Root Resorption: What It Is, Symptoms & Treatments

Root Resorption: What It Is, Symptoms & Treatments

There are some oral health problems that can go undetected for a long time. Root resorption is one such condition. Although this process occurs naturally in children to allow the baby teeth to fall out, it can also abnormally affect permanent teeth.  

Early diagnosis of root resorption can stop further damage and even the complete loss of a tooth. Understanding some of the causes of root resorption is important for preventing the condition from developing.

What Is Root Resorption?

Root resorption is a rare condition in which the body’s immune system breaks down the dentin (yellowish dental tissue that lies immediately underneath the enamel), cementum (tissue that covers tooth root), and bone. Clastic cells reabsorb the mineralised tissues. This resorption process can occur internally or externally. 

Root resorption is a result of traumatic dental injuries. And according to the American Association of Endodontics (AAE), where the injury has taken place and the kind of “structures” that support it can determine the type of root resorption that will take place. It commonly affects people between the ages of 21 and 30. 

Keep in mind that it is important to get this condition diagnosed and treated in time because it can result in the loss of teeth. Clinical examination and X-rays are not always enough to detect this problem. This is especially true for the resorption that takes place internally and is still in its early stages. For that reason, digital radiography or cone-beam computed tomography (CBCT) may be needed. 

What Does Root Resorption Look Like?

In the case of external root resorption, you might notice the formation of chips or holes. As far as internal tooth resorption is concerned, if it’s affecting the crown region of the tooth, it can cause discolouration. You might end up with what’s known as a “pink tooth.” It can be a small pink spot on the tooth or affect the tooth in its entirety. 

What Are Root Resorption Symptoms?

It should be noted that many times, root resorption is asymptomatic. You can go years without experiencing any symptoms. It can, however, also cause the following symptoms: 

  • Swelling 
  • Pain 
  • Moving and weak tooth
  • Discolouration 

If left untreated, root resorption can cause further oral health complications like misalignment of teeth, infections, teeth chipping, and tooth decay. 

What Causes Root Resorption?

Root resorption can be caused by a traumatic dental injury that results in damage to the tissue surrounding the tooth. It can also be caused by infections, cavities or periodontal or orthodontic treatments. 

Typically, orthodontic treatments cause root resorption in the upper jaw’s front teeth, but any tooth can be affected. Certain risk factors increase the incidence of root resorption in people undergoing orthodontic treatment. This includes: 

  • Allergy or asthma 
  • Onychophagia (biting fingernails) 
  • Gum disease 
  • History of root resorption 
  • Teeth that have had root canal therapy 
  • Traumatic injury 

Other than that, root resorption can be a result of pressure that can come from a partially erupted tooth (impacted), tumour or cyst. If you’re applying too much pressure when biting on food or chewing them, that can also cause this problem. Bruxism can also result in the dissolution of the tooth root structure. Bleaching the teeth with hydrogen peroxide can also reportedly cause this problem. 

Some systemic (affecting the whole body) and endocrine disorders may also be responsible for the development of this condition. Root resorption can occur if the person has: 

  • Paget’s Disease 
  • Calcinosis 
  • Hyperparathyroidism 
  • Herpes Zoster 
  • Gaucher’s Disease 
  • Turner Syndrome 

Following the development of the problem, there has to be a stimulus for the root resorption to continue. If that doesn’t happen, the root resorption process can stop on its own after 2-3 weeks. However, you shouldn’t wait to get yourself checked by a doctor because you don’t know the extent of the damage. 

What Are The Different Root Resorption Types? 

There are two main types of root resorptions, which are as follows:

Internal Resorption

When the internal root resorbs, the dental pulp is inflamed, which damages the tooth from the inside out. There are two different types of internal root resorption: 

  • Inflammatory Internal Resorption – It is a rare, chronic inflammatory process in which loss of tooth dentin occurs. It begins in the root canals. 
  • Replacement Internal Resorption – This is also a rare condition in which the pulp and dentin inside the tooth are “replaced” by bone. 

