Root Caries
In patients with advanced gingival recession or periodontal disease, the tooth roots become progressively more exposed as gums recede, increasing the vulnerability to caries because the exposed root surface, which is covered in cementum, is less strong than the rest of the tooth covered by enamel.
Etiology
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- In the presence of caries-causing bacteria and a diet high in sugars, caries can develop easily and progress rapidly.
- Roots do not have protective enamel like crowns of teeth, so caries progresses rapidly in the roots.
Preventive Measures & Treatment
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- Regular dental visits to remove plaque accumulation and reinforce appropriate home care.
- Lesions can be prevented or arrested using fluoride containing toothpaste, fluoride gels, varnish, or silver diamine fluoride.
- Chlorhexidine-Thymol varnish 1:1 mixture of may be efficacious in prevention of root caries.
- Sucrose-free chewing gum containing xylitol only or xylitol lozenges may be used as adjunctive therapy for adults at higher risk of caries by increasing salivary flow.
- Advanced lesions require restoration or extraction.
Two examples of extensive gingival recession with root exposure and carious lesions
References
Nonfluoride caries-preventive agents. Executive summary of evidence-based clinical recommendations. JADA. 2011; 142(9);1065-1071.
Baca P, Clavero J, Baca AP, et al. Effect of chlorhexidine-thymol varnish on root caries in a geriatric population: a randomized double-blind clinical trial. J Dent. 2009; 37(9):679-85.
Wen Y, Zhao X, Li SKY, Lo ECM, Jiang CM. Factors associated with the success of restorative treatment for root caries: A systematic review with meta-analysis. J Dent. 2024 Dec 20;153:105539. doi: 10.1016/j.jdent.2024.105539. Epub ahead of print. PMID: 39709998
Worthington HV, Lewis SR, Glenny AM, Huang SS, Innes NP, O'Malley L, Riley P, Walsh T, Wong MCM, Clarkson JE, Veitz-Keenan A. Topical silver diamine fluoride (SDF) for preventing and managing dental caries in children and adults. Cochrane Database Syst Rev. 2024 Nov 7;11(11):CD012718. doi: 10.1002/14651858.CD012718.pub2. PMID: 39508296; PMCID: PMC11542151.