Tooth Resorption

Resorption is a body mechanism that eliminates hard tissue structures. It is a process when one part of the body absorbs or draws into another part.

In the oral cavity, resorption can occur in the jaw bone, tooth structure and root of the tooth.

Tooth and root resorption is a natural process that occurs in baby teeth. However, this event can be a topic of concern if it happens in permanent teeth.

So what happens during tooth resorption?

Tooth resorption is a process that causes inflammation and eventual loss of inner tissues of the tooth like dentin and cementum by absorption.

Two types of tooth resorption are divided by the kind of tooth surface being resorbed.

Early stages of tooth resorption are treatable. However, excessive loss of tooth structure cannot be repaired, and the tooth will have to be replaced.

This article will highlight the process of tooth resorption and its different types. We will also read about specific treatment options available to stop the process of tooth resorption.

What is tooth resorption?

Tooth resorption is a process which causes absorption of dentin and cementum due to the hyperactivity of osteoclasts.

Tooth resorption is usually a physiological process that is commonly seen during the exfoliation of primary teeth.

The permanent teeth exert pressure on the primary teeth to differentiate osteoclasts and initiate the process of resorption. (1)

However, when tooth resorption occurs in permanent teeth, it is considered as a pathological process.

Types of tooth resorption

There are two types of tooth resorption –

Internal

Internal tooth resorption refers to the absorption of the dentin and cementum into the tooth’s canal. This process inflames the inner and outer surfaces of the tooth.

The consistency of the tooth tissue changes from normal to an inflamed cell which gets absorbed into the tooth root. (2)

Internal tooth resorption eventually leaves the tooth hollow. Moreover, it weakens the tooth structure and makes it prone to damage and tooth decay.

The first sign of internal tooth resorption can be seen as a discoloration of the tooth. Usually, the affected tooth has a pinkish tinge on its surface.  The cause of internal tooth resorption can be detected from a dental x-ray by the dentist.

External

External tooth resorption affects the outer layers of the cementum and dentin. It may also affect the gums. (3)

In some terms, external tooth resorption is similar to internal tooth resorption. The symptoms include a brittle and inflamed tooth which is highly susceptible to tooth decay and damage. Other signs of external tooth resorption may consist of –

  • Tooth discoloration – not as prominent as seen during internal tooth resorption
  • Tooth sensitivity
  • Tooth loss
  • Tooth infection
  • Shifting of adjacent teeth
  • Gum and jaw problems

Causes

Several triggers activate the osteoclasts to start the process of tooth resorption. The cause of tooth resorption may differ for each type.

Causes for internal tooth resorption

Breakdown of internal tooth structure can happen due to the following reasons –

  • Tooth decay – excessive bacterial accumulation on the tooth structure can penetrate to cause infection of the pulpal tissue. Pulp infection can trigger the process of internal tooth resorption can cause inflammation within the tooth
  • Dental trauma – any injury to the tooth can cause internal tooth resorption
  • Use of specific chemicals – extreme heat or use of particular substances like bleaching products for tooth whitening cause breakdown of the tooth structure

Causes for external tooth resorption

External tooth resorption is caused by –

  • Gum diseases – plaque and bacterial accumulation around the gums can trigger inflammation of the tissues and cause external tooth resorption
  • Orthodontic treatments – rapid teeth alignment using excessive force by braces can cause trauma to the gums and the teeth. This process gradually causes external tooth resorption
  • Chemicals – any chemical applied on to the surface of the gums and teeth may trigger the process of external tooth resorption
  • Trauma – injury to the surface of the tooth is a common cause of external tooth resorption

Treatment

Treatment modalities depend on the cause, type, and extent of tooth resorption. Early stages of tooth resorption can be treated by –  (4)

  • Root canal treatment – to fill and seal the tooth
  • Gum surgery if required
  • Laser gum reconstruction in extreme damage to the gums

Unfortunately, advanced stages of tooth resorption cannot be repaired. However, the only line of treatment for such cases is tooth extraction and replacement using implant, crown or bridge.

Prevention

Good news is that proper care and specific preventive techniques can help you to stay away from the misery of tooth resorption.

You can prevent tooth resorption as follows –

  • Wear a protective mouth guard while playing outdoor sports to protect the teeth from trauma or injury
  • If you have the habit of clenching r grinding your teeth, wear a bite plate to prevent erosion and inflammation of the tooth structure
  • Maintain good oral hygiene. Bacterial infections are the prime cause of tooth decay and resorption. Brush and floss regularly to maintain a healthy mouth
  • Do not miss your regular dental check-ups. A dentist can detect tooth resorption at an early stage and can help to stop the process immediately and save you from losing a tooth.

Take away message

Tooth resorption is becoming an increasing dental problem. The symptoms are often painless, and the initial signs may not be noticeable by the patient.

In such cases, tooth resorption often progresses causing loss of tooth and trauma to the surrounding gums and bone.

Regular dental check-ups can prove to be helpful in such situations. A dentist is the best person to diagnose even minor dental issues and treat them appropriately.

Prevention is always better than cure. Take precautions while playing sports. Keep a check on your oral habits to maintain the health of your oral tissues. Stay aware and live healthily.