Root Caries

A root lesion may appear as a white, brown or black area. As decay advances, the tooth can become soft and sticky, painful or sensitive, particularly when the lesion approaches the nerve.

Plaque bacteria convert sugars into acids. Those acids remove minerals from the tooth, while frequent sugar exposure and inadequate fluoride allow the process to continue. When root surfaces are exposed, the lesion develops in root dentine rather than only in enamel.

The process can begin with mineral loss and then move to softened, cavitated tooth structure. The extent of the lesion, oral hygiene and the person's health all affect its outlook.

Risk is linked to plaque, repeated exposure to fermentable carbohydrates and insufficient fluoride. Root-caries progression is also affected by oral hygiene and the person's general health.

A dental examination can reveal staining, a cavity or soft and sticky areas. An X-ray may show decay that cannot be seen directly on the surface.

Early lesions can be managed with fluoride, plaque removal and measures that support remineralisation. When tooth structure has been lost, the lesion may need to be arrested or restored using a minimally invasive approach.

The amount of lost root structure changes whether care focuses on arresting the lesion or restoring it. A non-cavitated lesion and a cavitated lesion therefore require different levels of care.

Progressive decay can reach the nerve, causing pain, infection and eventually tooth loss. Dental-caries complications can include apical periodontitis, abscess, cellulitis, osteomyelitis and other spread of infection.

Brush with fluoride toothpaste, clean between teeth every day, reduce sugary drinks and foods, and use fluoride rinse or professional fluoride where appropriate. Regular cleaning helps remove plaque before it can maintain an acid-producing biofilm.