or was that not your intention??

Thanks.