Root Resorption

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Ryann - 05 Jan 2004 22:18 GMT

Hello All.

I have used this group several times over the last several months with
questions regarding my root resorption problem and dental implant
surgery. Thanks a bunch, btw!!!

Needless to say I have been reading alot about these conditions and
proceedures and I have a question that is disturbing me. If anyone
could give me their honest 2 cents I would appreciate it.

My root resorption was discovered immediately after my orthodontic
treatment (1995)when I had a problem with my teeth being "loose" when
I removed my retainer in the morning. I was told to stop wearing my
retainer to let my teeth "firm up". I was told about the root
resorption and that I would eventually loose my front teeth (and
ushered out the door). I accepted this information, but did not
understand its full impact at the time. Now, sitting here without
front teeth and a flapper, let me tell you, I understand very well!

I have read on several occassions now that a key cause of root
resorbtion is caused by too rapid orthodontic treatment. As this
condition was discovered immediately following my orthodontic
treatment I am lead to believe this was the cause.

Had I been monitored more closely could this condition have been
discovered earlier and possibly prevented by slowing down or stopping
my orthodontic treatment, preventing further damage to my teeth?

The purpose of my orthodontic treatment was to improve my bite and
overal oral health. Should I really be accepting the loss of my four
front teeth as a satisfactory result of orthordontic treatment?

I am not comfortable with the possibility of my root resorption being
caused by rapid orthodontic treatment. Should my orthodontist accept
some responsibility for this happening to me?

As I understand it, this topic may be a matter of opinion. If you
choose not to publish your response, feel free to contact me at the
above email address.

Thanks in advance.

Reply to this Message

NOYB - 05 Jan 2004 22:58 GMT

> Hello All.
>
[quoted text clipped - 31 lines]
> caused by rapid orthodontic treatment. Should my orthodontist accept
> some responsibility for this happening to me?

Possibly. When did he note the root resorption? ie--If he took an x-ray
several months before treatment was completed, and that x-ray showed
resorption, continuing with treatment without discussing it with you is a
definite no-no.

Reply to this Message

Orthodmd - 05 Jan 2004 23:42 GMT

>Hello All.
>
[quoted text clipped - 19 lines]
>condition was discovered immediately following my orthodontic
>treatment I am lead to believe this was the cause.

probably not the cause. we unfortunately don't have good understanding of all
the ins and outs of the cause of root resorption. rapid tooth movement even if
you wanted to do it, is difficult to achieve with modern braces.

>Had I been monitored more closely could this condition have been
>discovered earlier and possibly prevented by slowing down or stopping
>my orthodontic treatment, preventing further damage to my teeth?

true statement. many orthodontists including myself take regular xrays every
6-9 months to monitor the health the roots and for other reasons. if root
shortening was seen, it should have been discussed with you and you would then
have been able to make an informed decision regarding what to do -- continue
with tx or stop.

>The purpose of my orthodontic treatment was to improve my bite and
>overal oral health. Should I really be accepting the loss of my four
>front teeth as a satisfactory result of orthordontic treatment?

tough call but if there was no discussion of this issue by the orthodontist
with you prior to starting tx (some patients are seen as high risk for this and
need to be forewarned of the real risk of tx. of rothers the reisk is
generally minor.)

>I am not comfortable with the possibility of my root resorption being
>caused by rapid orthodontic treatment. Should my orthodontist accept
[quoted text clipped - 3 lines]
>choose not to publish your response, feel free to contact me at the
>above email address.

it may be a matter of opinion or it may be a matter of law. it comes under
what we call the standard of care. the standard of care continues to evolve
over time and it is not clear if regular xrays during tx are part of the
standard of care legally. they are in my practice and they fit my standard of
care. for the rest of the profession ???
it is what is called a "jury question"

it may be too late as far as statute of limitations but you might want to
contact an attornery specializing in health care issues. if you called the
local or regional bar association, they can point you in the right direction.

good luck
Charlie Ruff, DMD
Specialist in Orthodontics
Diplomate American Board of Orthodontics

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Joel M. Eichen D.D.S. - 06 Jan 2004 13:21 GMT

In Pennsylvania the injured has 24 months from the point where the
neglicence OCCURS or was discovered, depending on which was later.

So far, it is undiscovered.

Joel

DISCLAIMER: This is information not legal opinion. I have no expertise
in law.

>it may be too late as far as statute of limitations but you might want to
>contact an attornery specializing in health care issues. if you called the
[quoted text clipped - 3 lines]
>Charlie Ruff, DMD
>Specialist in Orthodontics

Signature

Joel M. Eichen, .
Philadelphia PA

DISCLAIMER FOLLOWS:

*********

Dental health-related material
is provided for information purposes
only and does not necessarily
represent endorsement by or an official
position of the SciMedDentistry gang
or any other official agency either
actual or fictitious or Steve Mancuso.

