Grades 1 and 2 mobility in teeth

[NooNooHead]

Posted on General Health board but I'm posting here too for traffic.

Argh. Just saw the dentist for a checkup and have grades 1 and 2 in a couple of molars apparently 😳

I'm 44, perimenopausal, and not on HRT. I've been having lots more problems with gingivitis since having started
perimenopause, and never had bleeding gums before. I think I'm pretty
meticulous with my oral health, using an electric toothbrush, floss, interdental brushes, mouthwash, but clearly I need to do something else to prevent my teeth getting worse 😬

Having said that, maybe I am being a bit OTT, and it's just age 🤔 😅 I don't have any pain with the teeth mobility, so I might just watch and wait rather than jump to the worst conclusion!
Getting older sucks 😕

Any wise words would be appreciated please, to stop me panicking a bit!

Never heard of grades of mobility. Does this mean your teeth are loose at the sockets because of loss of gum/ receding gum?

This is linked to loss of estrogen because gums shrink and bone loss also occurs in the jaw as well as all over the body.

Are your gums inflamed and bleeding?

My gums aren't inflamed at the moment but they have been quite susceptible to bleeding at certain points in my cycle. I keep on top of brushing and flossing which helps a lot, but it is definitely hormones as I never had any gums problems or greater sensitivity to plaque before.

I think grade 1 is quite minimal but I Googled grade 2 which is moderate apparently and that freaked me out a bit!

Yes, I am guessing it means loose teeth at the sockets but I've never noticed anything moving 😅

I think it would be best to ask your dentist for more info.
If your teeth are loose because of gum inflammation you need a treatment plan.

Teeth that are loose are at the 'end stage' of gum disease.
Does your dentist not mean the amount of gum lost, rather than looseness of teeth?

Do you have a proper clean/ scaling with a hygienist?
I have mine done every 4 months but I'm much older than you!

Blimey, I am now going to be really worried 😟 I will definitely need an x-ray as I know it's something that needs really thoroughly checking.

I didn't think my teeth are that loose - they've never felt loose to me before 😫

Do you grind/clench your teeth, OP? My upper front teeth are ever so slightly mobile - not quite at grade 1 level - and it’s due to clenching them at night. My gums are perfect (I always score 0 on the poky BPE thing) so it’s not always to do with gum disease. I wear a night guard now and my dentist checks mobility at each checkup. They have remained stable for about six years. I have a neuralgia thing called atypical facial pain which means I am on three month checkups, despite my teeth/gums being fine.

If you have such significant gum disease it’s caused your teeth to be mobile and your dentist has never told you and given you an action plan they are absolutely negligent - so it’s very unlikely to be that.

I have intractable gum disease and have lost quite a lot of molars. Grade 2 is pretty bad. I have impeccable oral hygiene and have never had a filling (although didn’t start flossing till my 20s) and just lost the genetic gum lottery (parents and brother similar). I have had lots of treatment at the dental hospital but really only 3 monthly hygiene appointments go anywhere near keeping on top of it.

Your dentist sounds a bit rubbish to be honest @NooNooHead
Surely they should explain all of this and get a treatment plan going?

I had to have one tooth deep cleaned by going right under the gum to clean it all out because inflammation was affecting the root.

Why isn't your dentist on top of this?

To be honest, i had a couple of deep cleans (scale and polish) a couple of years ago, and the hygienist didn't seem worried. She never said anything about mobility or loosening and nothing about a treatment plan.

I was very anxious when my gingivitis and bleeding gums started during the post natal period after my youngest daughter was born so booked to see the gum specialist in Norwich. The hygienist actually said about seeing them and questioned why I had gone as it was so expensive, so clearly they weren't that concerned 😅

I also remember her saying that I had lots of roots left so my teeth and guns weren't in danger of falling out.

However, I do grind my teeth when stressed quite often, and sometimes as a symptom of my movement disorder. I actually wonder if I grind at night too.

God knows, it is all very odd and worrying!

To be honest, i had a couple of deep cleans (scale and polish) a couple of years ago, and the hygienist didn't seem worried. She never said anything about mobility or loosening and nothing about a treatment plan.

It's not really the hygienist's call in my own experience. (And a lot can change in 2 years.)

I have a scale and polish every 4 months. They recommend every 6 months as a minimum but my teeth need more (hard water where I live for a start.)

A scale and polish isn't really regarded as a deep clean. I've had a deep clean of one tooth and it needed a local jab as they go right down the root, sort of peeling the gum away while they clean - and this isn't done by a hygienist.

My guess is you need to ask if you have receding gums and that is what the grades mean (they measure the amount of gum loss against your tooth) or if you have loose teeth and active gum disease.

I think the different numbers might be confusing here, and also that you need to ring the dentist and go back in, even just to have it all explained.

