A crown that feels loose but isn't, is most likely a periodontal problem which has absolutely nothing to do with your tooth cap. We'll explain why the cause isn't due to the crown being loose because it's simply impossible.
It's definitely a gum issue which we'll prove to you. Just so that we don't leave you hanging, we'll tell you about treatment options so that you know what to expect for your perplexing condition when you see your dentist.
What this condition is not
A tooth with a crown that feels loose but the crown itself isn't loose, is not a crown problem. That means there is absolutely nothing wrong with the cement or glue holding the crown to the tooth.
One of the most common crown complications is a crown that has fallen off because the glue melted off or debonded. Since the tooth cap has not come off yet, it can't be a problem with the glue.
To drive the point home, we would like to say that it is actually impossible for a crown to even become loose. Tooth caps can only exist in two states, they are cemented on or have fallen off. There is no in between state.
Two possible states for crowns:
It is cemented on. The glue is still viable and the prosthesis is securely glued on.
It has fallen off. The glue has melted or debonded so the crown fell off.
It is easier to understand what we mean by that via a video demonstration. Watch the video below for our explanation of why there are only two states a tooth cap can be in.
In summary, it is impossible for a regular dental crown to be in a "loose" state. It is either on your tooth or it is off of it. If it falls off, you can place it back on your tooth even without glue.
Implant crowns are an exception
There is one exception to the rule and that is with implant crowns because these can be loose. If you've a screw retained implant crown, the screw inside can be loosening and the cap will wobble from side to side if it happens.
However, we presume most people are referring to a regular crown which sits on their natural tooth and not an implant. Although if you do have an implant, this could be a potential cause.
What it could be
If your crown feels like it is loose but won't come off, it could only mean one thing, it's a periodontal problem. That means there is something wrong with your periodontium, the structures (gums and jaw bone) that surround the crown tooth.
Healthy vs Unhealthy Periodontium:
A healthy periodontium will have teeth that are sturdy, stable, and non-mobile.
A tell tale sign of an unhealthy periodontium is loose teeth.
What we're trying to say is that what you're actually feeling is the entire tooth along with its root moving. That is why the crown feels like it is loose but isn't when you touch it.
Conditions that can make your tooth feel loose:
Active periodontitis
Inactive periodontal disease
Periodontal abscess
Active periodontitis
Active periodontal disease such as untreated periodontitis can make your teeth feel loose. We call it gum disease but it is more accurate to refer to it as a gum and bone disease.
The defining feature of this precarious condition which separates it from gingivitis is the presence of bone loss.
Gingivitis is defined as gum inflammation.
Periodontitis is defined as gum and bone inflammation.
This is important because as you lose bone around your teeth, the teeth will start becoming looser. If you lose enough bone, the tooth will fall out on their own which is a dire consequence of severe periodontitis.
Inactive periodontal disease
Periodontal disease which have been successfully treated is considered inactive but the bone loss which has occurred is irreversible. Your teeth can still be loose despite having successful perio treatment because the damage cannot be reversed.
Essentially the crown tooth that feels loose may be a result of residual periodontal bone loss.
Periodontal abscess
If the tooth with the crown was not loose the day before but is all of a sudden loose now, it could be due to a periodontal abscess. An infection may have formed recently which has now caused the tooth to be loose.
The bad news is that you've an abscess but the good news is that once you treat the infection, the tooth should tighten up again.
Potential treatments
The causes for a loose tooth with a crown are of periodontal origins so the treatments will be mostly periodontally based. Depending on the specific cause, the treatment will differ.
Treatment:
Deep cleaning. Moderate periodontitis can be successfully treated with deep cleaning of the teeth. This won't restore the loss bone but will at least stop further damage.
Gum surgery. Severe periodontitis will need gum surgery which is the surgical version of a deep cleaning. This involves peeling the gums back in order to thoroughly debride the plaque and tartar from the teeth.
Localized antibiotic delivery. Deep periodontal pockets can benefit from minocycline (Arrestin) placement into the pocket. This is an antibiotic that helps the gum pocket heal.
Incision and drainage. An abscess will need to be drained with a procedure called a dental incision and drainage.
Teeth splinting. After the periodontal disease has been successfully treated, the teeth can be stabilized by splinting them. This will reduce the looseness and mobility of the crown tooth.
Antibiotic mouth rinse. A prescription antibacterial rinse will be prescribed after periodontal treatment. The most commonly used rinse is chlorhexidine gluconate.
Teeth splinting
Splinting your tooth is the only way to tighten a crown tooth that is loose but isn't due to the crown coming off.
All of the periodontal treatments such as deep cleanings, gum surgery, and antibiotics will inactive the disease by bringing it under control. However, the bone loss which has occurred will remain since the damage is irreversible. It is due to the loss of bone that the tooth feels loose.
Unfortunately, the bone around the crown tooth will not grow back. However, what we can do is stabilize the tooth and make it less mobile by splinting it.
Ways to splint a loose crown tooth:
Bonding. You can potentially bond a retainer wire to the loose tooth along with the adjacent teeth to stabilize it. This would be very similar to getting metal wire retainers after orthodontic treatment.
Dental bridge. Alternatively you can remove the crown on the loose tooth and make a tooth bridge instead. The bridge will provide much needed stabilize and minimize the looseness.
Takeaway
If your crown feels loose but isn't actually loose, it probably isn't the crown because it may be a periodontal issue instead. Rather than focus on the tooth cap, you should explore periodontal treatments to address the cause and then think about splinting the tooth to stabilize it afterwards.