Advice on the treatment or care
of an individual patient should
be obtained through consultation
with a dentist who has examined
that patient or is familiar with
that patient's dental history.

STANDARD DISCLAIMER

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MINDY ROSE - 28 Feb 2005 20:50 GMT

Dr. Arnold Greene, Lake Worth, Florida removed by son's braces on Feb. 26,
2004. He had worn the braces for a little over 2 years. As we were leaving
Dr. Greene's office, the child complained to me that his gum was bleeding
and sore, and the Dr. Greene's assistant Peggy had been rough on him and
that she had chipped his tooth. The child was afraid to say anything
because he was afraid that Peggy would be angry. Little did I know that
something was terribly wrong - and told my son to rinse.

Three weeks later, on March 22, 2004, during a regular dental visit for a
check-up and cleaning, I was informed that the tooth was resorbed. Turns
out that Peggy chipped the tooth on Feb. 26 because it was so severely
resorbed. By this time the tooth was reddis/brown. Dr. Greene had sent a
child out of their office without observing his condition, with a tooth
that was visibly compromised.

Coincidentally, we had an appointment with Dr. Greene later that afternoon,
March 22. Dr. Greene still did not notice the tooth until I pointed it out
to him. He ran to take an x-ray of the tooth.

He never took a single x-ray during the course of treatment, and only took
notice of anything AFTER we pointed it out to him. He never discussed
anything with me. He also refused to give me my son's dental records -
only after my complaining to the Department of Health did he give me the
records - and it turns out that he took a photograph of the child's mouth,
including the tooth on May 8, 2004 without informing me, the mother, or
asking my permission.

He sent us on our way that day without having a disucssion of what was
wrong, what the causes could be, and what our options might be.

Whether or not Dr. Greene's orthodontia caused the work is not my problem
with this whole thing. It is his incompetence at not paying attention to
the child's wounded mouth that day - and his rather sneaky ways of covering
up his negligence.

Reply to this Message

Joel M. Eichen D.D.S. - 06 Jan 2004 13:18 GMT

>Hello All.
>
[quoted text clipped - 10 lines]
>I removed my retainer in the morning. I was told to stop wearing my
>retainer to let my teeth "firm up".

?? Skipping the retainer will not cause roots to grow back. I am
wondering what the x-rays look like back then when the root resorption
was discovered.

That sounds like bad advice. Well useless advice anyway.

> I was told about the root
>resorption and that I would eventually loose my front teeth (and
>ushered out the door).

There's an idea .... I want ushers in my office too. I will give them
flashlights and when they are not busy they can work the carpet
sweeper.

>I accepted this information, but did not
>understand its full impact at the time. Now, sitting here without
>front teeth and a flapper, let me tell you, I understand very well!

Teeth were removed? Let's see the x-rays!

>I have read on several occassions now that a key cause of root
>resorbtion is caused by too rapid orthodontic treatment.

I have heard that too. I will await independent confirmation.

> As this
>condition was discovered immediately following my orthodontic
[quoted text clipped - 3 lines]
>discovered earlier and possibly prevented by slowing down or stopping
>my orthodontic treatment, preventing further damage to my teeth?

Dentist's repsonsibility not the patient's responsibility. Your
responsibility is to appear for appointments on time.

For me, no! For you ...... well you tell me.

>I am not comfortable with the possibility of my root resorption being
>caused by rapid orthodontic treatment. Should my orthodontist accept
>some responsibility for this happening to me?

What does he say?

Oh, does the usher serve the popcorn or do they have separate peop,e
for that? (Just wondering for my own operation).

>As I understand it, this topic may be a matter of opinion. If you
>choose not to publish your response, feel free to contact me at the
>above email address.

No it is not opinion. Its factual. You had an unfortunate turn of
events. You deserve a COMPLETE explanation. I am concerned about that.

Joel M. Eichen DDS

>Thanks in advance.

Signature

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FMN - 07 Jan 2004 04:52 GMT

I agree with really all of what Charlie says. Most of the orthodontics
literature eventually comes to the point that, like heart disease, you are
either a resorber when pressure is placed on the teeth or you are not. It
really has no proof that it has much to do with speed. Many folks have
excess pressure (and teeth stop moving btw in this case, not move faster)
There are many theoretical factors.
I also monitor with xrays at least every 6 months for this very reason so
you can have some choices.
regards
fmn

> Hello All.
>
[quoted text clipped - 37 lines]
>
> Thanks in advance.

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