Tooth mobility is graded - grade 1 means a little bit of movement and then as it goes up it’s more wobbly until like a tooth might pop out if you ate an apple. Remember that all teeth have some tiny bit of mobility, like a tree in high winds, or they would snap when you bit something hard.

The other number is the BPE score which is your gum health. It goes from 0-4, and again, low is good, high is bad. Your mouth is divided into four quadrants and each bit gets a score, so you could have one section that you are not cleaning properly that is a high number and that needs attention, but the rest of your mouth is fine. I have a crown up on my top right and occasionally score 1 there and know I need to up my brushing!

My dentist is amazing, explains absolutely everything, and I am an eager student - per my earlier post, my gums are pretty much always zero in the BPE but I still have that tiny bit of mobility from clenching. If you do grind/clench your dentist can make you a nightguard to wear. I’m full of a cold and have left mine out the last two nights and I can feel the difference not wearing it has made.

Ah in that case, I've never had a proper deep clean as nothing was ever peeled back under local anaesthetic. Just cleaned with the scaling tool.

I think my Oral B electric toothbrush is quite vicious as my gums are absolutely receding a lot, and since I changed from Sonicare to this one, the receding seems to be worse.

I know that my back right top molars look as though there's a gap between them, that goes quite high, almost like the gum problems have been quite bad that they've been rotting the gum away (it looks like it's disappearing in between several teeth and the gum ends higher up 😳).

I think being perimenopausal probably doesn't help but means I need to brush better, see the hygienist maybe more, and get a treatment plan from the dentist if necessary. I'm not very flush so I don't know how I'm going to afford a lot of treatment if necessary 😳😫

Gums do recede because of a lack of estrogen.
Worth bearing in mind.

You'll have head the expression 'long in the tooth'?
That's a sign of age as the gums recede and more tooth is visible, eventually even right down to the roots.

My deep clean was done by a specialist in gum issues. It started with an x ray, then clean and an appt afterwards to check. Total cost was several hundred £££s.

More teeth are lost through gum disease than tooth decay.

I’ve had a lot of gum issues - believed to be genetic. It takes a lot of work to keep on top of - water flossing, tee pee brushing as well as interspace cleaning daily alongside using a good electric toothbrush. You also need a decent hygienist every 3 months doing deep cleans when needed under LA to really clean out deep gum pockets. I’ve recently had some sessions with a proper periodontist and wish I’d seen them years ago. Cost a lot but has brought down the pocket depths far more and quicker than the hygienist ever managed.

So sorry to hear of your gum issues. It's such a pain 😢

I'm doing everything I can at home really to keep on top of it, and use things like interdental brushes, floss, and occasionally mouthwash etc. The only thing I've never had is z deep clean under my gums. I've just had a scale and polish.

I'm certain mine is bone loss from perimenopause too, which the lack of oestrogen over the past 6 years has probably contributed to.

You only need a clean under the gums if you have 'pockets' of inflammation under the gum line or an absess around the roots. This is for a periodontist not a hygienist as it needs a local jab.

If you have pockets they need sorting.

Otherwise, seeing the hygienist every 3 -4 months should keep it under control.

there are 0, 1, 2, and 3 stages of mobility so those teeth that you have marked as 2 are at risk.

Regular scale and polish is not a deep clean. Deep clean is when they go under the gum (after numbing areas of course). It is quite an intense treatment, rarely done in one go (sometimes done per lower vs upper or even quadrants).

Ok, but I've never felt anything like mobility or loosened teeth although obviously it might not be noticeable to a lay person.

What treatment is recommended for helping the loose grade 2 tooth? I think it was only one of them with grade 2.

And how come now it's only been noticed by a dentist and not before? 😳

Dentist do not normally treat this as part of NHS treatment. And if there is no pain or bleeding it goes unnoticed until it becomes late stage paradontosis.
it happened to me. I've had several teeth out in the last 2 years (level 3 mobility), several deep cleanings plus regular 3 monthly ones. Flossing, brushing meticulously. May need bone treatment where there is a bone loss (x ray will show this).
It's scary but I can only focus on what is doable.

Can you ask your dentist for a pockets chart review? and X ray to determine level of bone loss.

Is that a 'given' or your personal experience?

I have private dentistry but if the NHS doesn't treat severe gum disease, why not?

I'm not sure if you've ben told you have loose teeth or gum loss. Or both?

They measure gum loss by measuring the depth of the exposed tooth which is normally covered by your gum.

That doesn't equate to a tooth being loose.

It's a sign of where gum disease has happened and also old(er ) age- receding gums.

There is no treatment for gum loss and more tooth exposure. All you can do is prevent it from getting worse.

I believe taking collagen can support gum health.

It can't.

Swallowing collagen doesn't mean it ends up where it was before.
There's a lot of medical research online on this.

If it worked dentists would advise it.