Dr. Greg Jorgensen
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Rio Rancho, NM 87124

The Jorgensen Orthodontics Blog

Do Braces Make the Roots of Your Teeth Shorter?

Posted by Dr. Jorgensen on March 23rd, 2013

I was recently asked to be an expert witness against another orthodontist in my community that had “caused” some root shortening (root resorption) in one of his patients. Could something that orthodontist did actually have caused the roots to get shorter? How serious is root resorption? Can it be prevented or treated?

Braces work by creating little cramps or “Charlie Horses” around each tooth. The enzymes that are summoned by orthodontic forces cause old bone to dissolve where there is pressure and new bone to be formed where there is a void. These responses are normal and are the basis for orthodontic tooth movement. Research has shown that tooth movement causes at least small changes in the shape and length of the roots in ALL patients. In 98% however, these changes are undetectable with the naked eye.

In 1-2% of patients, however, obvious root shortening occurs during routine orthodontic treatment. These patients are just more genetically susceptible to root resorption. I have even noticed that root shortening runs in families (after noticing resorption in two children from the same family I looked at the mom’s records and found the same thing). This genetic predisposition is important and should be communicated to your orthodontist if you are aware that it has been noticed in your family.

Are there things an orthodontist can do to cause or prevent root resorption? Some have theorized that root resorption happens if the teeth are moved too quickly or too slowly. Teeth that are moved too quickly may be subject to too much force they say. However, in my cases where I’ve seen resorption I’ve used exactly the same amount of force for exactly the same amount of time as everyone else. Braces that are on longer logically have more time to cause a problem. Having said that, I’ve seen transfer cases that have had braces on for more than 5 years with no signs of root change. There really is neither documented cause of nor protocol to follow to prevent this shortening.

So what can be done about root shortening during treatment? About the only thing we can do as orthodontists is monitor our patients during treatment using routine x-rays. These should be taken at least annually as long as the braces are on. If root shortening is noticed, it should be pointed out and discussed with the patient and their family. Depending upon the amount of shortening, treatment may be continued as normal, the treatment time shortened (stopping after spaces close for example), or the braces immediately removed. It is generally believed however that a tooth can lose up to half of its root length and never have a problem. In my 21 years of private practice, not a single tooth has been lost to root resorption.

My answer to the prosecuting attorney trying to sue my competitor was this. “Root resorption is a normal consequence of orthodontic treatment. I’ll bet [the doctor] can produce hundreds of cases he’s treated exactly the same way without incident. As long as he took annual x-rays to monitor the presence and amount of shortening, I think he’s done everything he possibly could to give his patient good treatment. I don’t think you have a case.” I never heard from him again. Be sure you allow your orthodontist to take x-rays on a regular basis to monitor your progress and screen for problems during treatment. Ask him to specifically look for root shortening if he doesn’t bring it up himself.

NOTE: The author, Dr. Greg Jorgensen, is a board-certified orthodontist who is in the private practice of orthodontics in Rio Rancho, New Mexico (a suburb on the westside of Albuquerque). He was trained at BYU, Washington University in St. Louis, and the University of Iowa in the United States. Dr. Jorgensen’s 25 years of specialty practice and 10,000 finished cases qualify him an expert in two-phase treatment, extraction and non-extraction therapy, functional orthodontics, clear aligners (Invisalign), and multiple bracket systems (including conventional braces, Damon and other self-ligating brackets, Suresmile, and lingual braces). This blog for informational purposes only and is designed to help consumers understand currently accepted orthodontic concepts. It is not a venue for debating alternative treatment theories. Dr. Jorgensen is licensed to diagnose and treat patients only in the state of New Mexico. He cannot diagnose cases described in comments nor can he select treatment plans for readers. Because he has over 25,000 readers each month, it is impossible for him respond to all questions. Please read all of the comments associated with each article as most of the questions he receives each week have been asked and answered previously. The opinions expressed here are protected by copyright laws and can only be used with written permission from the author.

148 comments so far in response to “Do Braces Make the Roots of Your Teeth Shorter?”

  1. Taryn says:

    Hi Dr. Jorgensen,

    I had braces on for 5 years, which was almost 3 times the amount of time that my orthodontist had originally projected for treatment time. She would always say she “overcorrected” my teeth at one appointment, and then say she “undercorrected” them at the next one, indicating that she moved my teeth quite rapidly.

