Tooth mobility refers to loose teeth that can move within their sockets. It is classified on a scale of 0 to 3 based on the degree of horizontal and vertical movement. Physiologic mobility of about 0.25mm is normal, while pathologic mobility over 1mm indicates loose teeth from periodontal disease or trauma. Periodontal disease is a primary cause as it leads to loss of attachment and bone supporting the teeth. Treatment involves splinting loose teeth together, replacing missing teeth, and correcting occlusal surfaces to reduce excessive forces. For advanced periodontal cases, extraction may be necessary.
2. Contents
1. What is tooth mobility?
2. Symptons of Tooth mobility.
3. Types of tooth mobility.
4. Stages of tooth mobility.
5. Evaluation of T.M.
6. Classification of tooth
mobility.
7. Causes of tooth mobility.
8. Treatment of tooth mobility.
9. Summary.
3. WHAT IS DENTAL MOBILITY?
Dental or tooth mobility is the medical term for loose teeth.
It can be defined as “the degree of looseness of a tooth”
In simple words it refers to the movement of loose teeth within their
sockets vertically and horizontally
. Primarily caused by gum diseases and trauma.
Loosing decidious teeth as a child is one of the most common types
of tooth mobility.
5. “DENTAL MOBILITY SHOWS THE TOTAL LOSS
OF TOOTH ATTACHMENT:
(1)”Total loss of attachment” is the sum of:
(2)“gingival recession”
(3)“probing depth”
• Total loss of attachment is also called Clinical
Attachment Loss (CAL)
• Probing is done by “periodontal probe”.
6. SYMPTOMS OF PATIENTS WITH MOBILE
TEETH:
Patients with Loose Teeth complain of-
1. Discomfort while chewing food.
2. Pain may accompany the mobility of teeth.
3. The tissues around a mobile tooth are invariably red,
swollen and damaged.
8. PHYSIOLOGICAL TOOTH MOBILITY:
• Physiologic mobility refers to the slight degree of movement that all
teeth, even perfectly healthy ones, have when some force is applied.
• It refers to moderate force exerted on the crown of the tooth surrounded
by a healthy and intact periodontium and tooth will show tipping
movement until a closer contact has been established between root and
marginal bony tissues.
• The amount of physiologic mobility varies from person to person, from
tooth to tooth, and even varies by the time of day that the mobility is
measured.
• It is greatest during morning and minimal during sleep.
10. PATHOLOGIC TOOTH MOBILITY:
• Pathologic mobility refers to tooth movement caused by the
progression of gum disease or trauma.
• It refers to any degree of perceptible movement in facio-
lingual, mesio-distal or axial when the force is applied to
tooth.
11. STAGES OF TOOTH MOBILITY:
1. INITIAL STAGE (Intra-socket stage):
Tooth moves within confines of periodontal ligament associated with visco-
elastic distortion of ligament and redistribution of periodontal fluids, inter-
bundle contents and fibers.
2. SECONDARY STAGE:
Occurs gradually and entails deformation of alveolar bone in response to
increased horizontal forces.
12. HOW IS T.M EVALUATED?
• Dentists evaluate tooth mobility during routine examinations.
• Movement is usually measured by applying direct pressure to
individual teeth with a finger or dental instrument.
• In order to accurately evaluate mobility, two non-working ends of
the dental instruments (i.e., the mirror handle and the probe
handle) are pressed on the buccal and lingual surfaces of the tooth.
• Another method involves placing a finger on the front surface of
the tooth and feeling for movement while the patient grinds their
teeth or chews.
14. CLASSIFICATION OF TOOTH MOBILITY:
• Tooth mobility is classified by assigning a score between zero and
three to represent the amount of movement a tooth is capable of.
• A normal tooth that is not loose scores a zero, and a severely loose
tooth that moves both horizontally and vertically scores a three.
• Normal, physiologic tooth mobility of about 0.25 mm is present in
health.
• Milk (deciduous) teeth also become looser naturally just before their
exfoliation. This is caused by gradual resorption of their roots,
stimulated by the developing permanent tooth underneath.
15. MILLER’S CLASSIFICATION OF TOOTH MOBILITY:
Preston D. Miller described the most common clinical method in which
tooth is held between two handles of 2 instruments and moved in bucco-
lingual direction with finger and instrument.
SCORING CRITERIA OF T.M
CLASS 1:(score 1)
<1mm(HORIZONTAL)
Distinguisable T.M
CLASS 2:(score 2)
>1mm(HORIZONTAL)
Crown of the tooth
moves more then 1mm
in any direction.
CLASS 3:(score 3)
>1mm(HORIZONTAL
& VERTICAL
MOBILITY)
SCORE 0 HAS NO DETECTABLE MOBILITY.
16. CAUSES OF TOOTH MOBILITY:
1. Loss of attachment:
• Periodontal disease(.i.e.periodontitis)
• Dental abscesses
• Resorption of roots and receding alveolar bone.
2. Pathological conditions (i.e Langerhans cell histiocytosis)
• Pragnancy hormones
• Osteoporosis( decrease in density of bones)
3. Increased forces on tooth:
• Bruxism(clenching of teeth)
• Dental trauma( hiting on tooth forcefully)
• Malocclusion(bite interruption)
• Failure of orthodontic treatment.
19. TREATMENT OF TOOTH MOBILITY:
• Proper Correction of occlusal surfaces of tooth to normalize the relationship
between antagonizing teeth in occlusion, thereby eliminating excessive forces.
• Excessive tooth mobility can be eliminated by splinting process by joining
mobile teeth by other teeth in the jaw into fixed unit
• Replacing of missing teeth
20. CONTINUED:
• Incase of extremely advanced periodontal disease, a “cross-arch splint”
maybe regarded as an acceptable result of rehabilitation and preventation
of tipping or orthodontic displacement of tooth splint.
• If parafunctional clenching or grinding habits are evident, then a
removable occlusal splint or nightguard may further protect the teeth
from the consequences of too much biting force.
• In very severe cases extraction is recommended.
21. SPLINTING OF TEETH NIGHT GUARDS
CORRECTION OF
OCCLUSAL SURFACES
CROSS-ARCH SPLINTING REPLACEMENT OF
MISSING TEETH
22. What is splint?
Splint is an appliance designed to stabilize mobile teeth.
Fabricated in form of joined composite fillings, fixed bridges, RPD’S
(Removable Partial Dentures) etc
23.
24.
25. GLOSSARY:
1.visco-elastic: The property of materials that exhibit both viscous and elastic
characteristics when undergoing deformation.
2.Abscess: A swollen area within body tissue, containing an accumulation of pus.
3.Langerhan’s cell histiocytosis: A disorder in which excess immune system cells
called Langerhans cells build up in the body.
4.Rehabilitation: The act of restoring something to its original state.
5.Tipping: An orthodontic procedure which forcibly pivots a tooth so that its crown is
moved labially or lingually.
6.Para-functional: Movements of the mandible that are outside normal function (e.g.,
bruxism).
7. Fabricated: construct or manufacture
8. <: less then
9. >: greater then
