What Holds Your Teeth in Place? A Dentist Explains

Your teeth are held in place by a team of living tissues: the gums that seal around each tooth, a thin layer called cementum covering the roots, the periodontal ligament that attaches each root to the jaw, and the jawbone itself. When those supports stay healthy, teeth stay firm. When gum disease, grinding or a missing tooth damages them, teeth can loosen, shift or be lost. A dentist can measure, image and treat each of those supporting tissues, often long before you would notice a problem yourself.

This article explains how a tooth is built and anchored, what can weaken that anchorage, and what the team at the Timonium office of Dr. Steven W. Haywood, DDS can do to protect it.

Teeth are living structures

A tooth can feel like a solid piece of bone, but it is made of several layers, and the inside is alive.

Enamel

Enamel is the hard outer shell of the crown, the part of the tooth you can see. It protects the tooth from chewing forces and temperature, but it can be worn away by acid and grinding, and it doesn’t grow back.

Dentin

Beneath the enamel is dentin, a mineralized tissue that makes up most of the tooth. Dentin contains tiny channels that lead toward the nerve, which is why exposed dentin often feels sensitive. See sensitive teeth causes and treatment.

Pulp

At the center of each tooth is the pulp, which holds nerves and blood vessels and runs down through canals in the roots. When decay or a crack reaches the pulp, it can become infected; read the dangers of oral infections.

What holds your teeth in place

The tissues that surround and support a tooth are called the periodontium. “Periodontal” disease is named after them.

The gums

Healthy gums are firm and fit snugly around each tooth, forming a seal that helps keep bacteria out of the deeper tissues. A shallow space between the gum and tooth is normal. When gums are inflamed, that space deepens into a pocket.

Cementum

Cementum is a thin, bone-like layer covering the root surfaces. It gives the fibers of the periodontal ligament something to attach to.

The periodontal ligament

The periodontal ligament is a network of fibers that connects the cementum on the root to the surrounding bone. It holds the tooth firmly while allowing a tiny amount of cushioning movement when you chew.

The jawbone

The bone around each root, sometimes called the alveolar bone, is the foundation for everything else. It stays healthy partly because the tooth in it is in use. When bone is lost, teeth lose support.

What can weaken a tooth’s support

Gum disease

Gum disease is the most common threat. It begins when plaque inflames the gums, and if it continues, the infection moves below the gumline and damages the ligament and bone. Pockets deepen, gums recede and teeth can loosen. Periodontal disease is the leading cause of tooth loss in adults. For how it is found, read do you have periodontal disease?

Brushing too hard

Aggressive brushing can wear gums back and expose root surfaces. Read smart brushing beats aggressive brushing.

Grinding and clenching

Grinding puts heavy, repeated force on teeth. It slowly wears down and cracks enamel, often without you noticing, and uncontrolled grinding destroys comfort, health and appearance as we age.

A bite that doesn’t fit together well

When teeth meet unevenly, some take more force than others. Bite problems can also show up as jaw tenderness and frequent head or neck aches. See can a bad bite cause headaches?

A missing tooth

When a tooth is lost, the bone that held it no longer gets the stimulation of chewing and can shrink over time. That can leave the bone too thin to support an implant later without grafting, and nearby teeth may drift.

What can the dentist do for you?

Most of what protects your teeth’s support happens quietly, at routine visits. Here is what the team at Dr. Haywood’s practice can do.

Measure and monitor your gums

The experienced hygienists check your gums with careful measurements and track them over time, so small changes are caught early. Cleaning appointments are a full 60 minutes, and a professional cleaning every six months is recommended.

See below the surface

Digital X-rays appear on screen right away with less radiation than standard dental X-rays and show the bone around your teeth. Intraoral cameras zoom in on each section of your mouth. When a fuller picture is needed, cone beam CT scanning gives a three-dimensional view of your teeth and jaw, and the Green CT scanner does so with a much lower radiation dose. See dental technology.

Identify the bacteria involved

Oral DNA testing identifies which of the 11 most suspected periodontal pathogens are present, so gum disease can be treated more accurately.

Clear infection from beneath the gums

Scaling and root planing, a deep cleaning, removes harmful bacteria from beneath the gums and gives the tissue a clean surface to heal against. Depending on your plan, treatment can add irrigation, site-specific antibiotics such as Arestin or Atridox, and the Picasso laser. For a holistic approach, laser and ozone therapy clear bacteria and infection from the gums without chemicals. Ninety-eight percent of the practice’s periodontal therapy is non-surgical. Read effective gum disease treatment.

Keep the infection in check

Gum infection can be managed and controlled but not completely cured, so periodontal maintenance and regular hygiene visits keep it in check. Regular follow-up care creates an environment for the gums and bone to heal and helps prevent further damage.

Protect teeth from grinding

Comfortable, clear bite guards custom-made for you help protect your teeth from further wear. If jaw pain or headaches are part of the picture, a full evaluation, which may include bite analysis and CT imaging of the joint, comes first. See TMJ disorder treatment.

Replace a lost tooth and preserve bone

A dental implant replaces the root as well as the crown, which helps preserve bone. Dr. Haywood reviews X-rays or a cone beam CT scan to check the quality and quantity of your bone, active gum disease is treated first, and thin bone can often be built up with grafting. Learn about dental implants in Timonium.

Reshape the gum line for appearance

Not every gum concern is about disease. When too much gum tissue shows and teeth look short, a gum lift can move the gum line upward on the upper teeth for ideal proportions. See gum lift in Timonium.

What you can do at home

• Brush gently twice a day with a soft brush, angled toward the gumline
• Clean between your teeth every day
• Avoid tobacco and vaping, which make gum disease harder to control
• Limit frequent sugary snacks and drinks
• Wear your bite guard if you grind
• Keep every cleaning and maintenance visit

For a full routine, read how to prevent gum disease.

Paying for your care

The practice is out of network with all dental insurance providers. You pay at the time of your visit, and the office files the claim on your behalf so your plan can reimburse you for whatever it covers. Health savings and flex plans are welcome, and financing is available through CareCredit, with no-interest options for up to 12 months, and Cherry, with plans from 3 to 24 months. See financing options.

Frequently asked questions

Why do teeth become loose?

Usually because the gums, ligament and bone that support them have been damaged, most often by advanced gum disease. Heavy grinding and injuries can also loosen teeth. A loose adult tooth should be checked promptly.

Can lost bone around teeth grow back?

Treating gum infection and keeping up follow-up care creates an environment for the gums and bone to heal and prevents further damage. Where bone is too thin for an implant, grafting can often build it back up.

Are teeth alive?

Yes. The pulp at the center of each tooth contains nerves and blood vessels, and the ligament and bone around the roots are living tissues too.

How often should my gums be checked?

A professional cleaning every six months is recommended. After treatment for gum disease, follow-up care every 3 to 4 months may be recommended.

Protect what holds your teeth in place

A thorough exam shows how healthy your gums and bone are today. Request an appointment or call (410) 453-9399. The office of Dr. Steven W. Haywood, DDS is at 108 W Timonium Rd, Ste 200, Timonium, MD 21093, serving Timonium, Towson, Pikesville, Baltimore and the surrounding communities. Learn more about gum disease treatment in Timonium.