Getting braces for the first time will trigger all kinds of sensations. You’ll probably feel pain at first, and a tightening sensation. You won’t be able to chew and eat like you used to, and overall, you’ll just have a hard time. For that, you have my sympathy.
But once that ordeal is finally over, your teeth may feel weird and loose, and some may even visibly wiggle a little bit. So is this loosening of the teeth a real thing? Is it dangerous?
A sensation of loose teeth during orthodontic treatment is normal and is a result of periodontal ligaments stretching and bone remodeling. Tooth movement wouldn’t be possible without bone resorption, or “dissolving”, and some degree of tooth mobility is expected while wearing braces.
In short, your teeth really are loose, and that’s a good thing for your treatment, but there are always some exceptions that need to be carefully monitored. Read on if you want to learn more.
How teeth move – the basics
I’m sure you’ve seen incredible transformations and you’re probably wondering how teeth can travel such extreme distances. Here’s a simplified biology lesson to help you understand how teeth move with braces.
Bone is dense and hard – there’s absolutely no way anything can pass through it under normal conditions. But bone is very much alive, and populated by cells that can make it grow or dissolve. Think of a broken arm healing in a few weeks – it’s all thanks to these wonderful bone-creating cells called osteoblasts.
Teeth aren’t fused to the bone. They sit in little pockets of tissue called the periodontium – basically a bunch of fibers that are stretched in various directions, attached to both the bone and the tooth. This periodontium tissue is very active – it holds onto the tooth, protects it from bacteria, tells you when you’re chewing too hard, and yes, even communicates with your bone through processes much too complicated to explain here.
During orthodontic treatment, teeth are under pressure when they’re pulled to new locations. At the root level, one side of the tooth will press the bone. On that side, the periodontal ligaments will compress and activate the osteoclast cells which will “melt” the bone away. Bone resorption is an inflammatory process, but in this case, the forces are very gentle, so it’s a necessary type of inflammation that’s favorable to tooth movement.
On the opposite side of the tooth, the one away from the force, the periodontium will experience pulling. Its fibers will elongate, and, as a result, they’ll trigger osteoblast activity, which will create new bone in a matter of weeks. It’s the tooth’s way of saying – hey, I’m getting out of here, better fill that hole!
That, in a nutshell, is how teeth advance through bone.
The force applied to teeth in order to cause movement needs to be very gentle and precise – too low and the teeth won’t budge, too intense and the teeth won’t move in the desired direction, but the trauma may make them worryingly mobile.
During your appointment, your orthodontist will evaluate your tooth mobility and place it on a scale. Moderate to severe mobility (1mm to 3mm of horizontal displacement, and the presence of vertical displacement) is a cause for concern. Your orthodontist will evaluate your periodontium and refer you to a periodontal specialist if needed.
Braces are making your teeth loose. Can they fall out?
You now have a better idea of how teeth move through bone, and why mobility is a normal symptom. You may not feel your teeth loosen at all, in which case you needn’t worry – everyone is different.
For many patients, loose teeth during orthodontic treatment is a scary thing to experience. And your secret fear may be that they’ll all fall out. We’ve all had that nightmare – or is it just me?
But is that even possible? Can braces cause teeth to fall out? Let me tell you that in all my experience, and in most literature, I haven’t encountered teeth falling out because of braces. The only thing that drives teeth out of the bone is blunt force trauma to the jaws.
Can you weaken a tooth and compromise its position inside the bone with the use of braces? Absolutely, that can happen. But even in that situation, with good periodontal care and maybe some bone addition surgery, we can prolong the tooth’s life.
Here are the most high-risk situations that can cause teeth to become dangerously loose during orthodontic treatment. Check with your orthodontist if you’re in any of the categories below:
- Severe periodontitis – many orthodontists are on the fence about treating patients with severe periodontitis because of the limited bone support and risk for inflammation – some teeth may become increasingly mobile and need to be pulled out. But under the careful supervision of a periodontal specialist and with the application of gentle forces, it can be done.
