ROOT RESORPTION, UNUSUAL, BUT CAN HAPPEN TO YOUR FRONT TOOTH
My patient’s upper front tooth was discolored at the gum line. Clinical examination detected a “hole” at the neck of the tooth just under the gumline. She had no idea the defect was there!
Although unusual in adults, root resorption is a phenomenon characterized by the process where one’s own body cells eat away and dissolve the tooth structure involved. Often, this process is asymptomatic and is not related to infection or pain. Root resorption can begin on the inside ( internal resortpion ) or on the external surface of the tooth ( external resorption ), the more common manner. When visible from the cervical ( neck-like ) surface of the tooth, it typically is located just under the gum line and may appear pinkish, or dark when associated with a more advanced cavitation or hole. If not treated in a timely manner, the damage extends deeper and invades unrestorable aspects of the tooth.
Resorption ( breakdown ) and deposition ( adding ) is a fine balance achieved by the body and is necessary for normal growth and maintenance. When imbalanced, the body’s response to resorption is detected via a damaged area. Several factors are associated with external root resorption of the dentition. I will name a few:
- Excessive Orthodontic Pressure may cause resorption in later years.
- Trauma may damage the periodontal ligament, one which attaches your teeth to the surrounding bone.
- Internal Teeth Bleaching may cause resorption if completed without protecting the surrounding tooth structure
- Teeth Grinding
Although not fully understood, external root resorption can be associated with the above factors although the majority of patients having experienced these go on normally without developing any resorptive signs or symtpoms.
Root resorption, although usually painless, has the potential to cause great damage to the tooth structure, rendering the affected tooth hopeless. It is typically detected on a routine xray and appears as a dark spot. Clinically, if not treated early, extensive damage and invasion of surrounding tooth structure may cause enough damage to render the tooth unrestorable and in need of an extraction and replacement with a dental implant. The most common teeth affected are the upper front incisors and canines and the lower first molars.
Destruction can be rapid. Treatment should be rendered as soon as the defect is detected. When small and accessible, the lesion may be treated by exposure at the gum line ( at times requiring minor gum surgery ), the bad cells removed, and the defect restored by a tooth colored resin or similar material that matches the original shade of the tooth in question. More extensive damage may require orthodontic assistance and more extensive surgery to expose the damage and actually create a restorable environment. Cone Beam Imaging that allows three dimensional views to be evaluated can be extremely important in accurately diagnosing the problem and determining the extend of the damage.
Although uncommon, tooth resorption is often treated successfully. The key is early detection and immediate treatment to prevent it extension into deeper and less accessble aspects of the tooth.
This should serve as another reason to schedule regular visits to your dentist’s office, completing comprehensive examinations, radiographic assessments, and hygiene maintenance.
Afterall, our aim is to help you achieve, and maintain, a “Smile You’d Be Proud To Wear…ANYWHERE!”