Keeping That ‘Unsavable’ Tooth Is Not Only Possible, It Should Be A Priority!
Sure, on a scale of terrible things that can happen, it may not even rate. With the countless incidents that can possibly happen to a human being, discovering a tooth is loose in a game of ‘Would you rather..’ has a relatively high chance of winning. Particularly if it was up against finding a thrashing shark on the end of your leg, or having a spell put on you that permanently added two hundred grams to your body weight every time you swore.
We’re not actually holding a trauma competition here. Anyone rolling their eyes at how freaked out someone can be with the realisation they can wiggle a tooth with their tongue, either simply cannot imagine it ever happening to a responsible adult, or is still getting visits from the Tooth Fairy.
It can, it does; and a piece of string and a slammed door will get her to you faster.
Unless you regularly see your dentist every six months, even if you’ve had perfectly straight, perfectly anchored teeth throughout your adult life is no guarantee they’ll stay that way. Stuff happens. And it starts happening before you’re even aware of it. Shockingly, unless you’ve been punched in the face, the reason you notice it is because it’s been happening for a while.
So it’s a punch in the face anyway.
More often than not, the dentist you see will deliver the news that it will have to be extracted. That if you’d seen them months earlier it may have had a different outcome, but now it’s beyond the point of being able to be saved.
It’s devastating. Especially since we have the idea that dentists have enough incredible skills to be able to fix everything. This is just a loose tooth. It’s hanging on, it’s still in your mouth; so surely it can’t be that bad..? Some professional intervention, maybe a prescription to fill, a few do’s and don’ts for a while … a big lesson learned, and it’ll be okay, right..?
It definitely should be.
Presented at the Vienna 2025 EuroPerio11, the global leading congress on gum health and implant dentistry held by the European Federation of Periodontology (EFP), was a major long-term study. For 20 years, it followed 50 patients who had either had a tooth extraction replaced with either a fixed bridge or implant; or undergone advanced regenerative procedures to keep the same tooth.
It reveals that saving teeth – even ones with severe bone loss – through periodontal regeneration (PR) proves to have benefits equal to if not greater than, extraction and replacement.
What is patently clear in the findings is that saving the tooth not only work just as well, it’s more economical in the long term. For the majority of patients, it’s also a better experience.
One lead investigator, oral surgery dentist Dr Simone Cortellini from one of Europe’s most innovative universities KU Leuven, Belgium, is strongly of the belief that the idea that a tooth with severe bone loss must always be removed “isn’t necessarily true.”
In acute cases of periodontitis (being Stage III or IV) deterioration occurs to the tooth’s supportive tissues, including bone – and sometimes even to the root tip (apex) of the tooth. These cases are always deemed ‘unsavable’ or ‘hopeless’ in conventional dentistry, and standard procedures are applied. It means too, that in order to maintain teeth positioning a bridge, or prosthetic – either via a partial plate or implant – needs to take its place at the extraction site.
It was Dr Cortellini’s goal to redefine which type of cases were truly beyond the point of regenerative therapies producing a viable result. She wanted to prove that there are patients with even advanced tissue and bone damage that can be so successfully treated, that the tooth is retained.
It looked at saving the natural tooth, or having it replaced with an implant. Both were successful treatment options. In the group that kept their natural teeth, only four were lost. Gum health remained stable; which allowed healthy attachment levels to be maintained over the two decades. In patients with replacements, there were only two implant failures, with gingivae health equivalent to the retention participants.
Even with both groups having similar complication counts, the study revealed that in the long-term, keeping the natural tooth is significantly less costly than replacement, regardless of ongoing maintenance therapy. Saving a tooth is always a win for the patient.
Extraction may eventually occur, but with a focus on actually regenerating the affected area rather than automatically replacing it, the delay in removal can be over many years.
Not only are regenerative procedures less expensive from the beginning, teeth that have been able to remain in their place generally require fewer repairs across a longer period of time.
It’s important to realise that periodontal regeneration is a complex technique. It’s not for everyone, or every tooth. Patient selection – in terms of non-smokers in good general health – is hugely important; their compliance in maintaining utmost oral hygiene and follow-up care is key to the success of the procedure. What’s certain, is that ongoing developments in biomaterials and dental innovation will eventually extend the enormous advantages of PR to a broader category of patients.
So if you do find yourself in the unenviable situation of finding a loose tooth, there is another option to explore.
It doesn’t involve the Tooth Fairy you knew, although it could prove equally magical.
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Services We Mentioned:
Dental Implants
Emergency Dentistry
Restorative Dentistry
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Kristen K.
I have been going to Dr Cai for almost two years and each time I visit he and the staff are so lovely and professional. I cannot recommend them enough.
Nikki J.
Best dentists I have ever been to. I even travelled to Pitt Street Dental when we lived interstate to see them. Very capable, thoughtful and kind dentists and team.
