Root Resorption (Periodontal)

Types of Periodontal Root Resorption

Periodontal root resorption generally falls into two patterns:

• External inflammatory resorption, where bacterial toxins from periodontal infection stimulate cells that dissolve root surface tissue
• Replacement resorption, a less common pattern where the root surface is gradually replaced by bone, most often seen after significant periodontal ligament damage or tooth replantation following injury

Both patterns are usually confined to the outer root surface and are distinct from internal resorption, which begins inside the tooth's pulp chamber.

What Causes Periodontal Root Resorption

Periodontal root resorption is closely linked to the severity of underlying gum disease.

Contributing factors include:

• Long-standing, untreated periodontitis that has damaged the periodontal ligament
• Deep periodontal pockets and significant bone loss around the tooth
• Chronic bacterial infection reaching the root surface through the periodontal ligament
• Trauma to the periodontal ligament, including from tooth replantation after injury
• Combined orthodontic and periodontal treatment on a tooth with existing gum disease

A 2024 radiographic study of patients with periodontitis found that external root resorption was significantly more common as the severity of periodontitis increased, and was more frequent in teeth with greater bone loss.

Symptoms and Signs to Watch For

Periodontal root resorption is often silent in its early stages and is typically found on routine X-rays rather than through symptoms the patient notices. When signs do appear, they can include:

• Increasing tooth mobility in a tooth with existing gum disease
• Gum recession or deepening pockets around the affected tooth
• Sensitivity or mild discomfort near the gumline

Because symptoms are inconsistent, regular dental checkups and X-rays remain the most reliable way to catch this condition early.

Why Periodontal Root Resorption Should Not Be Left Untreated

Left unaddressed, periodontal root resorption progresses alongside the gum disease driving it. As more of the root surface breaks down, the tooth loses the structural support it needs to stay firmly anchored, increasing the risk of mobility and eventual tooth loss. Because the underlying cause is active infection, delaying treatment also allows the periodontal disease itself to continue damaging the bone and soft tissue around neighboring teeth.

How Periodontal Root Resorption Is Treated

Treatment centers on controlling the periodontal disease that is driving the resorption, alongside monitoring the affected root.

• Periodontal Treatment

  A clinical examination and X-ray — with CBCT imaging where a more detailed view of the root is needed — are used to assess the extent of resorption and the health of the surrounding bone. From there, scaling and root planing performed by a Specialist Periodontist removes the bacterial deposits fueling the inflammation and allows the periodontal tissues to begin healing.

• Ongoing Monitoring

  Once the underlying gum disease is controlled, the affected tooth is monitored with periodic X-rays to confirm the resorption has stabilized rather than progressed.

• Restorative or Surgical Care

  In cases where resorption has significantly weakened the tooth, additional periodontal or restorative treatment may be needed to preserve it. Where a tooth cannot be saved, your dentist will discuss the most appropriate next steps with you.

Can Periodontal Root Resorption Be Prevented

The most effective way to reduce the risk of periodontal root resorption is to prevent or promptly treat gum disease itself. This includes:

• Attending regular dental checkups and professional cleanings, including Guided Biofilm Therapy where recommended
• Maintaining consistent oral hygiene at home
• Seeking prompt treatment at the first signs of gum disease, such as bleeding or swollen gums
• Informing your dentist of any tooth trauma so the periodontal ligament can be assessed early