- Root resorption – some people are born with very short roots because of genetics, or as part of a syndrome, while others might have short roots on certain teeth as a result of infection or trauma. Even teeth with incredibly short roots can last inside the bone for a long time, but braces can endanger their stability and cause them to become mobile.
- Pregnancy – pregnancy hormones often cause the gums to swell, and teeth to loosen. The baby may deplete the mother’s stores of calcium, leading to weaker, softer bone. I’ve seen teeth loosen severely during pregnancy, only to recover to healthy limits after birth.
- Trauma – teeth that have been subjected to new trauma should be spared during orthodontic treatment, or else the force exerted by braces could cause them to become even looser. However, old trauma can behave in the opposite way – teeth will possibly not move at all because they’re fused to the bone.
- Infection – signs of infection include pain, swelling, redness, and even a pulsating feeling. An infection will dissolve the bone in that area, and braces may accelerate this, causing damage and loose teeth. To prevent this, your orthodontist will check you for cavities and periodontal problems, and you will need to maintain excellent hygiene.
One tooth is much looser than the others. Is that a problem?
If you’re worried about one particular tooth feeling looser, it’s not always a problem. Most likely, that tooth is under a lot more force than the others. It may fall under the following situations:
- The tooth is very crooked and it needs to be rotated and pulled in.
- The tooth is higher than the others, and you feel it hitting on the other teeth first.
- The tooth has bite blocks and is under constant pressure from chewing.
Once the tooth in question gets in line with the others, it should stop feeling so loose.
In rare instances, a tooth may not have enough bone around it, and displacing it will cause moderate to severe mobility. Your orthodontist will need to order a CT scan to evaluate the bone and take necessary measures.
Braces on adults can sometimes lead to complicated issues like tooth mobility because of periodontal disease and old extraction sites with limited bone.
The bottom line is – if one specific tooth is worryingly loose, call your orthodontist and set up an appointment sooner rather than later.
How long will your teeth feel loose after getting braces removed?
The reaction I get when removing braces from my patients’ teeth is mixed. Some sigh in relief, and experience freedom they haven’t tasted in years. Others are anxious that their teeth feel too loose, with nothing to support them.
Everyone is different because everyone’s bone is different. Some patients don’t have loose teeth at all, while others may have loose teeth their entire lives, and braces just add to that feeling. But, in general, that loose feeling should subside within a month or two after removing their braces.
Once braces are off, you’ll receive a retainer that you’ll need to wear diligently. If you only wear it every couple of days, the constant push and pull will cause your teeth to become loose, just like they would during active orthodontic treatment.
Supplements you can take for tooth mobility
So, aside from good hygiene and regular dental checkups, is there anything you can do to actively strengthen your bone, and consequently, your teeth?
Studies suggest that taking Calcium in conjunction with vitamin D may increase tooth retention in elderly populations. As they get treated for osteoporosis, their teeth benefit as well.
In my practice, I’ve also come across younger patients whose teeth reduced in mobility after supplementing with Calcium, but there aren’t enough studies to confirm this.
As for vitamin D, many of us are deficient to some extent, but while supplementing can help with faster tooth movement, it won’t necessarily address tooth mobility.
Ask your medical practitioner about supplementation and your overall bone health – it certainly won’t hurt, but it may not be a miraculous cure either.
Most of the time, if you’re wearing braces and your teeth feel loose, it’s normal and the sensation will pass. In fact, you can expect a whole cycle of tightening, loosening, and feeling neutral, as your orthodontist activates your wires at every appointment.
If you’re in that special high-risk category, you can rest assured that even mobile teeth can stay on your dental arch for a long time. Always express your concerns to your orthodontist and he or she will take a look, but most likely, they’ll already know what’s going on.
And if you’re the lucky owner of newly straight teeth and your braces have come off, loose teeth are temporary and they’ll soon become a thing of the past.