Dental and Medical Problems

Dent. Med. Probl.
Index Copernicus (ICV 2019) – 118.76
MNiSW – 20
CiteScore (2020) – 1.2
Average rejection rate (2020) – 88.71%
ISSN 1644-387X (print)
ISSN 2300-9020 (online)
Periodicity – quarterly

Download PDF

Dental and Medical Problems

2017, vol. 54, nr 4, October-December, p. 403–408

doi: 10.17219/dmp/75872

Publication type: review article

Language: English

Download citation:

  • BIBTEX (JabRef, Mendeley)
  • RIS (Papers, Reference Manager, RefWorks, Zotero)

Creative Commons BY-NC-ND 3.0 Open Access

Root caries: A geriatric challenge

Próchnica korzenia – problem gerostomatologiczny

Shiji Dinakaran1,A,B,C,D,E,F, Anupama S. Gopinathan1,B,D,E

1 Department of Conservative Dentistry and Endodontics, Government Dental College, Thiruvananthapuram, Kerala, India


Root caries is an important problem of concern for the elderly population in many countries. Due to its rapidly progressing nature and occurrence in areas of limited visibility, these lesions often go unnoticed unless they become symptomatic. Multiple systemic diseases, poor oral hygiene coupled with reduced manual dexterity of this age group add to the severity of the challenge. Limitations of available biomaterials along with reduced accessibility and isolation make the restoration of such dental lesions a clinical challenge also for dentists. Routine dental checkups and regular monitoring of risk factors can significantly reduce the occurrence of such caries to a major extent. This article reviews the contemporary literature concerning the clinical features, etiology, risk factors and prevention of root caries. The main topic of the work is the electronic search of literature related to root caries; it was carried out in MEDLINE PubMed database using MeSH terms “root caries”, “etiology”, “prevention”.

Key words

risk factors, prevention, restoration, root caries

Słowa kluczowe

czynniki ryzyka, zapobieganie, odbudowa, próchnica korzeni

References (49)