Internal resorption most commonly affects the front teeth because they are most susceptible to trauma. It is also more likely to affect those people who have dental cavities. Men are more likely to experience internal resorption than women. 

External Resorption 

External resorption is much more common than internal resorption and affects the surface of the tooth root. It has four different types: 

  • External Inflammatory Resorption – Following external trauma, external inflammatory resorption results from the damage to the cementum and infection of the root canals due to cavities/leakage of bacteria. In this case, the roots of the tooth will look shorter than estimated. 
  • External Replacement Resorption – This occurs due to the same injuries that cause external inflammatory resorption. In this, the cementum, dentin, and periodontal ligament are lost and replaced by bone. This process results in the fusion of the tooth root to the bone surrounding it. 
  • External Cervical Resorption – While it is so-called, external cervical resorption doesn’t always affect the cervical region of the tooth. The dental cervix is the region of the tooth that sits between the crown and the roots. It is also referred to as the “neck” of the tooth. Cervical resorption can spread to other parts of the tooth. It can result in the loss of enamel, dentin and cementum. 
  • External Surface Resorption – This only involves the external surface of the tooth and affects the cementum, although it can also spread to the dentin. This usually occurs due to trauma, pressure or bacterial infection. If these stimuli are only present for a short while, external surface resorption may heal on its own. It is usually asymptomatic. 

As can be seen, this type of resorption results in the inflammation of connective tissue and damages the tooth structure from the outside in. The cementum and the root inside it can be affected by this. The most common cause of external root resorption is trauma.  

How Is Root Resorption Treated?

Treatment for root resorption depends on the cause and severity of the problem. If root resorption is occurring due to bacterial infection, you may be recommended a root canal treatment to prevent further damage to the tooth. 

The tooth that’s undergoing root resorption can stay in the mouth for a long time. Your dentist may not recommend extracting it unless the case is too severe. However, if there’s a need for extraction or you’ve lost the tooth, your dentist may recommend restorative treatment like a dental implant with a crown fitted on top. 

If the root resorption is occurring due to an orthodontic treatment like braces, it is possible that the dental appliance may be removed or readjusted. For those who have a teeth-grinding problem, a night guard can help with this problem. 

To prevent sports-related traumatic injuries to the teeth, a mouth guard is useful. Keep in mind that not all kinds of tooth resorption require treatment. Some of them may heal on their own, but you should get your teeth checked by a dentist first. 

How To Prevent Root Resorption?

It’s better to prevent root resorption from occurring in the first place, and for that, your dentist may recommend the following: 

  • Good dental hygiene – Since bacterial infection can set off this process, make sure that you have good oral hygiene. You need to brush twice a day using fluoride toothpaste and floss. If you wear braces, you can consider using an oral irrigator to better clean the spaces between the teeth. 
  • Wear a mouthpiece – If you have bruxism, you should wear a nightguard and a mouthguard if you’re a sportsperson. You can also consider wearing a retainer to further protect the teeth against traumatic injuries. 
  • Get regular dental checkups – Your dentist might be able to detect root resorption early on if you get regular dental checkups. It will prevent deterioration or complete loss of tooth structure. 

By doing these things, you can better take care of your teeth and avoid any extensive damage to them.  

Concluding Remarks

Everyone experiences root resorption in their lifetime. Through this process, the baby teeth fall out, and permanent teeth erupt. However, rarely does root resorption affect the permanent teeth of adults. In that case, it is not normal and could be occurring due to different reasons, such as dental trauma, cavities, infection, bleaching, orthodontic treatment, illness, tumour, cyst, or teeth grinding. In rare cases, the exact cause of root resorption isn’t known. 

For an accurate diagnosis, your dentist will most likely require a digital radiographic image of the teeth. Keep in mind that since the causes of root resorption are so varied, there’s no fixed treatment. It is possible that you may need a root canal or tooth extraction treatment. If you’ve lost the tooth, you may also require a dental implant to restore the aesthetics of your smile. If you’re experiencing any symptoms of this problem, make sure to get in touch with your dentist.