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Dentistry/teeth shifting



At a recent checkup my regular dentist commented that my teeth are looser than is considered normal, but he couldn't see any obvious cause (I have very good dental health, am 34 yrs old, and do not grind my teeth).  I mentioned that I've worn retainers at night for 20 years following extensive orthodontic work as a child, and that my teeth move quite a bit each day until I put the retainers back in at night (at which point they move back).  My dentist recommended I see an orthodontist about this.

I've met with two orthodontists (wanted two opinions).  The first didn't comment on the teeth movement, just said my bite looked great and she could make me new retainers if I wanted them.  The second orthodontist recommended I stop wearing my retainers for a few weeks to let the teeth shift to where they wanted to settle, then have new retainers made.  He didn't much discuss the original concern of my teeth being kinda loose.  Another dentist that didn't see me in person suggested possibly having a fixed/cemented wire retainer installed.

So three orthodontists with three different suggestions.  I'm hesitant to go retainer-less for weeks because when I've tried this in the past for just 2-3 days my teeth seem to move a lot and end up in positions that aren't comfortable for my bite.  I also really dislike the idea of a cemented wire forever in my mouth.  And I'm not sure that simply getting new retainers will do any good.

So my questions are...
- Are loose teeth a serious problem that I should be concerned about?  If so, why?  (The "why" is a question that nobody has been able to answer for me so far).
- Is it likely or unlikely that my loose teeth are caused by wearing retainers that move my teeth around each night?
- In your opinion (I know this is a tough one without seeing my teeth) how should I best proceed?

Thanks for taking the time to read this long question, and for your advice!

Your two chief complaints, loose teeth and shifting teeth, may be related or may be two separate problems.  This can be a rather complicated issue and you may be more confused after I share my opinions with you.
Let's take the two issues separately.

(1)Loose teeth can be due to misalignment of the teeth.  When the retainers are not in place the teeth attempt to move into different positions and then when the retainers are in place they get moved back into positions dictated by the retainers.  This repeated "round tripping" of the teeth can result in loose teeth and is something to be avoided since it can result in loose teeth and tooth shifting.  I have no opinion as to whether or not this is taking place in your mouth, and it appears that not all the clinicians you've consulted and have examined you have that opinion.

(2)Another cause of generalized loose teeth is periodontal disease resulting in generalized loss of bone support around the teeth.  With diminished bone support the teeth can become loose and this can result in shifting of teeth.  This problem can be readily evaluated with xrays and an examination.  I have no opinion as to whether or not this is taking place in your mouth, and it appears that none of the clinicians you've consulted and have examined you have that opinion.

(3)Still another cause of generalized loose teeth is a fundamental problem with the bone itself.  Osteopenia, which is a lower than normal bone density, begins to occur in women sometime after the age of 30 years.  It is considered a precursor of osteoporosis, a more advanced stage of the process.  This is a rather common problem in middle age women and once diagnosed can be easily and effectively managed. This, however, can only be diagnosed by a physician by doing a bone density study.

Now, on to the question you ask, "How should I best proceed?"

I would proceed by first getting an answer to each of the three possibilities that I've discussed in the order that I discussed them:
(1) is an orthodontic issue.  That's where you are at this point.
(2) is a periodontal issue. That's where you go next. Your general dentist is the person to ask.  I'm going to assume since you started with your dentist and this was not presented to you as a cause then this is not a problem. I don't like to assume anything so here's my recommendation:  just ask "How is the bone support around my teeth? Do I have any periodontal problems?"
(3) is a medical issue.  If you get this far then it's time to discuss your problem with your medical doctor.

I hope this helps because I don't have a (4) for you.
All the best.


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Dr. Randolph Myerson


Please limit your inquiry to questions about orthodontics (braces) and children's dentistry. I am both an Orthodontist and a Pediatric Dentist, having been trained in both of these dental specialty fields. Orthodontics is the dental specialty that treats problems of tooth, bite and jaw alignment using braces and removable appliances. Pediatric Dentistry is the dental specialty also known as dentistry for children, which deals specifically with the dental problems of this special age group from infants to adolescents. I am also experienced in Forensic Dentistry, the application of dentistry to law enforcement and identification using dental records.


I have been in the private practice of orthodontics and pediatric dentistry for over 20 years. Prior to that I served for three years on the Cleft Palate and Cranio-facial Reconstruction team at Children''s Hospital of Philadelphia and was an Assistant Professor of Dentistry at University of Pennsylvania School of Dental Medicine. I also served as a dentist in the U.S.Air Force, stationed at Andrews AFB in Washington, DC.

I am a Fellow in the American Academy of Pediatric Dentistry, and a member of the American Association of Orthodontics, as well as a member of the American Dental Association and the Dental Society of the State of New York.

I received my BA in Biology from Frankin & Marshall College in 1969, and my dental degree from University of Pennsylvania School of Dental Medicine in 1973. In 1978 I received both my Certificate in Orthodontics from University of Pennsylvania School of Dental Medicine, and my Certificate in Pediatric Dentistry from Children''s Hospital of Philadelphia after completing a three year Teaching Fellowship in Orthodontics and Pediatric Dentistry in 1978.

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