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A tooth is primarily held in place by the periodontal ligament. The ligament runs the entire length of the tooth root surface and attaches to the bone of the jaw. The width of the ligament is typically less than a millimeter in width. There is a small amount of epithelial tissue (gum tissue) that covers the coronal (top) of the ligament and attaches to the tooth itself, but this attachment is not nearly as strong as the ligament.

In periodontal disease (gum disease) bacteria colonize in the small pocket between the tooth and gum. If it remains long enough, the bacteria cause the body to respond in an inflammatory reaction. The immune system produces enzymes that destroy the attachment and the bone surrounding the tooth. Eventually, the tooth no longer has enough attachment and support to withstand the forces of biting and chewing, and the tooth becomes loose and has to be removed.

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17y ago

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