Concrescence: When Two Tooth Roots Fuse Together After They've Formed

Concrescence is a condition where the roots of two adjacent teeth become joined together by cementum, the hard tissue covering the tooth root, without the crowns or the internal dentin structure of the teeth being connected, distinguishing it from fusion.

Fusion occurs during tooth development, when two forming tooth buds join together early on, affecting the internal structure of the teeth. Concrescence typically happens later, sometimes after the teeth have already fully formed, joining only the outer cementum layer of the roots, often related to close proximity between adjacent teeth combined with excessive cementum deposition in that area.

Since it involves cementum, a tissue that continues to be deposited on the tooth root throughout life, concrescence can develop after teeth are already fully formed, sometimes related to local factors like inflammation, crowding, or excessive bone density in the area pushing the roots into close contact.

Upper molars, particularly a second molar and a nearby third molar (wisdom tooth), are among the more commonly discussed locations for concrescence, given their close proximity in many people's mouths.

Generally, no, this condition typically doesn't cause any noticeable symptoms and often goes completely unnoticed unless specifically identified on an X-ray or discovered during an attempted extraction.

If one of the two joined teeth needs to be extracted, such as a wisdom tooth requiring removal, the cementum connection to the neighboring tooth means there's a genuine risk of inadvertently affecting or loosening the adjacent, unintended tooth during the extraction attempt, making this a significant, practical surgical consideration.

Careful review of dental X-rays, sometimes including more detailed 3D imaging for complex cases, allows your oral surgeon to identify a suspected connection between roots before beginning an extraction, enabling appropriate surgical planning to safely address the situation.

Your surgeon may need to use a modified surgical technique, sometimes sectioning the tooth being removed more carefully, or in some cases, planning to address both connected teeth together if separating them safely isn't feasible, depending on the specific situation identified through imaging.

Yes, sometimes this is noted incidentally on routine X-rays without any planned extraction, in which case it's simply documented in your dental record as relevant background information for any future treatment planning involving those specific teeth.

This is considered a relatively uncommon finding, though its practical surgical relevance, particularly for wisdom tooth extraction, makes it an important consideration dentists and oral surgeons are trained to look for during pre-extraction imaging review.

Your oral surgeon reviews your imaging as a standard part of surgical planning, which would include checking for this and other anatomical considerations relevant to a safe procedure, though it's reasonable to ask directly if you're curious about your specific imaging findings.