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.


    • ┬áIn 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

    • 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.
    • Advanced lesions require restoration or extraction.

Two examples of extensive gingival recession with root exposure and carious lesions

Robert Henry, DMD, MPH
Robert Henry, DMD, MPH
John McDowell, DDS
John McDowell, DDS


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.