We are now open!

Greetings to all of our patients!  

I want to take this time to reach out to you all and reconnect so as to let you all know what we've been up to during the Novel Corona Virus Pandemic.  I want to state that our #1 priority is, and has always been the health & safety of our patients, and, of course, to provide to you the highest quality dental care we can!  

I am sure most of you have questions and concerns regarding the safety of dentistry during this time, so we'd like to share the measures and actions we are taking to ensure your safety here at our office.

First of all, the culture here will be a little bit different in the “post novel corona virus world”.  At least until researchers come up with therapies and /or a vaccine!  We will be implementing some new systems in our practice to mitigate the risk of disease transmission here.  

What to expect when you come to the office?  Prior to your appointment, when Diana calls you to confirm your appointment date and time, she will ask a few quick questions regarding your medical status, and any symptoms suggestive of an illness...We ask that if you are ill with a fever, coughing, etc. to please reschedule for when you are well.  

We ask that you please call when you arrive to the office. Diana, Chelsea or Susie will meet you at your car to take a quick, touch-less temperature scan of the forehead, also you will have a small device clipped to your finger called an oximeter. This gadget shines light through your fingertip or earlobe. It works out how much oxygen is in your blood. We will then escort you directly to your treatment room.  

We will be spacing out our patient appointments so that there is only one patient on the dentistry side with Susie and I, and only one patient in the hygiene side with Chelsea.  For the most part, no one is allowed to wait in the lobby until further notice...We will of course, accommodate people escorting children or elderly patients.

All surfaces will be disinfected with Hospital Grade Disinfectants (as we've always done in the past) between patients.  All door knobs, light switches, etc. will be disinfected every 30 minutes throughout the day!  This will mitigate the risk of any infectious disease transmission via surfaces.

Ever since the HIV epidemic in the 1980's, dentistry as an industry has employed “Universal Precautions” (masks, gloves, “single use” disposable equipment, etc.) to mitigate disease transmission.  

The most concerning of transmission routes for infection, including novel corona virus, is via “'aerosols”.  Dentists and hygienists  have used “High Volume Evacuation” (HVE) routinely for decades to capture aerosols generated by dental hand pieces (drill) and ultra-sonic scaling devices.  HVE reduces aerosols by 90% !  

We will continue to use HVE for all procedures that generate aerosols.  In addition to HVE, we've invested in Medical Grade H-13 HEPA aerosol scavengers in our operatories (basically a very powerful vacuum) with a snorkel hose that we can position adjacent to the treatment field to scavenge any aerosol the HVE misses.

We have also invested in nine medical grade H-13 HEPA air filtration units placed throughout the office which will completely clean/turn over the air every 10 minutes, or six times per hour.

Another investment made was having medical grade UVC (Ultra-Violet C) units installed in our Central  Air Conditioning/Heating units that kill Bacteria and Virus as the air passes through. 

Finally, we will fog the office with Hypochlorous Acid, a human safe, yet powerful disinfectant at the end of each day.

We want you all to know that we are taking all possible precautions and measures to ensure your safety, and the safety of our team here!

To further streamline your experience at the office, we will be scheduling return visits for you in the operatory, at the end of your appointment.  We will make available electronic payment options in order to minimize visiting the front desk.

Warm regards,

Dr. Paulerio and Team

Loose Tooth

loose toothWhile a loose tooth is a typical occurrence for a child, a loose adult tooth generally indicates an issue with your oral health. In adults, teeth become loose when they no longer have sufficient support from gums and other underlying structures. Instability can stem from a variety of conditions, including gum disease, osteoporosis, or a traumatic force, such as clenching or grinding your teeth. Typically, loose teeth are accompanied by sore or receding gums, or inflammation. In some cases, early treatment of a loose tooth can save it from otherwise necessary extraction. The optimal treatment option for you will depend on the cause of the instability and how long it has gone untreated. 

How to Tell If You Have a Loose Tooth

Loose teeth do not behave the same in adults as in children. When a child has a loose tooth, they can generally wiggle it and are sure which tooth is causing the issue. Most adult patients with a loose tooth recognize that something does not feel right, but they are not sure exactly what it is. If you have a loose tooth, you may have other symptoms as well, such as:

You should speak to your dentist right away if you experience looseness of a tooth or any of the associated symptoms. Early treatment is the best way to prevent tooth loss

What Causes a Loose Tooth?

In general, the causes of loosening teeth are split into two categories:

  • Primary occlusal trauma
  • Secondary occlusal trauma

Occlusal is a term that refers to your bite, and trauma is anything that can damage or injure the supporting structures of your teeth. A primary occlusal trauma can occur as a result of force exerted by your bite, such as clenching or grinding your teeth, and affects only the teeth themselves. At this point, there has been no loss of periodontal attachment. A secondary occlusal trauma occurs after tooth has already lost support from the bone or ligaments due to another condition. Loose teeth are typically caused by secondary trauma, such as gum disease.

Periodontal disease, a chronic infection that affects your gums, is one of the most common causes of loose and shifting teeth.

Gum Disease

Periodontal disease, a chronic infection that affects your gums, is one of the most common causes of loose and shifting teeth. Most often attributed to poor oral hygiene, this condition occurs when bacteria forms around the gum line and begins to affect the bone and connective tissues of your teeth. The longer gum disease is left untreated, the more likely it is you will have serious oral health issues. Advanced stages of this condition can cause tooth loss. 

