Tooth Mobility

Tooth Mobility

Write short note on tooth mobility.
Answer. All the teeth consist of slight degree of physiologic mobility which vary for different teeth and during different times of the day.

• Tooth mobility is highest in the morning and progressively decreases. Increase in tooth mobility in morning is attributed to slight extrusion of tooth due to limited occlusal contact during sleep. While later on this reduces by chewing and swallowing forces, which intrude tooth in the socket.
• The above variation is less marked in people with healthy periodontium as compared to bruxers and clenchers.
• Single rooted tooth shows less mobility as compared to multirooted teeth.
• Mobility in tooth is in the horizontal direction although some axial mobility also occur.

Periodontal Splinting Material

Etiology of Tooth Mobility

Following are the causes of tooth mobility:

• Loss of tooth support (Bone loss): Amount of mobility depends on the severity and distribution of bone loss at individual root surfaces, the length and shape of the roots, and the root size compared with that of the crown. Tooth with short, tapered roots is more likely to loosen than one with bulbous roots with the same amount of bone loss.
• Trauma from occlusion: It is produced by excessive occlusal forces or incurred because of abnormal occlusal habits, i.e. bruxism and clenching, is common cause of tooth mobility. Mobility is also increased due to hypofunction. Mobility caused by trauma from occlusion occurs initially as a result of resorption of the cortical layer of bone, leading to reduced fiber support, and later as an adaptation phenomenon resulting in a widened periodontal space.
• Due to extension of inflammation: As inflammation extends from gingiva or from periapex in periodontal ligament produces changes which causes tooth mobility.
• Periodontal surgery: It increases tooth mobility for short period.
• In pregnancy: Tooth mobility is increased in pregnancy and is associated with the menstrual cycle or the use of contraceptives. Mobility occurs in patients with or without periodontal disease, because of physicochemical changes in periodontal tissues.
• Pathologic processes of jaws: Pathological processes of the jaws that destroy the alveolar bone or the roots of the teeth can also result in mobility. Such processes include osteomyelitis and tumors of the jaws.

Stages of Tooth Mobility

• In initial stages, the tooth moves within the confines of the periodontal ligament. This is associated with viscoelastic distortion of periodontal ligament and redistribution of periodontal fluids, interbundle content in fibers.
• Secondary stages occur gradually and entail elastic deformation of alveolar bone in response to increased horizontal forces.

Checking of Tooth Mobility

As a general rule, mobility is graded clinically by simple method, i.e. tooth is held firmly between the handles of two metallic instruments or by one metallic instrument and one finger, and an effort is made to move the tooth in all directions. Abnormal mobility occur faciolingually.

Grading of Tooth Mobility

Tooth mobility is graded according to ease and extent of tooth movement

• Normal mobility
• Grade 1: Slightly more than normal
• Grade 2: Moderately more than normal
• Grade 3: Severe mobility faciolingually and mesiodistally, combined with vertical displacement