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.

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

  1. Mai Yang says:

    Today is 8/11/16, my daughter is 13 years old. Got braces on for almost months. Her 6.5 months xray shown that the 2 top front teeth root is not growing as it supposed to and in her 7.5 months they got worse. The xray shown that the root is not growing any longer than her 6.5 months xray instead I saw her teeth moved out to the front more leaving the root very short. I was told that in four weeks if it doesn’t improve she will have to remove her braces. My concern is yes I know her teeth is more straight then before and the little over bite from the top is not a big deal for me but her jaw that is shifting to the right is still visible so if she has to stop the whole process will her root grow and can she goes back to wear braces in the future to adjust her jaw? Or is she done? Nothing to fix her? I’m concerns because I don’t know if the force on the braces stress out the root growth or she simply just has short root. What do I do? Please advise. Thank you, Mai

    • You need to discuss this with your local orthodontist. Only he can professionally evaluate the actual changes to her root lengths and appropriately determine the best course of action if there really is root resorption.

  2. T'Shauna jackson says:

    Are your teeth suppose to hurt if u had your braces for about close to being three months

    • It depends upon what is happening to your teeth in the third month. If you have recently had an adjustment or if there is something that is continuing to move your teeth, discomfort may be normal

  3. Lori OBrien says:

    I am researching Root damage as a result of my current treatment in adult braces and came across your article. As an adult, I am interested in a quick outcome and gave a time line to my orthodontist of doing what we can within 6 months. I wasn’t looking for perfection, just a nicer smile. He replied that if we shifted teeth too quickly, we could damage the root. He also said he could work with my time line (My son’s wedding in 6 months was the window of time I gave). 5-1/2 months in, I noticed huge sensitivity with upper left incisor, and a noticeable darkening of the tooth. At the last adjustment, the tech advised that she’ll be tightening extra this week and that I would notice the pressure. 3 weeks later, I noticed the extreme sensitivity with cold or air and darkening of the affected tooth. I asked for a consultation with my orthodontist. He agreed that my root may be damaged, and he is sending me to my dentist for evaluation, but he also tried to assure me that it was highly unlikely that it was caused by aggressive orthodontics. He has treated thousands of patients and had never seen this before.
    My question is this: I feel partly to blame because I pushed for the timeline. Yet I feel he is also at fault for allowing aggressive adjustments. In your knowledgeable experience, is it reasonable for me to expect him to be partly or fully liable for any root treatment, should I need it?

    • Unfortunately teeth can become devitalized (loose their blood supply) at any time before, during, or after treatment. This does not happen from orthodontics alone, but it can be exacerbated by the orthodontic forces. Usually a tooth that turns dark during treatment has had some type of trauma previously and the braces just “push it over the edge.” I believe that your braces were a factor, but not the cause of your problem. It does NOT occur because a tooth is moved too quickly or too far. It just happens and there’s nothing either you or your orthodontist could have done to prevent it.

  4. Dr.V says:

    Dr.Jorgensen,
    I am a dentist and I have a Pt who underwent orthodontic treatment for 4 years. I saw him for the first time and was shocked to see just about 3-4 mm to root on #8 and has grade 1 mobility. He has severe root resorption on all other teeth too. His braces were taken off a year and a half ago. What do you suggest I do in such a case. I have never come across such a severe case ever before but again my career is just 1 year long. Your input will be highly appreciated.

    • Unfortunately there is nothing you can do to “re-grow” the length of the roots. All we can do in cases like this is to educate the patients, stabilize the teeth (passive bonded lingual retainers), and encourage mouth guard wear for any activities that may threaten the teeth. As I’m sure you’ve read in my article, some patients are just predisposed to root shortening and some aren’t. The only thing the orthodontist could have done differently is recognize the shortening earlier (i.e. 6 to 12 months in) and change the treatment goals (like leaving some uncorrected overjet). Luckily the shortening usually stops once the orthodontic movement stops, so it shouldn’t get any worse.

  5. Krystal says:

    Hello,

    My daughter is 11 yrs old and last year we discovered that one of her bottom eye teeth was growing under her front four teeth. After speaking to an orthodontist we decided to do a phase 1 and attach a button and chain to that tooth to move it into its correct place. She had that procedure in March. They did an x-ray today to see how well it is moving and though it has moved the orthodontist showed me the before and after pics and wanted me to know that the roots on the front teeth have shorten. Seeing how the tooth was directly under the front teeth I can understand how it would mess the other roots up as they pull it back in the other direction. My question is since she is so young will they now not grow anymore? I’m just worried that I opted to save one tooth only to damage her front teeth. Reading your article was very informative and made me feel a little better knowing that it is pretty common.

    • You probably will not see much more shortening after the canine is moved from the region, but there will be very little if any regaining of length. There will be some slight repair by a substance called cementum, but it wouldn’t add the root length back.

  6. Donna says:

    My 17 year old daughter had braces off just over year ago she discovered a lump on her gum front bottom tooth X Ray’s done today said tooth dead the only trauma ever done to her teeth is braces please advice very upset

    • Although it is possible for teeth to “die” before, during, and after orthodontic treatment, it is very rare. I have moved millions of teeth in over 10,000 patients and I’ll be I can count on one hand the number that actually lost their vitality during treatment. In almost every case there was previous trauma to the teeth, even years before the braces. If teeth routinely died due to orthodontic treatment, it would be commonly known and no one would ever get braces. I’m sorry that your daughter experienced this.

  7. Emily says:

    Hi I’m 13 years old and I have had braces on since February 2016 and I still have them.My problem is that when I had X-rays done before I received my braces and it showed that my two upper teeth roots were short (3mm) and they said I have a chance of them falling out.I wasn’t too worried at first as I wanted a better smile but now I have just had them tighten for about the fifth time and they are really starting to hurt.I am really anxious as I don’t want them to fall out, and even though they said that if they do fall out,i would receive dentures for free.Is there anything you can suggest for my situation?

    • The most important thing you and your orthodontist can do is to monitor the length of your roots during treatment. This requires an x-ray every 6 months. You may not see any further changes, but if you do, you should discuss ending treatment earlier than originally planned.

  8. Nick says:

    Hi, I’m 40 and recently my front two upper teeth and the two teeth either side all started to wobble. i had braces upper and lower when i was younger. My dentist thinks there is impact trauma from my bottom teeth on the back of my top teeth due to my bite coupled with x-rays showing shortening of all of my roots on all of my teeth

    He tried to stabilise them a a couple of weeks ago with splinting from canine to canine which helped initially but now it feels like the whole lot are moving again, just joined together! And it feels like there is movement up and down in the sockets when i bite. I can only think things are deteriorating quickly.

    I have a couple of gaps in my teeth and he is providing a denture which will fill these and minimise trauma by adjusting my bite, but I can help but feel that its too late.

    Is there no other way to treat this? Have you seen a case where things deteriorate this quickly and am I better of just going for removal and a full denture?

    Thanks

    • I would recommend two consultations for you. First, see a periodontist (a gum and bone specialist) who can tell you if your teeth can be saved. Second, see an orthodontist if your gums and bone are healthy to see if the bite and be improved so that you’re not ruining the teeth by hitting so hard.

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