Traumatic Forces

Occlusal trauma can come from a variety of sources. Whenever extreme force is placed on teeth, the ligaments and connective tissues that hold your teeth in place can become stretched and lose their strength. If you regularly grind your teeth or clench your jaw, you are placing excessive pressure on your teeth. 

In addition, misalignment in your teeth can cause extra force to affect certain teeth over others. External trauma from a fall or accident can also damage the ligaments and bone and loosen your teeth. You should visit your dentist right away after any injury to your mouth.


Osteoporosis is a condition that diminishes the natural density of bones and causes them to weaken. This disorder can affect both men and women. When the density of the bone is lowered by osteoporosis, teeth can become loose. 


During menopause, your body produces less estrogen, which can cause the bone supporting your teeth to weaken. Jawbone loss can result in tooth loss.

Missing Teeth

examining the biteIf you are missing multiple teeth, every bite exerts a greater amount of pressure on your remaining teeth than it normally would. In addition, tooth loss leaves gaps in your smile, allowing space for other teeth to shift and increasing the chance of loose teeth. 

Infections or Abscesses

Infection below the gum line or abscesses around a tooth can affect the bone and connective soft tissues of your teeth. Loss of bone and periodontal ligament can result from an abscess, reducing the amount of support your teeth have.

Treating a Loose Tooth

Your treatment options will depend on the underlying cause of your loose tooth. For example, performing a soft tissue graft may not help if the cause of your tooth mobility is clenching your teeth. Your dentist can examine your overall oral health and recommend the optimal treatment for your specific needs. 

Treatment for Periodontal Disease

If the cause of your tooth mobility is gum disease, a treatment to control the infection and restore the health of your gums will likely improve the situation. A variety of periodontal treatments exist, including:

  • Scaling and root planing: Also known as a deep cleaning, a scaling and root planing procedure involves the removal of bacteria from below the gum line. Your hygienist can also smooth your dental roots to prevent bacteria from returning.
  • Flap surgery: When a deep cleaning is not sufficient, your dentist can perform a flap surgery. During this procedure, they will create a small flap in the affected gum tissue to better access the bacteria underneath.
  • Antibiotic therapy: Certain antibiotics, such as Arestin®, can help destroy bacteria and encourage your gums to heal more quickly.
  • Gingivectomy: During this treatment, your dentist can remove damaged soft tissue and reattach the gums more securely to tooth roots. Many dentists will perform this procedure using soft diode lasers.
  • Grafting: A soft tissue graft or bone graft can restore lost tissue and prevent further recession.

In many cases, clearing the infection allows gums to heal and as they do so, the tissue tightens around the loose tooth for a more stable and secure bite. 

Mouth Guards

For patients with bruxism, also known as clenching or grinding, wearing a mouthguard while they sleep can reduce the pressure exerted on their teeth. By removing the source of the traumatic forces, your teeth can heal, which can reduce or eliminate tooth mobility.


Another method of reducing traumatic force is splinting. If your teeth are very loose, your dentist can place a temporary or permanent splint to join the teeth together. This treatment distributes the biting force more evenly across a group of teeth, putting less pressure on individual loosened teeth.

Since loose teeth often stem from periodontal disease, maintaining good oral hygiene is an effective way to prevent teeth from loosening.

Bite Adjustments

For some patients, the source of tooth mobility is misalignment in their bite. By reshaping the biting surface, your dentist can reduce the pressure placed on the affected tooth and allow it to heal. During a bite adjustment, your dentist will remove a small amount of enamel or place a dental crown to redistribute the force of your bite.

Extraction and Replacement

In cases of severely loosened teeth, tooth extraction may be the only option to protect your smile. Generally, dentists will only use extraction as a last resort when other methods have failed. Certain patients may qualify for immediate placement of a dental implant after an extraction. Replacing a single missing tooth with a dental implant can provide significant benefits for the long-term health and stability of your smile. 

How to Prevent Tooth Mobility

Since loose teeth often stem from periodontal disease, maintaining good oral hygiene is an effective way to prevent teeth from loosening. A consistent home care routine combined with regular professional cleanings at your dentist’s office can help protect the health of your gums. Improved gum health can keep your teeth secure. 

Treating other health concerns, especially systemic issues such as diabetes, can also prevent tooth mobility.  Your dentist may also recommend a mouth guard to wear while sleeping or playing sports to protect your smile from traumatic forces. In general, healthy eating and regular exercise can improve your oral health as well. Talk to your doctor today to learn more about your options.

Point Loma Family Dentistry team

Point Loma Family Dentistry

Dr. Louis E. Paulerio is a top-rated dentist who is committed to providing the latest dental treatments in a caring, warm setting. He is a member of several prestigious dental organizations, including: 

  • Academy of General Dentistry
  • International Dental Implant Association

He also uses CEREC technology to create beautiful, long-lasting dental restorations in just one appointment. Ready to schedule a consultation at our Point Loma office? Request your appointment online or call us at (619) 223-3811.

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1635 Rosecrans St
Ste A
San Diego, CA 92106

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