Tooth resorption is a dental condition where the body’s own cells begin to break down and absorb parts of a tooth. This process can affect the hard tissues of the tooth, including the dentin, cementum, and sometimes the enamel. Resorption can originate from within the tooth’s pulp chamber, known as internal resorption, or from the outer surface of the tooth root, termed external resorption. The condition is a concern for many individuals seeking to understand if its progression can be halted.
Understanding Tooth Resorption
Tooth resorption involves the gradual loss of tooth structure. Internal resorption begins within the pulp chamber, characterized by a uniform, semicircular radiolucent area continuous with the pulp canal space on an X-ray.
External resorption originates from the outer surface of the tooth, often near the gum line, and progresses inward. It can manifest as pink spots on the tooth where enamel is compromised. While normal resorption occurs in primary teeth to allow for permanent tooth eruption, its occurrence in adult teeth indicates an injury or infection.
Causes of Tooth Resorption
Dental trauma, such as luxation injuries or tooth displacement, is a common trigger. These injuries can damage the protective layers of the tooth, exposing the underlying dentin to cells that cause resorption.
Orthodontic treatment is another cause. Chronic inflammation of the tooth’s pulp or the surrounding periodontal ligament, often due to infection or an untreated cavity, can also stimulate the resorptive process. Certain dental procedures, like tooth bleaching or surgical interventions, are also predisposing factors. In some instances, the cause remains unknown, referred to as idiopathic resorption.
Stopping Tooth Resorption: Diagnosis and Treatment
In many instances, tooth resorption can be stopped, particularly when diagnosed early. The diagnostic process begins with a thorough clinical examination, where a dentist will look for visible signs like discoloration, swelling, or unusual tooth spacing. Dental X-rays are used to visualize the internal structure of the teeth and can reveal dark spots indicating tissue loss.
To precisely understand the extent and location of the resorption, 3D imaging techniques like Cone Beam Computed Tomography (CBCT) are employed. CBCT provides detailed cross-sectional views, helping to differentiate between internal and external lesions and guiding treatment planning. Once diagnosed, treatment options vary based on the type, location, and severity of the resorption.
Root canal therapy is a common treatment for internal resorption, as it involves removing the inflamed pulp tissue and the cells responsible for the resorption. This procedure severs the tooth’s blood supply to the affected area, halting the resorptive process. The root canal is then cleaned, disinfected, and filled to seal the space and promote healing.
For external resorption, surgical intervention may be necessary to remove the resorptive tissue and repair the affected area of the tooth. If the resorption has progressed into the dental pulp, a root canal may also be required in conjunction with the surgical repair.
When orthodontic treatment is a contributing factor, adjustments to the forces applied or even temporary removal of appliances may be considered to prevent further damage. In cases where the tooth is extensively damaged and cannot be saved, extraction becomes the last resort. For very slow-progressing or non-progressive cases, careful monitoring may be the initial approach.
Consequences of Untreated Resorption
If tooth resorption is not diagnosed and treated, the condition typically progresses, leading to more significant damage. As the resorption advances, individuals may experience symptoms such as pain, increased sensitivity to temperature, and gum swelling around the affected tooth. The continuous breakdown of tooth structure weakens the tooth, making it more susceptible to fractures or breaks, even under normal chewing forces.
Untreated resorption can also lead to infection as bacteria infiltrate the compromised tooth structure. This can result in the formation of abscesses, causing severe pain and swelling. Ultimately, if left unchecked, tooth resorption can lead to irreversible tooth loss. The loss of a tooth can then impact the alignment of adjacent teeth and overall oral health.