Teeth are an integral part of the human body. We use them every day for eating, speaking, and smiling. Most people are born with a full set of baby teeth that eventually fall out and are replaced by permanent adult teeth. This all seems like a seamless biological process. However, there are times when the body may reject or fail to fully accept a tooth. Rejection of a tooth is rare but can occur for various reasons.
What is Tooth Rejection?
Tooth rejection refers to a condition in which the body does not fully accept a tooth. This can happen with natural adult teeth that erupt, or it may occur with a transplanted tooth. Some signs that the body is rejecting a tooth include:
- Looseness or excessive mobility of the tooth
- Pain or sensitivity in the tooth and surrounding areas
- Swollen gums around the tooth
- Discoloration of the tooth
- Infection around the tooth
- Failure of a transplanted tooth to integrate with the jawbone
With rejection, the body sees the tooth as a foreign object and mounts an immune response against it. This leads to inflammation, infection, and eventual exfoliation or loss of the tooth. If untreated, full rejection will result in the tooth falling out.
Causes of Tooth Rejection
There are several potential causes for tooth rejection:
Poor Fit
If a permanent tooth is misaligned or does not fit properly in the dental arch, rejection may occur. The tooth may grow in at an odd angle or be impacted against another tooth. This can put pressure on surrounding teeth and bone, leading to inflammation. The body mounts an immune attack against the poorly positioned tooth, resulting in rejection.
Gum Disease
Untreated gingivitis or periodontal disease provides an outlet for tooth rejection. The bacteria from gum disease can travel down the root of the tooth and damage the bone and ligaments holding it in place. As these tissues are destroyed, the tooth loses its foundations. The infection essentially loosens the tooth, prompting the body’s immune response.
Trauma
Injury to a tooth or jaw can set the stage for later rejection. Knocking out, cracking, or loosening a permanent tooth makes it more likely to suffer rejection. The initial trauma disrupts the nourishing blood supply to the tooth. Later on, the damaged ligaments may fail to keep the tooth rooted properly.
Crowding
Too many teeth in too little space is a common cause of rejection. when the deciduous teeth are lost, There needs to be adequate room for the permanent teeth to align properly. If the space is too cramped, the erupting teeth may displace each other or come in at odd angles. The misalignment causes pressure, inflammation, and eventually rejection.
Oral Surgery
Extraction of impacted or problematic teeth can inadvertently damage surrounding teeth. Similarly, prep work during extensive dental procedures may increase rejection risk. Oral surgery aims to preserve as many natural teeth as possible but may disrupt a tooth’s integration in the process.
Transplant Rejection
Following a tooth transplant surgery, the recipient’s body may reject the new tooth. The body views the transplanted tooth as foreign tissue and attacks it through the immune system. Without immunosuppressant drugs, most tooth transplants would result in rejection.
Autoimmune Disorders
Rare disorders where the immune system attacks the body’s own cells can affect oral health. Conditions like leukocyte adhesion deficiency may cause recurring tooth loss. The body fails to distinguish natural teeth from harmful pathogens, leading to tooth rejection episodes.
Are Wisdom Teeth More Prone to Rejection?
Wisdom teeth are known for becoming impacted, infected, and damaged. This vulnerability also predisposes them to rejection. The scientific term for wisdom teeth is third molars. They represent the last teeth to erupt in the late teens to early 20s. The lateness of their arrival can cause problems:
- Jaw growth is often complete before wisdom teeth erupt.
- There may not be enough room for them to properly emerge.
- They often become impacted against the second molars.
- The odd angle can lead to painful inflammation of the gums.
- Impaction makes them hard to clean and maintain.
- They are prone to decay and aggressive gum disease.
The combination of impaction, infection, and crowding makes rejection more likely. For this reason, dentists often recommend early removal of wisdom teeth before they cause problems. However, wisdom tooth extraction surgery also poses a small rejection risk for the adjacent second molar. Proper oral hygiene and checkups are key to ensuring long-term tooth and gum health.
Can a Tooth Be Reimplanted After Rejection?
Under some circumstances, a rejected tooth can be replanted back into the socket. This is more likely with teeth rejected due to trauma versus other causes. With quick action, the tooth can be reinserted and splinted to hold it in place initially. However, later rejection is still possible due to:
- Damage to the ligaments and bone socket
- Infection risk from outside exposure
- Lack of adequate blood flow
- Chance of ankylosis where the tooth fuses to the bone
Over time, the bony socket will begin to fill in and reject the tooth again without a blood supply. Dentists may attempt reimplantation but advise patients that long-term prognosis is poor. The best course is trying to preserve teeth before rejection occurs through preventive dental care.
