Our bodies are capable of amazing things. Throughout our entire lives, and with no conscious effort on our part, they are constantly building, repairing, and removing tissues and bones. For the most part, this activity is positive. In some cases, though, the balance of construction and destruction can be thrown off. Internal tooth resorption is one such case. Here’s what it is and how dentists treat it.

What is tooth resorption?

Tooth resorption begins as a natural process in children, but it can become serious in adults. The word “resorption” means, essentially, breaking down and absorbing. Our body is constantly breaking down what do not need and either eliminating it or absorbing it into our bodies.

While this is helpful for some processes (e.g., removing toxins and waste), when it comes to teeth, resorption is not always positive. Tooth resorption in children is a generally harmless event that is a necessary part of growth and development. Baby teeth must move to make way for adult teeth. In adults, internal tooth resorption can seriously impact oral health, potentially resulting in tooth loss.

To understand tooth resorption it can be helpful to know more about a tooth’s structure.

Tooth structure

The visible part of a tooth—the part outside of your gums—is called a crown. This part of the tooth consists of an outer layer of enamel that covers dentin. Dentin is the harder living tissue that forms the bulk of the tooth. Inside the dentin is dental pulp. Dental pulp consists of softer living tissue and nerves.

The crown of the tooth anchors in the jawbone by one to three roots. These roots are encased in connective tissue called cementum. This attaches to the jawbone with the periodontal ligament.

Types of tooth resorption

Tooth resorption occurs when something triggers a destructive response in your teeth. There are two types of tooth resorption: internal tooth resorption and external tooth resorption.

Internal tooth resorption occurs when the breakdown begins inside the tooth, either beneath the gumline or in the dental pulp itself. Conversely, external tooth resorption starts on the outside of the tooth, moving through the enamel and then into the dentin.

Internal root resorption is largely an invisible process.

What causes internal resorption of a tooth?

There are two further types of internal root resorption. Each shares internal tooth resorption causes.

  • Internal root canal inflammatory resorption: The inflammatory type of root resorption occurs with a simple breakdown of tissue and does not leave behind any waste or deposits.
  • Internal root canal replacement resorption: Replacement root resorption occurs when the body begins to create more material to replace what is being absorbed. This results in deposits of bone-like tissues in or around the dental chamber.

The most common causes of both types of internal root resorption are trauma and infection.

Trauma

Trauma can be any type of injury that occurs within the mouth. This can occur because of an accident or some kind of blow to the jaw.

Infection

Infection is a broad category that includes a number of possibilities. Dental abscess, cavity, and periodontal disease can all come with infection that leads to internal root resorption.

Internal root resorption can also occur when teeth are moved too quickly with braces (or for an extended period of time).

In all cases of internal root resorption, the body essentially turns on itself. Like an autoimmune disorder, it becomes unable to tell what part of the body is unhealthy and thus attacks cells indiscriminately.

What are common internal root resorption symptoms?

There are very few overt internal root resorption symptoms, making this dental condition one of the most difficult to diagnose. If nerves are involved in the internal resorption, patients may experience pain or discomfort, but this is not common.

In many patients, pink spots (lesions) will appear on the affected tooth. These lesions resemble cavities in size but are not “sticky” when probed with a dental scaler (as cavities are). As the internal root resorption progresses, the entire tooth may appear to be pink. This is due to an excess of blood inside the dental pulp.

Dentists will also use routine radiographs to diagnose internal root resorption. If the lesion is visible in the dental pulp, then chances are good it is internal resorption.

Once the cells have all been resorbed, the tooth may turn grey, brown, or black, indicating a bad tooth.

What internal root resorption treatments work?

If internal root resorption is discovered after your tooth is necrotic, the only treatment option available is extraction (followed by restoration). With early detection, there are internal resorption treatments that can work to save your tooth and bring it back to health.

Root canal therapy

Root canal therapy cleans out the dead pulp and can halt the progression of disease.

Patients often experience quick recovery after the cycle of resorption is broken with this procedure. Root canal therapy is the most successful treatment option for saving a tooth.

Treatment for periodontal disease

If the internal root resorption occurs because of periodontal disease, it is crucial to treat the underlying cause.

Scaling and root planing are the standard of care for periodontal disease, with antibiotics like Arestin sometimes indicated as well.

Improved dental hygiene

While just doing a better job with brushing and flossing won’t halt the progression of root resorption, this simple step can go a long way to prevent further infection or bacteria colonization below the gumline. After your treatment for periodontal disease, a review of proper dental hygiene practices, including the proper way to brush teeth, may be in order.

Early diagnosis is key. It is important to visit your Phoenix area dentist twice annually for regular cleanings and annual X-rays. If it has been awhile, get in touch with AZ Dentist to schedule your appointment today!

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