Dr. Greg Jorgensen
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1401 Barbara Loop SE
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.

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

  1. Jessica says:

    I’m so glad that you covered this topic on your blog! And, after looking through the comments, thank you so much for responding to all the questions! It’s very helpful!

    It’s been a year since I’ve had braces. I just got out of my orthodontist appointment on Saturday. I had some X-rays done, and my orthodontist showed them to me and notified me that I have root shortening on my first top four teeth. He said that it isn’t a grave concern because it’s only a little bit of the root for now. Therefore, he gave me the options to stop or continue with my treatment. However, if it gets worse, then he will stop my treatment.

    Now, I did decide to continue on because in that moment, I questioned myself if I wanted to stop the process when this is a $5000 plan. Of course, this will definitely be a question that I need to direct to my ortho, but he really is not sociable at all, and he rarely talks to me when I go in for my appointments (just except for this past Saturday about the root shortening). My question is, if it gets worse, and he proposes that we stop the treatment, but my teeth aren’t how I like them yet, will I still have to pay the full cost?

    If I will still have to pay the full cost, can I request to continue on even though the root shortening gets worse? What are the side effects of having severe root shortening?

    • I can’t answer for him, but if we have to stop treatment short of the finish for whatever reason, we adjust the fee accordingly. This is something you’ll have to discuss with your orthodontic office specifically.

  2. rongrong zhang says:

    I think this is the right place to talk my teeth problem.
    I have my brace on for 2.5 years.

    Frist, I am very worry about my lower front teeth. Because 1 of them visibly come out and also verified by the x-ray and dentist. The tooth gonna lost after the brace. Hoever my otho think it is still fine. He always thinks everything he did seems perfect. Even the X-ray tells the root is shorten and the teeth is moving.

    Secondly, after 2.5 years my lower teeth still crooked and lots of space. I do not know whether I need take the risk to continue wear the brace or take it off. Because I also see other otho and they suggest take the brace off immediately.

    thirly, I want to know if the teeth fall off after take off the brace. Can I ask for the compensation from my otho. One of the other otho tell me he put the charlie horse too close to the gum and put too much power on it.

    Last, I want to know if I take off the brace, it is still good to wear the bond retainer? Because the teeth is moving, my otho said he gonna put the bond wire to fix them to invoid the teeth lost. Do you think it is a good idea? does it affect the teeth recover?

    Thanks so much for your advice. I am so frustrated now. By the way this is the first time I have the brace and I am 33.

    • I’m sorry that you are having such a rough time with your treatment. It sound like you have lost confidence in your doctor. I would get a second opinion from another doctor in your area so you can get a fresh start. Good luck.

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