Q.F. Nayibe Cubillos Morales
Dr. Gustavo Assatourians D.D.S
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Dental resorption is a serious dental condition that requires immediate attention. This comprehensive guide covers everything you need to know. Discover the signs, symptoms, and prevention strategies as well as the available treatment options.
What is Dental Resorption?
This is an abnormal condition that occurs when part of the dental tissue is lost, either by the action of cells that destroy the tissue, or the surrounding tissues that damage or “reabsorb” the tooth. Dental resorption can occur anywhere in the tooth.
What are the Types of Dental Resorption?
There are two main types of dental resorption:
1. External resorption
•Occurs on the external surface of the tooth.
•Is the most common.
•Bone cells or the presence of other teeth destroy dental tissue, causing loss of structure.
•It can be caused by factors such as bone pressure, contact with an adjacent tooth, dental infection, or injury.
2. Internal resorption
•It occurs inside the root of the tooth.
•Dental pulp cells (the soft tissue inside the tooth) start to destroy dental tissue, causing the loss of dental structure.
•It is usually detected with radiographic images.
Internal resorption is the progressive destruction of dentin, with its corresponding traumatic effects and infection. We have a complete and comprehensive guide about internal tooth resorption that can help you to maintain your good oral health.
Why does Dental Resorption Occur?
Several causes can contribute to dental resorption. Among them are:
1. Dental trauma: It can be caused by trauma to the tooth, such as a fracture or injury.
2. Dental infection: Untreated dental infections can cause tooth resorption.
3. Impacted teeth: When teeth get stuck inside the bone or try to come out in the wrong position, they can resorb the tissue of another tooth, damaging its structure.
4. Orthodontics: Excessive pressure exerted by brackets or wires can cause dental resorption in some patients. This risk increases if the patient has already undergone other orthodontic treatments in the past.
5. Dental reimplantation or transplantation surgery: When a tooth is lost or extracted and inserted back into the bone, the risk of dental resorption increases.
Signs and Symptoms
Most of the time, patients with dental resorption do not present symptoms. However, depending on the type and severity of the condition, the following may occur:
•Pain
•Pink or grayish dental discoloration
•Dental fractures
•Cavities in the teeth
•Spaces between the teeth
•Gum inflammation
How is Dental Resorption Diagnosed?
Dental resorptions are usually detected through a combination of methods:
1. Dental exam: The dentist evaluates the condition of the teeth, looking for signs and symptoms of resorption, and then applying sensitivity tests to cold and/or hot stimuli.
2. Interview: Dental history is important for diagnosing tooth resorption. The dentist may ask about the presence of symptoms, episodes of trauma, or orthodontic treatments performed in the past.
3. Diagnostic imaging: Most dental resorptions are discovered through diagnostic imaging. Although X-rays can detect some lesions due to resorption, tomography provides more reliable, detailed, and truthful information, so your dentist may recommend this exam.
Can I have Dental Resorption Without Knowing it?
The answer is yes. A study by the University of California showed that one-third of root resorptions are incidentally discovered during diagnostic imaging because patients do not present symptoms.
Treatment Recommendations
After identifying the extent of the lesion and its location, the treatment for tooth resorption aims to stop the damage to the dental tissue to preserve the tooth. Treatment options depend upon the type and severity of the condition and may include one or several of the following:
1. Root canal treatment
If dental resorption has affected the dental pulp, endodontic treatment may be required to remove the affected tissue and prevent the spread of the condition. It is likely that more than one appointment will be needed to finalize this treatment.
2. Dental restoration
The placement of a dental crown or composite restorations may be necessary to protect the affected tooth and restore its function and appearance.
3. Extraction and replacement of the tooth
When dental resorption has caused a significant loss of dental structure, dental extraction may be required. Subsequently, a prosthodontist could replace it using a prosthesis, a fixed bridge, or a dental implant.
It is important to mention that in some cases, when dental resorption is detected in time, and the cause of the damage is eliminated, the dentist may decide not to perform any treatment and monitor the condition of the tooth over time.
What happens if dental resorption is not treated in time?
Possible complications of dental resorption include:
•Infection
•Dental fractures due to weakening of the structure
•Color changes in the tooth
•Large cavities or holes
•Pain in advanced cases
•Dental loss
How to Prevent Dental Resorption?
Preventing dental resorption can be difficult since the cause of the condition is not always established. Nevertheless, some measures can help prevent dental resorption, including:
1. Maintaining good oral hygiene
Brushing your teeth three times a day with fluoride toothpaste, using dental floss, and regularly visiting the dentist are behaviors that help prevent dental caries and other conditions that may contribute to dental resorption.
2. Performing orthodontic treatments with a properly trained professional
Orthodontics performed by untrained individuals increases the risk of applying excessive force to the teeth, thus causing dental resorption. Therefore, it should always be verified that the healthcare provider is authorized to provide this service.
3. Avoiding dental injuries
The use of mouthguards is recommended in patients with bruxism or who practice sports that increase the risk of dental fractures.
Conclusion
•Dental resorption is a serious condition that may involve tooth loss if not treated in time and correctly.
•If dental resorption is suspected, it is important to consult a dentist or endodontic specialist for timely evaluation and diagnosis.
•Early diagnosis can help prevent tooth loss and other dental complications.
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References
1. Cirino, E. (Mau 29, 2019). Resorption of teeth: Causes, symptoms, and what to do. Healthline. https://www.healthline.com/health/dental-and-oral-health/resorption
2. Dexter, A. (s/f). Tooth resorption: Internal, external, causes, symptoms, and treatment. Dentaly.org. Recovered April 21, 2023, of https://www.dentaly.org/us/oral-health/tooth-resorption/
3. What is external resorption? (s/f). WebMD. Recovered April 21, 2023, of, de https://www.webmd.com/oral-health/what-is-external-resorption
4. Differentiating Resorption. (Jan 5, 2021). American Association of Endodontists. https://www.aae.org/specialty/differentiating-resorption/
5. Dao, V., Mallya, S. M., Markovic, D., Tetradis, S., & Chugal, N. (2022). Prevalence and Characteristics of Root Resorption Identified in Cone-Beam Computed Tomography Scans. Journal of Endodontics, 49(2), 144-154. https://doi.org/10.1016/j.joen.2022.11.006
6. Datana, S., & Radhakrishnan, V. (2011). Internal resorption: an unusual form of tooth resorption. Medical journal, Armed Forces India, 67(4), 364–366. https://doi.org/10.1016/S0377-1237(11)60087-7
7. Ne, R. F., Witherspoon, D. E., & Gutmann, J. L. (1999). Tooth resorption. Quintessence international (Berlin, Germany : 1985), 30(1), 9–25.
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