I need some dental advice. Has anyone suffered from any root absorption as a result of orthodontic work?
I was in braces years ago. I had a nice straight smile for a while as a result. However, a year ago, I started to notice bony bumps on my gums below four of my lower front teeth. Also, some of my teeth had gotten out of line again as a result of me not wearing my retainer (shame on me!). I want to get my two front teeth aligned again and my lower fronts. I went to my dentist a month ago and she looked at the bumps and gave me an X-ray. To my horror, the X-ray showed the roots on those lower front teeth with the bony gums had worn away quite a bit. They looked like they had been sanded down flat, whereas the healthy roots on my other teeth were nice and pointed. She thought it was root absorption that was caused by moving my teeth too fast and that I would need a root canal. She sent me to an endodontist who did not think she was correct and that I was fine. I am scared to move anymore of my teeth now even to get them straightened. Can further ortho work cause more root absorption?
The best answer
Root resorption can be the result of several different local and systemic problems. For example, some local factors for root resorption would include a history of orthodontic tooth movement, a history of internal bleaching for an endodontically treated tooth, erosion by a cyst or other expansile lesion, a history of traumatic injury to a tooth, or a failed root canal treatment. Of the systemic factors, root resorption sometimes develops as a result of endocrine disturbance (e.g., hyperparathyroidism), or disseminated malignancy. However, a relatively large proportion of root resorption is of unknown cause, or "idiopathic". I very much doubt that you are doing something that is causing your problem. Although isolated areas of root resorption can sometimes be managed by a combination of root canal therapy and surgical curettage of the affected area, the results of these interventions often do not justify all the effort. Unfortunately, it is difficult or impossible to manage idiopathic root resorption, since (by definition) the cause cannot be addressed. I feel your frustration, as well as that of your dentist. Although I am ambivalent about raising another issue, I feel I would be remiss if I didn't offer one more note of caution. There has been increasing evidence of late of an association between Fosamax and other drugs of its class and a diminished capacity for bone healing. Specifically, these types of medications predispose the jaws to serious chronic infections following extractions or other surgical procedures. Because this side effect is only now becoming more widely known, the management of these complications and the means of preventing them from occuring are in a state of flux. It is important that your dentist remain fully informed about current protocols with regard to this drug should you require tooth extractions in the future.
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