Dr. Greg Jorgensen
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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.

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

  1. Grace says:

    Hi dr, just to continue with above, does shortening treatment time usually involve more movement and force? If not, how do dentists usually achieve the same results for patients having them on for two or three years.

    Based on what you said if there is no movement or little change, you will keep the braces on. Have you seen any patient where you end up taking the braces off because their roots are so short or their situation is so bad?

    • There are no secret ways to move teeth faster. There is a lot of misleading advertising out there these days trying to make people think that one guy can move teeth faster than another. Root resorption occurs more because of genetics than how fast teeth are moved. The only thing an orthodontist can do about root shortening is to monitor it and remove the braces if it progresses. Yes, I have removed braces early because of root resorption.

  2. Vic says:

    Hi, i am 32 yo female. I have good healhy teeth. No teeth root feeled or smth. I have deep bite and crowded teeth that i was encouranged by orthdontist and my dentist to correct. I had to have 3 extractions, 3 because i miss one 6th tooth from before in upper left jaw. I got very enthusiastic about finally making my teeth straight. I had now done my extractions and only now i stambled on information on internet about posdibility of root resorption and that i can loose my teeth during treatment!!! I got very concerned and feel like i got myself into trouble but its to late to turn back as extractions are done. Feel so powerless. My orthodontist said that they watch out for resorption, but i cant really calm dowm. I feel my teeth became sligthly mobile after extractions. I wonder as it due to crowding and as spase became fri after extraction teeth start moving on their own? I am due to put my braces on in 1,5 week now. I just cant imagine becoming toothless at age 35-36 (my treatment estimated for 2,5 years), heaving no problem before, just esthetics with my teeth. Is that possible that tooth resorption doesnt stop after removal of braces? How many teeth potentially can get loose? It horryfies me that me who had only two-three cavities for entire life will have to use dentures at young age. Dont think i will opt for implants

    • Root resorption is a rare risk that occurs in only 1-2% of patients. It happens whether or not patients have had teeth removed (it is not because of extractions). If you are one of the rare patients where it occurs, it stops when the braces are removed.

  3. Grace says:

    Hi doctor, sometimes I feel my teeth with short roots can’t even bite on food that is too hard like big chunks of chocolate. Is this a sign there is a high chance teeth will likely come off during the treatment with all the teeth movement?

    • The only way to evaluate the length of the roots and give a prognosis for what will happen when the braces come off is to have a current x-ray. I would recommend that you ask your local orthodontist this specifically at your next visit.

  4. Jon says:

    Hi Dr Jorgensen, my daughter is nearly 18 and has had orthodontic treatment leading to a shortening of the roots that has meant she can have no further treatment. She is still pretty unhappy with her front teeth as they still protrude a little. Is there any other form of treatment available now to give her the smile that she wants. Is it feasible to ‘shorten’ the actual teeth and use veneers or are any other processes available. Her orthodontist, while very nice, seems to be out of ideas. Thanks for your help.

    • I am sorry to hear about your daughter. As you read in my article, this happens in about 1-2% of our patients no matter what. They are just predisposed to shortening. If tooth movement is no longer an option, then the restorative you describe may be the way to go. Ask your dentist about bonding, veneers, or even crowns. Good luck!

  5. Nicolle says:

    Hey, I got a brave fitted on my top teeth in December but had to wait for my bottom brace due to having an overbite. I got my bottom brace fitted last month and since then one of my bottom teeth has felt wobbily. I went back to get my brace tightened today and told my doctor about this. He decided to take the bracket of my tooth and said this would give the tooth time to firm up again before refitting the bracket. I asked about root damage and he said in that amount of time it is very unlikely. I think I grind my teeth or clench my jaw whilst asleep and this may be the cause. I’m scared I’m going to loose my tooth, should I be worried? Should I request an X-ray?

    • I agree with your orthodontist that it is highly unlikely that the ROOT of your tooth has been damaged in such a short time. It is more likely that there is something going on with the bone around the tooth. Some mobility of moving teeth is normal. A lot is not. An x-ray would be a very good idea to see what is going on.

  6. Grace says:

    I just had an appointment with the dentist and was told that I have short roots in some tooth after an x-ray. This could be the result of my earlier braces.

    Would it still be advisable to get braces again? The roots have shortened about 50% (according to the dentist. will my teeth be severely affected as i grow older?

    • Your teeth will not get any worse if you DON’T have additional treatment. If you do get braces again, I would expect they will shorten more. I would be hesitant unless they really need it.

  7. Casey M says:

    https://db.tt/6nPL6I8
    I am the 1-2%. When it starts to become a problem what can be done about it? Implants? Partial dentures? I had extreme crowding, high high roof and a long tongue which my orthodontist said exacerbated the root resorption and I had a tongue crib in for a short while in 4th grade, the the roof spreader them braces for 5-6 years, 4 permanent teeth removed as well as wisdom teeth removed. I gather from what I know they are sitting pretty still bc of the gums and structure around what is left of them holding them in but it does frighten me what is to happen when it does become a problem. I have had braces off now for 20 years but there is a recent X-ray of my front top teeth which have been the most effected and has less root than tooth left. The angle of the pic is looking up but it is severe, I think, and has been pretty much the same since I got them off at 16 years old, although they have shortened a tiny bit more since. For people worried about immediate issues surrounding resorption just know that it’s been 20 years for me and still no looseness with my front teeth. Knock on wood I pray they continue to stay firm in place and I don’t get knocked in the teeth with any slabs of wood or anything lol. Any thoughts on potential future ways to deal if it does become a problem are appreciated. Thank you for this article!

    • The research shows that once orthodontic forces are removed, root resportion stops. If you have had your braces off for 20 years with no additional changes, I see no reason to worry that will change. If you lose some teeth some day, modern implants are almost as good as the originals (or better in your case).

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