What to do tonight

If the tooth is loose from a blow or fall, the first hours matter. Our knocked-out tooth page covers what to do right now.

• Do not wiggle it to test it. Every movement loosens it further
• Chew on the other side and avoid anything hard or sticky
• Keep brushing gently around it; plaque makes gum disease worse
• If it was knocked loose by an injury, call today, not this week

What I check first

Together these usually tell me whether the looseness is gum disease, bite force, a crack, or injury.

• X-rays, to see how much bone is around the root and whether there is infection at the tip
• Gum measurements, since deep pockets around one tooth point to gum disease as the cause
• Your bite, to see if that tooth is hitting first or taking more force than its neighbors
• Cracks, with a bite test, since a split root can make a tooth feel loose
• Wear patterns that suggest grinding

The honest range of outcomes

Gum disease with moderate bone loss: a deep cleaning, sometimes splinting the tooth to its neighbors while the gums heal, then periodontal maintenance. Many of these teeth tighten up and stay for years. For advanced cases, our periodontist Dr. Shah treats patients here at mend.

Grinding or a high bite: a bite adjustment and a custom night guard. Once the overload stops, the tooth often firms up.

Injury: repositioning and splinting, with follow-up to watch the nerve.

A split root or very little bone left: the tooth usually cannot be saved. We talk honestly about removal and replacement, with an implant, a bridge, or nothing, and what each means.

When to call today versus this week

Call today if the looseness came from an injury, if there is swelling or pus, or if the tooth has moved position. Call for a visit this week if it has been gradually loosening with no pain. Either way, do not wait a month. Bone that supports a tooth does not grow back, so the earlier we stop the loss, the more there is to work with.