Tooth mobility

Tooth mobility

1: Total loss of attachment (clinical attachment loss, CAL) is the sum of 2: Gingival recession, and 3: Probing depth (using a periodontal probe)
Classification and external resources
MeSH D014086

Tooth mobility is the medical term for loose teeth.

Classification

Mobility is graded clinically by applying pressure with the ends of 2 metal instruments (e.g. dental mirrors) and trying to rock a tooth gently in a bucco-lingual direction (towards the tongue and outwards again). Using the fingers is not reliable as they are too compressible and will not detect small increases in movement.[1]:184 The location of the fulcrum may be of interest in dental trauma. Teeth which are mobile about a fulcrum half way along their root likely have a fractured root.[1]:184

Normal, physiologic tooth mobility of about 0.25 mm is present in health. This is because the tooth is not fused to the bones of the jaws, but is connected to the sockets by the periodontal ligament. This slight mobility is to accommodate forces on the teeth during chewing without damaging them.[2]:55 Milk (deciduous) teeth also become looser naturally just before their exfoliation.[1]:197 This is caused by gradual resorption of their roots, stimulated by the developing permanent tooth underneath.

Abnormal, pathologic tooth mobility occurs when the attachment of the peridontal ligament to the tooth is reduced (attachment loss, see diagram), or if the periodontal ligament is inflamed.[1]:220 Generally, the degree of mobility is inversely related to the amount of bone and periodontal ligament support left.

Classification by S.D Miller

Causes

Loss of attachment:

Increased forces on the tooth:

References

  1. 1.0 1.1 1.2 1.3 1.4 Odell EW (Editor) (2010). Clinical problem solving in dentistry (3rd ed.). Edinburgh: Churchill Livingstone. ISBN 9780443067846.
  2. 2.0 2.1 2.2 Heasman P (editor) (2008). Master Dentistry Vol I: Restorative dentistry, paediatric dentistry and orthodontics (2nd ed.). Edinburgh: Churchill Livingstone. ISBN 9780443068959.