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Tooth Resorption
I went to see my dentist last week and from a routine x-ray he diagnosed one of my teeth with resorption . He said I will need a root canal but could not guarantee me that the tooth would last. Please give me some information about tooth resorption that may help me better understand what it is and what may happen to my tooth.-Karen L.
Tooth ?resorption? is when the body?s own cells attack and destroy actual tooth structure. The resorption can be either external or internal.
?External tooth resorption? occurs when the cells on the outside of a tooth attack and eat away at the outside surface of the tooth or its root. Logically, ?internal resorption? is when the tooth is attacked from the inside out. In reality, these are exactly the same situation, but they happen in different areas. No matter where tooth resorption is taking place, it is not a good situation.
The external type causes resorption of calcified dental tissue, beginning on the external surface of the root and extending through the cementum (outside root covering), dentin (layer under both the cementum and enamel), and eventually into the pulp chamber and root canal which houses the nerve and blood supply for a vital tooth. This kind is much worse and has a much poorer prognosis than internal resorption. As a matter of fact, most cases of external resorption result in tooth extraction.
If the destruction is limited only to the root of a tooth, then this is known as ?root resorption?. One type is ?external root resorption?. This is most commonly seen as a situation arising from unintentional, rapid orthodontic treatment but can occur for other unknown reasons. External root resorption is easily diagnosed by dental x-rays because the root of the tooth or teeth in question appears much shorter than normal or the sides of the root may appear eaten away. If the root pathology is too severe, then extraction is indicated.
If the damage is from inside the root, then it is called ?internal root resorption?. It can be difficult to treat because it can create round, hollow areas inside the root that can not be debrided properly, even with the most current root canal instrumentation.
The most treatable resorption overall is internal resorption. Here the cells are eating their way from the inside of the tooth out. This is often difficult to diagnose because it is usually asymptomatic and often not noticed until the tooth becomes so weak that it crumbles while chewing. Every tooth has a chamber within its crown that houses the majority of the nerves and blood vessels that supply the root canals for that tooth. This is called the pulp chamber and the problem usually starts at the top of the root canal and spreads into the chamber.
Internal resorption is generally painless and moves at a slow rate. If it is caught early enough, these damaging cells can be removed with standard root canal therapy and the resorption may cease.
We are not exactly sure what causes tooth resorption, but we do know that there is a relationship between resorption and trauma from tooth decay or a physical assault on the tooth. A cracked tooth?s cells can occasionally malfunction and resorb tooth structure and an unfinished or inadequate root canal therapy can cause internal tooth resorption. Regular dental exams and necessary dental x-rays are the best way to diagnose and treat dental disease, including resorption.
Read Dr. Mady's informative Windsor Star column Ask the Dentist on the first Thursday of each month.
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