Within the first 1-2 days after the braces are fitted, teeth will begin to shift and feel quite loose. This is the normal pattern of tooth movement and is the method teeth use to move through braces. Patients may feel as if their teeth are getting loose and may see opening where no spaces existed before. This is perfectly normal, although sometimes can cause concern to the patient if not addressed and explained by the orthodontist prior to the treatment.
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, but these changes are so small that in 98% of the cases are not visible to the naked eye.
However, in less than 2% of patients, some visible root shortening occurs during routine orthodontic treatment. The exact cause of tooth resorption (shortening) is not yet known, but it is believed that it’s caused by genetic predisposition, along with prolonged orthodontic treatment that is more than 3 years in duration. This genetic predisposition is important and should be communicated to your orthodontist if you are aware that it has been noticed in your family.This generally will not result in any long-term problems for teeth, since it is generally believed that a tooth can loosen up to half of each root length and never have a problem.
Overall, braces will not make the teeth loose. However, in rare cases of root resorption the orthodontist will monitor the progress and advise the patient accordingly.
Patients wearing braces should always communicate their thoughts to their orthodontist to get their concerns addressed right away.
About the only thing orthodontists can do is monitor thier 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.