Treatments to Prevent Tooth Rejection
While rejection cannot always be avoided, certain measures can minimize its likelihood:
Prompt Treatment of Gum Disease
Gingivitis and advanced periodontitis must be actively treated to reduce rejection potential. This includes proper brushing and flossing, regular dental cleanings, and in some cases periodontal surgery. Controlling oral bacteria is key.
Quick Correction of Crooked Teeth
Braces, retainers, or other orthodontic appliances can help straighten crowded, overlapping, or misaligned teeth. This prevents trauma and inflammation between teeth.
Careful Monitoring of Impacted Teeth
Dentists keep an eye on emerging wisdom teeth and other teeth at risk for impaction. Timely extraction or transplantation into the proper position may prevent later rejection.
Avoiding Tooth Damage and Grinding
Preventing injury to the teeth through good oral habits reduces rejection likelihood. Using mouth guards and addressing teeth grinding or clenching helps too.
Detailed Exams After Surgery
Postsurgical follow-up exams help detect signs of rejection early when treatment is most effective. Use of antibiotics or immunosuppressants may be warranted.
Prompt Reimplantation of Dislodged Teeth
Quickly reinserting a knocked out tooth gives the best shot at acceptance. Timely restoration of blood flow is critical.
Immunosuppressant Medication
Drug therapy helps prevent rejection in tooth transplant patients. Medications can calm the body’s extreme immune response.
The Outlook for a Rejected Tooth
The prognosis depends greatly on the cause and timing of treatment. Catching rejection early improves the chances of saving the tooth.
* Reimplanted teeth have a poor survival rate over many years due to ankylosis.
* With gum disease, antibiotics and dental cleaning may stop the rejection process if caught early. Extraction is likely if severe damage has already occurred.
* Teeth damaged beyond repair require extraction and possible replacement with dental implants or bridges.
* If caught early, orthodontic treatment may guide erupting teeth into proper alignment, preventing rejection.
* Wisdom teeth with recurrent infections or advanced crowding often require extraction.
* Rejection related to autoimmune conditions may reoccur over time.
While rejection does not have a high success rate, every effort should be made to salvage natural teeth whenever possible. Artificial tooth replacements cannot fully replicate the function of a healthy natural tooth. Working closely with your dentist provides the best chance of catching rejection before it progresses too far. With prompt treatment, many patients are able to keep all or most of their natural dentition over a lifetime.
The Takeaway
Rejection of natural or transplanted teeth is an uncommon but possible phenomenon. The body may launch an immune attack against teeth under certain situations like poor fit, overcrowding, gum infection, or trauma. Wisdom teeth are especially vulnerable due to frequent impaction. While not always preventable, tooth rejection can often be minimized through careful dental management and good oral hygiene. Catching rejection early increases the odds of saving the tooth. Patients should be vigilant about dental care and report any signs of rejection to their dentist promptly to achieve the best outcome. With proper precautions, our natural permanent teeth may remain functional for a lifetime.
| Cause of Tooth Rejection | Contributing Factors | Preventive Measures |
|---|---|---|
| Poor tooth alignment/position | Misaligned jaw growth, tooth crowding, odd eruption angles, impaction against other teeth | Orthodontic treatment such as braces, retainers, spacers |
| Gum disease | Poor oral hygiene, buildup of plaque, untreated gingivitis | Diligent brushing/flossing, regular cleanings, gum disease treatment |
| Trauma to tooth/jaw | Sports collisions, blows to the mouth, habits like teeth grinding | Wearing mouthguards during contact sports, correcting parafunctional habits, prompt treatment after injury |
| Complications of oral surgery | Damage to adjacent teeth during extraction, bone grafting, implant placement | Meticulous surgical technique, follow-up exams to detect issues early |
| Transplant rejection | Body’s immune response to foreign tissue | Tissue matching, immunosuppressive medications |
Conclusion
Tooth rejection is a relatively uncommon phenomenon that occurs when the body’s immune system attacks a natural or transplanted tooth. While the causes are varied, most cases relate to trauma, misalignment, gum disease, or surgical complications. Rejection may be prevented throughprompt dental care and treatment. Orthodontics, antibiotics, and immunsuppressing drugs may help stop the rejection process. However, severely damaged teeth often require extraction as a last resort. Patients should monitor their oral health closely and report any signs of rejection to their dentist as soon as possible. With quick action, many rejected teeth can be salvaged, avoiding the need for implants or tooth replacement.