Root caries

Beighton D and Lynch E (1995) Comparison of selected microflora of plaque and underlying carious dentine associated with primary root caries lesions. Caries Res 29, 154-158. 

Clarkson BH, Feagin FF, McCurdy SP, Sheetz JH and Speirs R (1991) Effects of phosphoprotein moieties on the remineralization of human root caries. Caries Res 25, 166-173. 

Ravald N and Birkhed D (1992) Prediction of root caries in periodontally treated patients maintained with different fluoride programmes. Caries Res 26, 450-458. 

Schiipbach P, Guggenheim B and Lutz F (1989) Human root caries histopathology of initial lesions in cementum and dentin. J Oral Pathol Med 18, 146-156. 

Schiipbach P, Osterwalder V and Guggenheim B (1995) Human root caries microbiota in plaque covering sound, carious and arrested root surfaces. Caries Res 29, 382-395. 

Vehkalahti M and Paunio I (1994) Association between root caries occurrence and periodontal state. Caries Res 28, 301-306. 

Root caries can occur when tooth roots are exposed to the oral environment, for example after periodontal surgery or gingival recession. Two stages are distinguished microscopically. First, the dentin mineral is dissolved and bacteria penetrate the tubules. Second, the demineralized dentin matrix is degraded, and bacteria infiltrate the intertubular area (Frank et al., 1989 Frank, 1990 Schiipbach et al., 1989). This sequence of events may indicate that the degradation of the dentin matrix occurs after it has become accessible by the removal of mineral. In an in vitro study, Klont and Ten Cate (1991) confirmed that the dentin matrix cannot be degraded unless it is demineralized. 

Featherstone JDB, McIntyre JM and Fu J (1987) Physico-chemical aspects of root caries progression. In Dentine and dentine reactions in the oral cavity (eds. Thylstrup A, Leach SA and Qvist V), pp. 127-137. IRL Press, Oxford UK. 

Frank RM, Steuer P and Hemmerle J (1989) Ultrastructural study on human root caries. Caries Res 23, 209-217. 

Lynch E and Beighton D (1994) A comparison of primary root caries lesions classified according to colour. Caries Res 28, 233-239. 

Schiipbach P, Lutz F and Guggenheim B (1992) Human root caries histopathology of arrested lesions. Caries Res 26, 153-164. 

The effect of fluoridation on adult dental health is harder to quantify. There are several reasons for this. Adults vary in the extent to which they may have been exposed to fluoride while growing up, and they may experience tooth loss for reasons other than dental caries, for example, trauma or periodontal disease. However, despite these difficulties, what evidence there is points to fluoride being beneficial for adult healthcare [136,137], and for older adults in particular, conditions such as root caries has been demonstrated quite clearly to be less prevalent in regions where the drinking water is fluoridated [138,139], The overall conclusion from all of these studies is that the whole population benefits from fluoridation in terms of improvements to their overall dental health. 

J.S. Stamm, D.W. Banting, P.B. Imrey, Adult root caries survey of two similar communities with contrasting natural waterfluoride levels, J. Am. Dent. Assoc. 120 (1990) 143-149. 

De Paola et al. [28], in a study of the clinical profiles of 273 adults with and without root surface caries, found that those without root caries had less coronal caries and less calculus, as well as more teeth, less recession, less debris, less gingivitis and more abrasion, than subjects with root caries. They attributed most, if not all, of the differences to one underlying factor, oral hygiene. 

Shu M, Wong L, Miller JH, Sissons CH Development of multi-species consortia biofilms of oral bacteria as an enamel and root caries model system. Arch Oral Biol 2000 -1. 27 -10. 

Several different types of dental caries have been described by clinicians. Specifically these are smooth-surface caries, pit and fissure caries, enamel caries, dentinal caries, secondary caries, early childhood caries and root caries [12], All occur by the same essential mechanism, as described above, and all arise as a consequence of a disturbance to the demineralization-remineralization balance. Attack by organic acids produced by bacteria in the plaque favours demineralization, but the natural remineralization processes of the mouth can reverse this. Certain dietary and hygiene behaviours as well as clinical treatments can enhance this natural remineralization provided they occur early enough in the demineralization part of the process. For example, complexes of casein phosphopeptide with amorphous calcium phosphate have been shown in various studies to be capable of enhancing the remineralization step under certain conditions and in specific groups of individuals [16,17]. These are now available commercially as an anticaries treatment for patients. 

High proportions in plaque (4-80% of total organisms) especially common in the gingival region. Weakly acidogenic but can cause root caries and periodontal disease in animals. Form basic plaque community along with streptococci. A. israelii causes actinomycosis. 

Thome, T., Mayer, M.P., Imazato, S., Geraldo-Martins, V.R., Marques, M.M. In vitro antily-sis of inhibitory effects of the antibacterial monomer MDPB-containing restorations on the progression of secondary root caries. J. Dent. 37, 705-711 (2009)... 

---