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.

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

  1. Laura says:

    Hi Dr. Jorgensen, I had braces for 2 1/2 years and I have root resorption and gum recession on # 24, my bite still off (no contacts) in the posterior teeth, my question is… Do you recommend me to have an invisalign treatment? and if so Do you think I can loss my front tooth? I’m planning to have bone graft and tissue graft, but my concern is that my tooth may not handle the forces for other ortho tx, besides the fact that I don’t know if the root can continue to shorten or a root canal tx will stop the resorption? Thank you very much for taking the time to answer my question I really appreciated.

    • Root resorption occurs with Invisalign just like braces. The teeth don’t know what is providing the force that is moving them. Losing your tooth is a possibility and having a root canal will not stop the shortening. If you are susceptible, you are susceptible. Discuss all of your options about moving your teeth and replacing any that are lost BEFORE you start treatment again.

  2. janet says:

    Hi doctor, I had braces for 3 years, i just had them removed, but my teeth are too forward. I Went to see other orthodontist because i was not happy with my smile. He told me I need braces again because my front teeth are (and I quote him) 135○ forward, but the biggest problem is that my xrays (i took a week after braces removal) show that my 5 front bottom teeth have short roots ( l still dont know if it was due to previous braces or i had them like that, l will go back to my other ortho to check my first xrays) and because these teeth are in that bad position, inclining at an angle of 135º IT IS ABSOLUTLY necesary i get braces again to take my teeth and SPECIALLY these teeth with short roots to the correct position, since they are teeth at risk, and they were forced and eventually with these short roots and bad position and use l will loose my teeth, and if this happens and it was not corrected i wont be able to get implants or new teeth becuase my bone will be in the incorrect position. IS THIS TRUE?
    Im really scared to loose my teeth, but im also scared to get braces again.
    do you think i shoul get braces again.? My roots are 2/3 lost
    he also told me i needed extractions, so im scared to loose 4 teeth (2 lowrr 2 upper)
    and then on top of that get the risk to loose more for me doing braces again or not doing braces again.
    Any advice?
    I want to thank you so much for the time u take to answer !

    • This is a very difficult decision Janet. On one hand you don’t like your teeth. On the other hand moving them any more may mean that you’ll lose them. I would get a consultation with an oral surgeon to discuss the bone in the area and the possibility of getting implants “just in case.” I would then work with the orthodontist that you trust the most and the two of you just proceed with caution knowing that you may lose your front teeth. BTW, I have a few implants and they are great! As for the other orthodontist, he may have done nothing wrong to cause the root shortening, but not monitoring your roots and informing you of the changes IS an issue. Good luck!

  3. Emme says:

    I had braces in my late teens, 16-18. One of my front teeth started to shift backward and my orthodontist would not put braces back on for me. All he did was shave my tooth and adjust my retainer. After numerous adjustments, the retainers wouldn’t fit anymore. I started to develop gaps in my teeth and I developed an open bite. Now I’m older and in my mid-20′s, I’m looking to get braces again but I have short roots. I’m not sure if my roots were short from the very beginning because my orthodontist never took x-rays during or after my braces. That one tooth has been move much further back and my open bite prevents me from bite into things. However, after discontinuing from wearing my ill-fitting retainers for about four months, my teeth are finally feeling solid in their places unlike before when they would feel very loose.

    I’ve been to about four different orthodontists who have differing opinions on what to do. Two didn’t want to touch my teeth because of the short roots. And two wanted me to get invisalign and think that my teeth will be okay. It’s taken me a long time to seek another professional for treatment because I became so skeptical after my original orthodontist brushed off my concerns. Now every time I take a photo with a smile, I get very sad looking at my smile. I get reminded every time I try to bite into something that I can’t do it.

    I’m not sure if it is worth getting braces again or if any orthodontist is diligent enough to take my concerns seriously. The internet is a great resource for information but it makes me scared that I will lose my teeth if I get braces again. I don’t want to lose my teeth just because I want my teeth to perform their job to help me eat. But I don’t want this negative emotional trigger around with me for most of my life.

    I want to ask you, if I spent roughly four years wearing an ill fitting retainer that was moving my teeth at night (I didn’t wear my retainer during the day after the first year), wouldn’t that be considered force on my teeth? If that is considered force and my roots have not worsen, then would braces be a viable option? My teeth aren’t bad. Aside from a minor open bite (the height of a flatten plastic straw) and one crooked front tooth, my teeth essentially fit together as if I had taken my braces off yesterday.

    I just feel very defeated that I feel that my original orthodontist didn’t pay attention to these things or fixed the problems that occurred after treatment.

    • I sympathize with your situation Emme. I cannot explain or justify your original orthodontist’s actions. I would like to mention two things about your comment. Root shortening can happen with braces or clear aligners. The teeth cannot tell what is producing the force on the teeth. Anyone who tells you that they would use clear aligners but not braces because of the possibility of root shortening doesn’t understand biology. As for a retainer repeatedly moving teeth at night and causing additional root shortening, I think it is possible although I’m unaware of any research that supports it.

  4. Ryan says:

    I’m 36yrs old (and a GP dentist). I’ve had orthodontics twice in my life. Once at 15yrs old, and again at 35yrs old (I didn’t wear my retainers). I got my lower braces off 5 months ago f/ a friend GP. I was given a clear retainer to wear for a few weeks until the acrlyic Hawley was fabricated. I continued to wear the clear retainer during the day (I hated the bulky acrylic) and the Hawley at night (I was suppose to wear the Hawley 24/7). I recently noticed my lower 4 anterior teeth are slightly mobile (1mm movement) (this might have existed over the last 5 months, but I didn’t pay any attention at the time). I’m wondering if this is due to wearing the clear retainer during the day (16hrs) and the Hawley (8hrs) at night. I noticed there is a difference in fit between the two. Do you think this is causing the slight mobility (the two being in different positions, thus causing slight orthodontic movement throughout the day)? I decided to try wearing the Hawley 24/7 (and have for the last three days), I noticed my teeth are sore. I had poor crown to root ratio (not from perio.ds.) at the beginnnig. I’m hoping to see improvement (ie. less mobility) in the next 2 months by wearing the Hawley 24/7. I do not have any traumatic occlusion. I did have the GP slender a few of the anterior teeth (3 months before removal of braces), because of the large embrasure spaces that were created when “untangling” the crowding, then a power chain was placed to pull spaces back together, (I had moderate success with this). Any advice? Does my logic have any merit? I appreciate your help!

    • Hi Ryan. I do think that switching between the retainers is not a good idea, especially since you perceive that they are different. This is like having your braces tightened every single day for the rest of your life! You and your orthodontist should choose the best retainer and stick with it. You may also want to consider a bonded lingual retainer which would stabilize your teeth passively and not move them.

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