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Root Caries Part 1: an Overview of the Challenges

From Volume 47, Issue 2, February 2020 | Pages 103-114

Authors

Stephen Burrows

BDS(L'Pool), DGDP(UK), MClinDent(Pros), Dist(GKT) PGCLTCP(EHU), FHEA

General Dental Practitioner, St Helens, Merseyside, UK

Articles by Stephen Burrows

Abstract

The elderly population is increasing and they have a higher retention of natural teeth than previous cohorts. The increased prevalence of root caries in this group presents challenges to all those concerned in its management. In this article, aetiology, risk factors and diagnosis of root caries are discussed with the aim of implementing effective approaches in its management.

CPD/Clinical Relevance: Caries control should, when possible, be non-operative.

Article

The population of the elderly is increasing worldwide and they are experiencing a higher retention of natural teeth than previous cohorts. The increased prevalence of root caries is multifactorial and treatment success may be compromised by many factors, including difficulties with diagnosis and poor non-operative management. The consequent upsurge in root carious lesions (RCLs) presents demographic and procedural challenges, with implications for all those involved in the delivery of effective treatment. The problems in diagnosing root caries and the associated aetiology and risk factors are outlined. Deciding on how best to manage these lesions, with the emphasis on non-operative approaches, is discussed.

The proportion of edentulous adults is decreasing in the UK, having reduced from 28% in 1978 to 6% in 2009. Additionally, 86% of adults had 21 or more natural teeth whilst, in 1978, this was the case for only 74% of adults.1 In 1900, 3% of the population of North America was over 60 years old, by 2000 this was 13% and, by 2030, it is estimated that at least 20% of the population will be 60 years of age or older.2 Findings of a 2009 Adult Dental Health Survey published in the BDJ in 2013 showed that, in the UK, there are currently 11 million people aged over 65, 70% of which are functionally independent.3 There is an expected 40% rise to 16 million by 2040, according to Age UK.3 However, teeth retained into older age are at an increased risk of root caries.4

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