    During this time, she and the referring dentist never took x-rays of my teeth. It was only upon conferring with another dentist for a second opinion that I was told that more than half my roots were gone and had a severe case of root resorption.

    I am unsure of whether or not to pursue this in court. One periodontist we consulted said there was no way we could prove when the resorption was caused during the course of the treatment. In your opinion, do I have case?

    Thank you!

    • It is extremely difficult to prove root resorption in court as your orthodontist can probably produce hundreds of other cases treated the same way in which the root lengths didn’t change. Root shortening occurs in 3-5% of patients regardless of what the orthodontist does. The only thing we can do is monitor their length and discuss the changes with the patient. Your orthodontist should have at least done that. Having said that, I don’t understand how or why a dollar amount could be assigned to root shortening unless you have to replace some of your teeth.

  2. Mae says:

    I had braces from when I was 11 to 13 years old and am now 22. My teeth were still never perfect and I have neither an under bite or over bite. My roots on my two front teeth resorbed during the braces. I wish Invisalign could fix my bite but I’m pretty sure that’s a braces fix… And if I open real wide my jaw does pop. I want braces again so I don’t have jaw problems In the future but I wanted to know if braces could be possible or not at this point…

  3. Caitlyn says:

    I recently got a palatial expander about a week and a half ago, and I already have a small gap. But I go back in about a month and they’re gonna lock my expander then put on top braces. Is it normal to have a gap this early? And how big will the gap get?

  4. Carmen says:

    I’ve had braces through a phase 1 and 2 system where I was born with mandibular prognathism and really crooked teeth. Started out with an expander for my upper jaw and braces on my top front four teeth to fix the underbite. There was the issue that as a kid, I was grinding my teeth and causing gumline recession that was threatening my teeth. So that was the first phase, started in Grade 4, so when I was about 9 or 10 years old. Some time into phase 1, I get an operation on the tag of skin connecting my gums to my lips in an attempt to slow the gum recession.

    Flash forward three years of treatment and two years of a break from treatment and I’m back in for phase 2. I have neither an underbite nor an overbite however the angle of my bottom teeth threatens to gradually shatter themselves from the impact of my top teeth. My underbite is also showing signs of relapse. Luckily, an x-ray shows that I have especially long roots so my teeth can take quite some movement before it gets sketchy.

    Flash forward another 2 years and it’s the present. So we’re getting to the point of this post, lol. My front teeth are where they should be and they’re just putting the finishing touches on my bottom teeth. On my next appointment, they’ll tell me when I can finally get my braces off. (I’ll need a permanent retainer though apparently) But tonight before I looked up this blog I panicked when I felt one of my top front teeth moving! I was thinking, it isn’t supposed to be moving because they’re just trying to hold the top teeth in place while they’re finishing with the bottom?? So after 6 years of treatment have the long roots run out of time or am I just over stressing?

    • The only way to tell if you have a problem with root resorption (short roots) is to look at an x-ray. Less than 5% of patients ever have a problem no matter how long the treatment. Ask your orthodontist to review your x-ray with you after your braces come off so that you’ll know exactly what is going on.

  5. Suleyma says:

    Well I have had braces for a while now and my orthodontist told me that I had to get me six month clean up but on the sheet she gave me it said ROOT RESTORATION is that bad?

    • I’m not sure what you orthodontist means by “restoration.” Root “resorption” means root shortening and that may be bad. Root restoration may mean that you need some decay repaired on your roots.

  6. Vernay says:

    My orthodontist put braces on me today. After they were bonded, and I went to schedule a future appointment, the receptionist gave me this release of Liability form that reads as follows:

    This signed form is intended to certify that I, Mrs… request orthodontic treatment from______ and thoroughly understand there are considerable risk of root resorption and possible loss of multiple teeth.

    As discussed with Mrs…. she has very short roots. We have thoroughly discussed other treatment options and Mrs….. has chosen to start orthodontic treatment fully understanding the risks involved, specifically with root resorption (shortening of the roots of her teeth).

    Mrs…..has been given an opportunity to think about the risk of potential root resorption and non-ideal results associated with starting orthodontic treatment and has chosen to start treatment understanding the risk. We have also discussed that her final occlusion will be compromised to multiple existing missing teeth.

    I hereby release Dr…. from any responsibility associated with her orthodontic treatment.

    If I would have been given this letter prior to the bonding, I would not have bonded my braces. I am 50 years old and am afraid. What would you do in this case? Any suggestions?

