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What Is Concrescence?

When you smile, you're showing off the enamel covering and protecting your teeth. But did you know that enamel stops at the root level and a protective substance called cementum takes over? And when the cementum of one tooth cements with the cementum of another tooth, concrescence occurs.

That phenomenon means the two teeth are connected at the roots, which is pretty unusual. Even more uncommon, sometimes the next tooth layer, dentin, fuses with another's tooth's dentin at the root level.

If you experience concrescence, you probably don't know it, as it can go undetected if the teeth appear normal. We'll let you know how concrescent teeth form, how to diagnose them, and what's involved during dental treatments if you have them.

How Common Is It?

Concrescence shows up in 0.8 percent of extracted adult teeth and in 0.2 to 3.7 percent of extracted baby teeth, reports an article in the journal Case Reports in Dentistry. The uncommon dental condition is commonly found in the back molars.

There's no evidence that concrescence occurs in particular demographics or geographic areas. It's truly a dental anomaly that, according to an Advances in Human Biology article, might have developed:

  • As your teeth roots formed when you were an embryo
  • After your teeth roots formed but your teeth came in overcrowded

Either way, there's no way you can prevent concrescence. And since it's not a genetic condition, the good news is that you can't pass concrescence on to future generations.

Concrescence Diagnosis

Because concrescence teeth are so unusual and are at the root level, dental professionals can't diagnose the issue with the naked eye. Though teeth overcrowding can alert them of a potential problem, only radiograph technology can lead to a proper diagnosis.

Cone-Beam Computed Tomography (CBCT): Because a CBCT produces a 3-D image, it's the most accurate diagnostic tool. However, a CBCT emits more radiation than an X-ray. So, your dental professional might use it only to pinpoint what shows up on an X-ray. For example, an X-ray might show two teeth superimposed on each other.

Dental X-Ray: If your dental office doesn't have a CBCT, two or more 2-D dental X-rays from various angles might provide the necessary imaging for a diagnosis.

If it's suspected, it's important to diagnose concrescence to deal with dental issues as they arise.

Concrescence and Dental Treatments

Dental work that involves getting into the roots of teeth or moving concrescent teeth can cause complications. There's also a greater chance of gum issues with concrescence. That's why a proper diagnosis is essential before undergoing the following procedures.

Extraction and Root Canal: If you need to have only one tooth extracted, there's a possibility its conjoined tooth also would need to be removed and replaced. Or, if a fused tooth needs a root canal, you'll need a referral to see a dental specialist.

Orthodontia: According to research published in the Dental Press Journal of Orthodontics, it's possible to separate concrescent teeth and move them via orthodontia, depending on how extensively the teeth are joined and other factors. However, this procedure might result in extracting one of the concrescent teeth.

Dental Hygiene Treatment: Dental hygienists need to know if concrescence is present since the condition could make it difficult to clean around the teeth and result in gum tissue loss.

Because concrescence might lead to periodontal issues, your dental professional might advise extraction of one or both teeth, replacing them with implants.

Though rare, concrescence can complicate your dental care. But with a proper diagnosis and extra care during dental procedures, you can keep smiling.

This article is intended to promote understanding of and knowledge about general oral health topics. It is not intended to be a substitute for professional advice, diagnosis or treatment. Always seek the advice of your dentist or other qualified healthcare provider with any questions you may have regarding a medical condition or treatment.

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