All about the Strange Condition known as Tooth Resorption

Tooth resorption is a bit of an odd condition.  Sometimes the body’s defense mechanisms become the body’s own worst enemy.  This betrayal of the body by its own defenses is at the center of several medical conditions.  Tooth resorption is just such a condition.

What is tooth resorption?

Resorption is when the body’s immune system turns on itself and begins destroying the tooth itself, as if the tooth were a foreign body invading and threatening the body.

What causes tooth resorption?

The typical causes of tooth resorption all have to do with pressure being applied to the tooth in question.  If one suffers a blow to the area of the teeth, for example, this could lead to the destruction of the entire tooth, because as the body attempts to dissolve the pieces of broken root, it sometimes continues onto the actual tooth.  If the root is substantially damaged the body goes on to break down the actual tooth.

Resorption might also arise from a tooth that erupts in the wrong place, putting pressure on the root of an already existing tooth.  This is, in fact, what happens normally with children when they lose their primary teeth in favor of their adult “secondary” teeth.  In children, the process occurs quite naturally.  When a misplaced tooth affects an already existing adult tooth, however, this can lead to problems.

If you have a bacterial infection that leads to inflammation, this too can weaken the root and lead to tooth resorption.  Tumors and cysts hidden beneath the gum line can also lead to a weakening of the root and be an early sign of a more serious condition.  In fact, if tooth resorption goes untreated it is likely to spread.

Two Types of Tooth Resorption

Dentists distinguish between two types of tooth resorption, external and internal.  An external resorption occurs when the root is attacked from its exterior edges and slowly dissolved, weakening the base of tooth.  Soon the tooth itself starts weakening and may either fail or suffer resorption as well.

More insidious is internal resorption, which happens when the root is destroyed.  When this happens, the deterioration occurs within the actual pulp of tooth.  Often the first true sign of a problem occurs when pink gummy tissue pops like a bald spot through the crown of the tooth.  This condition goes by the oddball moniker, “Pink tooth of Mummery”.  James Howard Mummery was a famous late 19th to early 20th century British dentist who wrote a well-respected guide to dental anatomy.

Treatment

Dentists treat external resorption via a combined therapy involving first killing bacterial infection with a treatment of calcium hydroxide and then possible root canal therapy, if necessary.  (See below.)

The usual treatment for internal resorption is root-canal therapy.  Root-canal therapy is a procedure that does not involve actual surgery.  The procedure is similar to getting a filling, except that in this case the cavity being filled is inside of the base of the tooth.  The dentist opens a small passage into the pulp, sucks out the infected material within, and then fills the newly formed cavity.  The dentist then seals hole and usually crowns the tooth.  In some cases, the tooth is then technically “dead” after this procedure.

The patient comes later for a follow up treatment to check to see if the process of resorption has restarted.  Sometimes the dentist must erect internal barriers to prevent further resorption. 

Of course, your dentist may find that in your particular case a different course of treatment is necessary.  Individual cases vary.  In general, however, resorption should not result in dental extraction if you dentist catches it in time.