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.

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

  1. Tina says:

    I am 18 and I had Invisalign for about 3 months. I was looking at my teeth and touching it and I felt this “blac” on one of my front teeth. I’m scared now cause it feels a little wiggly so is it gonna fall out? Is this normal?

    • Having teeth get “wiggly” during treatment not only normal, it is necessary. If you are worried about there being something wrong, please return to your orthodontist for a quick check. Good luck!

  2. John doyle says:

    I had braces in the 70s only ontop of my mouth. In the 80s my dentist told me that my roots were starting to deteriorate. He said by the time I am 50 I would have no teeth. I am 49 and I’ve lost 6 teeth and according to my xrays the other ones will be soon. I guess I’m part of the 2% that loose there teeth from braces. And sorry yes my gums etc are all excellent including my bottom teeth

    • I don’t think that losing your teeth is related to your braces. Root resorption only happens when the braces are on the teeth. It stops once they are off and there is actually some natural repair. Other things can cause roots and bone to change, but root resorption from braces does NOT continue after the braces are off

  3. Neena says:

    I had braces for 3 yrs.my doctor removed my braces bcoz of tooth resorption. Can i get braces after 6 mnths. I mean will tooth resorption continue evn if i give a gap. I want to continue my treatment bcz my teeth is not straight and looks really big.

    • The decision to remove braces because of root resorption is something that your orthodontist has been trained for. If he feels your teeth are not healthy enough to continue, it is best to follow his recommendations. Good luck

  4. Carol says:

    Hi, I have seen a periodontitis for the last six months and he gave me the all clear to go ahead with invisalign but after my orthodontist done the x-rays he noticed I have lots of short roots probably due to a brace I had in my 20s, I am now in my late 40s. He said I could go ahead with invisalign and he will do another xray after 3 months to check roots and we can then carry on with treatment or stop, depending on the xray results. Really not sure whether to go ahead as don’t want to loose my teeth. Would be grateful for any advice. Thank you.

  5. Monty says:

    Hello Dr Jorgensen
    I have found this article very helpful, thank you for it.
    I am considering Invisalign; however, I have root resorption in my front teeth due to previous orthodontic treatment. I have been advised that I can proceed with Invisalign, but I should slow the treatment down (so 6 months instead of 3 months) to try and prevent further significant root resorption. Would you consider this to be a reliable course of action? What are the most important factors in root resorption – is it speed rather than how much the teeth need to move?
    Many thanks

    • The most important factor in root resorption is genetic predisposition. In other words, some people get it, some don’t depending upon who their parents are. The most important thing to do with either clear aligners or braces is have frequent x-rays to evaluate pathological changes (at least one every 6 months). I would not slow movements as that will actually lengthen treatment. Good luck!

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