    Thank you in advance!

    • Root resorption is real and must be addressed. The only thing you can really do is just monitor the length of the roots (an x-ray every 6 months during treatment) and remove the braces if a problem develops. The form they presented you just let you know that they recognized the issue and want you to know that you ALL need to communicate during treatment so that the issue is not ignored. I’ve never had a patient lose their teeth due to root resorption.

  7. Marcela says:

    Hi Dr. Jorgensen, I have short roots and after reading your article, I still am not completely at ease. When I went in for my consultation, I was told I had short roots, but that they could “fix everything.” It had been suggested at the time that I would need to get TADs if I wanted to because I’m really gummy. After thinking about it, I came to the decision that yes, I want to get them. Every time I mention it though, my orthodontist has some reservations but won’t tell me directly if my teeth will fall out, even though I’ve asked her every time. She says it can be risky, but is willing to have me try them on and do a monthly check up. I have been so worried about this. Should I get them, and is there a possibility my teeth could fall out? Thank you for your time. -Marcela

    • I’ve never seen anyone lose their teeth because of root resorption, but that’s because I monitor the root during treatment. That is all any doctor can do. You and your orthodontist just need to work together to keep your eye on your roots and decide along the way if you’ll need to end your treatment early.

  8. Ken Brown says:

    My 9-year-old boy has rapid palatal expander and crozat for treating over crowding. During treatment, one of baby tooth (canine) is loose. Is it OK to continue with the treatment? Is it root resorption or is it normal? Thank you

  9. Cristine says:

    Here is a thinker for you.I am an identical twin and we both had braces at the same time. My teeth were twice as bad as my sister’s (I was badly buck-toothed with the next teeth turned sideways). We were both subjected to horrible treatment done by the orthodontist, but worse by his ‘assistants’ that did all the work. But I digress. He spent more time focused on bringing my jaw forward with a bionator rather than straightening my teeth. My father had enough and told him to just straighten my teeth. Anyway, my sister had her braces on for over 2 years. My teeth, which were really bad, had braces on for less than a year. I lost a lot of weight because of the inability to eat due to pain from excess tightening over a short period. I was later told by a dentist that was out of his region (and not under his influence) that I would be lucky if my teeth would last until I was 40 because of such horrible root shortening. I had regular x-rays at this place and nothing was mentioned.

    • I am sorry that your experience with braces was not good for you. I assure you that is not the norm. As for your root shortening, the good news is that after tooth movement has ended (your braces off), root shortening ceases. You need to be aware that your root are now shorter, but in 25 years of being a specialist, I’ve never seen a single patient lose a tooth because of it. I’ll be surprised if you every lose your teeth. Good luck!

  10. Good morning says:

    I am writing with the reference to the problem which I have. I have been wearing braces for 6 months ( 6 months upper jaw, 4 months lower jaw). Upper jaw is ok, but I have realized that I have loose teeth (especially anterior) in my lower bone. The last movement of my braces was done on 5th September. I decided that I would not move my teeth in the lower jaw till the moment they stabilize. My orto. decided that she would remove the braces from the lower jaw on 30th of October. The movement of the teeth is visible from 19th September till today, so 9th of November (although the last movement of the braces was on 5th September). Besides that, I am pregnant (have just started 30th week). My gums were puffy and occasionally bleeding during some weeks in the middle of pregnancy but it disappeared. I started my treatment in the same month I got pregnant (but did not know that the pregnancy had already started, x-rays were made 4 months before the beginning of the treatment). I have received some information that my teeth can be additionally loose because of hormones and braces (everything together). I am scared that the bone will not rebuilt because of minerals taken by the child. I have also a mild diabetes in pregnancy which should theoretically disappear after the childbirth. Is that possible that the worst case scenario of the treatment has already started? Or do you think that the period of the treatment is too short to damage the bone entirely and there is a huge likelihood that everything will stabilize. For me it is a horror story, really. I wanted to undergo a treatment and although it has already started, I have encountered so many problems. And …the fact that the braces while being pregnant are not an evil ( which my orto. confirmed) is untrue :(. Greetings from Poland and looking forward to your answer.

    • I am not an expert on pregnancy nor diabetes, but I have never seen a patient develop permanent problems with their bone, roots, or gums in only 6 months. You need to discuss your pregnancy and orthodontic treatment with your local dentist to decide how to proceed with both going forward.

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