05/15/2026
I see a TON of external cervical resorption (I call it the v**e shop of the mouth--it's popping up seemingly everywhere!...not to be confused with it being correlated with va**ng, which has not been suggested to my knowledge).
In my nearly ten years as a general dentist, I had no clue about ECR. I just assumed everything was good ol' internal or external, which were treated with RCT. Turns out those are internal INFLAMMATORY and external INFLAMMATORY resorptions and totally different beasts.
External CERVICAL is by far the most prevalent form of tooth resorption, and it's one that is not caused by the pulp...so treating the pulp (which isn't the problem) doesn't solve anything. I tell patients all the time, sometimes the pulp is a casualty of the gums-gone-wild (or the treatment thereof), but they're not the source. The pulp tries so hard to protect itself and typically lays down a dense wall between itself and the invading tissue.
This CBCT (pt was referred for #19 ECR, which is more apparent...images included) shows a great example of the distal canal resisting the invading ECR #18. #18 has a normal, asymptomatic vital pulp in this case.
Posting this to show how incredible the pulp is at resisting ECR and some visual evidence that the pulp is not the problem. Sometimes ECR treatment is recommended which includes RCT in order to access the ECR tissue or because of proximity of the ECR tissue to the pulp. RCT alone will never arrest an ECR situation.
Lastly, in this patient, none of the teeth are symptomatic. #18 is beyond the point of treating and is asymptomatic and otherwise healthy. Treatment plan is NO treatment. If it becomes symptomatic or gingival issues arise in the future, EXT might be recommended.
#19 is incredibly deep to the furcation and asymptomatic. I discussed with the patient that treatment could expedite her losing this tooth. As is, the tooth is asymptomatic, and there is no sign of infection. Luckily, ECR can arrest and even repair. We'll watch this one, too.
#20 has a very tiny early stage ECR. This tooth is planned for a new crown. Treatment is advised and does not involve RCT!
Happy Friday!