  1. Schamschula RG, Barmes DE, Keyes PH, Gulbinat W. Prevalence and interrelationships of root surface caries on Lufa, Papua New Guinea. Community Dent Oral Epidemiol. 1974;2:295–304.
  2. Sumney DL, Jordan HV. Characterization of bacteria isolated from human root surface carious lesions. J Dent Res. 1974;53:343–351.
  3. Aherne CA, O’Mullane D, Barrett BE. Indices of root surface caries. J Dent Res. 1990;69:1222–1226.
  4. Beighton D, Lynch E, Heath MR. A microbiological study of primary root-caries lesions with different treatment needs. J Dent Res. 1993;72:623–629.
  5. Jones JA. Root caries: Prevention and chemotherapy. Am J Dent. 1995;8:352–357.
  6. Surmont PA, Martens LC. Root surface caries: An update. Clin Prev Dent. 1989;11:14–20.
  7. McIntyre JM, Featherstone JD, Fu J. Studies of dental root surface caries. Aust Dent J. 2000;45,24–30.
  8. The role of cementum in root surface caries. Aust Dent J. 2000;45:97–102.
  9. Ellen RP, Banting DW, Fillery ED. Streptococcus mutans and Lactobacillus detection in the assessment of dental root surface caries risk. J Dent Res. 1985;64:1245–1249.
  10. Banting DW. Epidemiology of root caries. Gerodontol. 1986;5:5–11.
  11. Nisha G, Amit G. Textbook of Operative Dentistry. 2nd ed. New Delhi, India: Jaypee Brothers Medical Publishers; 2013.
  12. Katz RV. The RCI revisited after 15 years: Used, reinvented, modified, debated, and natural logged. J Public Health Dent. 1996;56:28–34.
  13. Dye BA, Tan S, Smith V, et al. Trends in oral health status: United States, 1988–1994 and 1999–2004. Vital Health Stat. 2007;11:1–92.
  14. Preza D, Olsen I, Willumsen T, et al. Microarray analysis of the microflora of root caries in elderly. Eur J Clin Microbiol Infect Dis. 2009;28:509–517.
  15. Hashimoto K, Sato T, Shimauchi H, Takahashi N. Profiling of dental plaque microflora on root caries lesions and the protein-denaturing activity of these bacteria. Am J Dent. 2011;24:295–299.
  16. Chen L, Qin B, Du M, et al. Extensive description and comparison of human supra-gingival microbiome in root caries and health. PLoS One. 2015;10. doi:10.1371/e 0117064.
  17. Shivakumar K, Prasad S, Chandu G. International caries detection and assessment system: A new paradigm in detection of dental caries. J Conserv Dent. 2009;12:10–16.
  18. Chi DL, Shyue C. Managing caries risk in adults. Dimen Dent Hyg. 2014;12:36–40.
  19. Joshi A, Douglass CW, Jette A, Feldman H. The distribution of root caries in community-dwelling elders in New England. J Public Health Dent. 1994;54:15–23.
  20. Lenander-Lumikari M, Loimaranta V. Saliva and dental caries. Adv Dent Res. 2000;14:40–47.
  21. Fischer D, Ship JA. Effect of age on variability of parotid salivary gland flow rates over time. Age Ageing. 1999;28:557–561.
  22. Shay K. Root caries in the older patient: Significance, prevention, and treatment. Dent Clin North Am. 1997;41:763–793.
  23. Yoshihara A, Takano N, Hirotomi T, Ogawa H, Hanada N, Miyazaki H. Longitudinal relationship between root caries and serum albumin. J Dent Res. 2007;86:1115–1119.
  24. Ringelberg ML, Gilbert GH, Antonson DE, et al. Root caries and root defects in urban and rural adults: The Florida dental care study. J Am Dent Assoc. 1996;127:885–891.
  25. Imazato S, Ikebe K, Nokubi T, Ebisu S, Walls AW. Prevalence of root caries in a selected population of older adults in Japan. J Oral Rehabil. 2006;33:137–143.
  26. Shaker Randa E. Diagnosis, prevention and treatment of root caries. Saudi Dent J. 2004;16:84–86.
  27. Keltjens H, Schaeken T, van der Hoeven H. Preventive aspects of root caries. Int Dent J. 1993;43:143–148.
  28. Rodrigues JA, Lussi A, Seemann R, Neuhaus KW. Prevention of crown and root caries in adults. Periodontol 2000. 2011;55:231–249.
  29. Gluzman R, Katz RV, Frey BJ, McGowan R. Prevention of root caries: A literature review of primary and secondary preventive agents. Spec Care Dent. 2013;33:133–140.
  30. Schwendicke F, Göstemeyer G. Cost-effectiveness of root caries preventive treatments. J Dent. 2017;56:58–64.
  31. Vale GC, Tabchoury CP, Del Bel Cury AA, Tenuta LM, ten Cate JM, Cury JA. APF and dentifrice effect on root dentin demineralization and biofilm. J Dent Res. 2011;90:77–81.
  32. ten Cate JM, Cummins D. Fluoride toothpaste containing 1.5% arginine and insoluble calcium as a new standard of care in caries prevention. J Clin Dent. 2013;24:79–87.
  33. Heasman PA, Ritchie M, Asuni A, Gavillet E, Simonsen JL, Nyvad B. Gingival recession and root caries in the ageing population: a critical evaluation of treatments. J Clin Periodontol. 2017;44(Suppl. 18):S178–S193.
  34. Wierichs RJ, Meyer-Lueckel H. Systematic review on noninvasive treatment of root caries lesions. J Dent Res. 2015;94:261–271.
  35. Mei ML, Chu CH, Lo EC, Samaranayake LP. Preventing root caries development under oral biofilm challenge in an artificial mouth. Med Oral Patol Oral Cir Bucal. 2013;18:e557–563.
  36. Inaba D, Duschner H, Jongebloed W, Odelius H, Takagi O, Arends J. The effects of a sodium hypochlorite treatment on demineralized root dentin. Eur J Oral Sci. 1995;103:368–374.
  37. Petersson LG, Magnusson K, Hakestam U, Baigi A, Twetman S. Reversal of primary root caries lesions after daily intake of milk supplemented with fluoride and probiotic lactobacilli in older adults. Acta Odontol Scand. 2011;69:321–327.
  38. Bedran-Russo AK, Pereira PN, Duarte WR, Drummond JL, Yamauchi M. Application of crosslinkers to dentin collagen enhances the ultimate tensile strength. J Biomed Mater Res B Appl Biomater. 2007;80:268–272.
  39. Jayakrishnan A, Jameela SR. Glutaraldehyde as a fixative in bioprostheses and drug delivery matrices. Biomaterials. 1996;17:471–484.
  40. Han B, Jaurequi J, Tang BW, Nimni ME. Proanthocyanidin: A natural crosslinking reagent for stabilizing collagen matrices. J Biomed Mater Res A. 2003;65:118–124.
  41. Epasinghe DJ, Yiu C, Burrow MF. Synergistic effect of proanthocyanidin and CPP-ACFP on remineralization of artificial root caries. Aust Dent J. 2015;60:463–470.
  42. Ma S, Imazato S, Chen JH, et al. Effects of a coating resin containing S-PRG filler to prevent demineralization of root surfaces. Dent Mater J. 2012;31:909–915.
  43. Rolland SL, McCabe JF, Imazato S, Walls AW. A randomised trial comparing the antibacterial effects of dentine primers against bacteria in natural root caries. Caries Res. 2011;45:574–580.
  44. Vlacic J, Meyers IA, Walsh LJ. Combined CPP-ACP and photoactivated disinfection (PAD) therapy in arresting root surface caries: A case report. Br Dent J. 2007;203:457–459.
  45. Brazzelli M, McKenzie L, Fielding S, et al. Systematic review of the effectiveness and cost-effectiveness of HealOzone for the treatment of occlusal pit/fissure caries and root caries. Health Technol Assess. 2006;10:75–80.
  46. Anusavice KJ. Dental caries: Risk assessment and treatment solutions for an elderly population. Compend Contin Educ Dent. 2002; 23(Suppl. 10):12–20.
  47. Burgess JO, Gallo JR. Treating root-surface caries. Dent Clin North Am. 2002;46:385–404.
  48. Turner EW, Shook LW, Lackey M. Accessing and restoring root caries: A case report. J Tenn Dent Assoc. 2007;87:20–24.
  49. Goldstein M, Nasatzky E, Goultschin J, Boyan BD, Schwartz Z. Coverage of previously carious roots is as predictable a procedure as coverage of intact roots. J Periodontol. 2002;73:1419–1426.