Tooth dislocation: the relationship with tooth wear and dental abscesses

Tooth dislocation (tilting) was recorded in 1,200 skulls from 34 museum collections. The findings of dislocation by tooth type, tooth wear, and abscess location are presented. A model for dislocation based upon the progressive loss of tooth support provides a rational explanation for the phenomenon. Physiological continuous tooth eruption was considered to account for a component of the progressive loss of tooth attachment. The process of attrition, pulp perforation, and dental abscess cavity formation resulted in further, more severe loss of tooth support. Heavy functional forces, in association with greatly reduced bone support, tilted the crown lingually and root buccally. When the tooth had tilted to such an extent that the root apices protruded from the bone and, presumably (in life) through the gingival/mucosal tissues, the infected root canals were effectively isolated from the internal environment. The tooth continued to function. The more typical consequence of severe attrition and dental abscess formation was tooth loss; it also isolated an infected tooth from living tissue, but without the benefit of retaining function.