The Challenge of Root Resorption

Root resorption of several types affects different areas of the tooth to varying degrees, all of which affect the prognosis for saving the damaged tooth.

Surprisingly, root resorption is generally asymptomatic. Common first indicators of root resorption are a pink area of the tooth near the gumline, a localized area of gum irritation, a cavity-like area at the gumline, or an incidental finding by your referring dentist on a radiographic image. Detecting the presence of root resorption in the initial stages is not obvious, and most patients are unaware that root resorption has progressed unnoticed.

We often do not know the cause of root resorption in adult teeth, but there are several factors which could act as contributors.  Pressure and tension during gentle orthodontic movement are mild stressors on the ligament and bone tissues surrounding teeth, and are necessary for straightening teeth; but, with excessive orthodontic force, a tooth may develop resorption over time.  Traumatic injury to a tooth may suddenly damage gum, ligaments and bone, resulting in a more rapid development of root resorption. Extreme teeth grinding, and some methods of internal tooth-bleaching have also been found to initiate root resorption.

Dr. Odum and Dr. O’Connor will look for clues to predict tooth prognosis from a clinical exam, 2-D images, and 3-D CBCT images.  Only teeth with a favorable prognosis will be recommended for treatment.  Specialized techniques are required to save teeth with root resorption, which may include root canal therapy, the use of biocompatible root repair materials, or root surgery below the gumline.


Resorption Types and locations with a favorable prognosis that are restorable.

  • Apical Resorption. Extra measures are utilized to assure a good seal at the end of the affected root during root canal therapy.
  • Internal Resorption (confined to the root canal). Advanced techniques are used during root canal therapy to seal the irregularly shaped resorptive damage in the canal. 
  • External Resorption (small and near the gumline).  Combined root canal therapy and surgical root repair is often necessary.

Resorption Types and locations with an unfavorable prognosis requiring extraction.

  • Internal Resorption with an damaging extension to the outer root surface that is not restorable.
  • External Resorption that destructively involves multiple surfaces of the root deep below the gumline.