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PubMed1980

Prevalence of root surface caries among institutionalized older persons.

Fifty-nine residents of a chronic hospital (average age 67.9 years) were examined visually for root surface caries. Root lesions were found to be present in 44 of the residents and were located most frequently on the proximal surfaces of anterior teeth. The number of coronal DF surfaces, age and number of retained teeth were the factors found to be helpful in discriminating between persons with and without root surface caries.

Adult↗

PubMed2003

The etiology and prevalence of gingival recession.

BACKGROUND: Gingival recession in its localized or generalized form is an undesirable condition resulting in root exposure. The result often is not esthetic and may lead to sensitivity and root caries. Exposed root surfaces also are prone to abrasion. The purpose of this article is to describe the prevalence, etiology and factors associated with gingival recession. TYPES OF STUDIES REVIEWED: The authors reviewed cross-sectional epidemiologic studies of gingival recession and found that they correlated the prevalence of recession to trauma, sex, malpositioned teeth, inflammation and tobacco consumption. The recent surveys they reviewed revealed that 88 percent of people 65 years of age and older and 50 percent of people 18 to 64 years of age have one or more sites with recession. The presence and extent of gingival recession also increased with age. RESULTS: More than 50 percent of the population has one or more sites with gingival recession of 1 mm or more. The prevalence of gingival recession was found in patients with both good and poor oral hygiene. It has been proposed that recession is multifactorial, with one type being associated with anatomical factors and another type with physiological or pathological factors. Recession has been found more frequently on buccal surfaces than on other aspects of the teeth. CLINICAL IMPLICATIONS: Dentists should be knowledgeable about the etiology, prevalence and associating factors of gingival recession, as well as treatment options, so that appropriate treatment modalities can be offered to patients. Treatments for gingival recession include gingival grafting, guided tissue regeneration and orthodontic therapy. Such treatments typically result in esthetic improvement, elimination of sensitivity and a decreased risk of developing root caries.

Adolescent↗

PubMedDate not supplied

Effect of a solution with high fluoride concentration on remineralization of shallow and deep root surface caries in vitro.

A root dentin single-section model was developed to compare the efficacy of different fluoride treatments on the remineralization of lesions. Shallow ( approximately 170 microm) and deep ( approximately 400 microm) lesions were produced in acetic acid buffer solutions (pH 5.0) with 0.1- and 0.5-ppm fluoride for 3 days and 2 weeks, respectively. Next, the sections were pH-cycled for 4 weeks. Following the pH cycling, all sections were first remineralized for 5 weeks, then subjected to 10 days of demineralization. The treatments were (1) no treatment (control), (2) daily 1,450-ppm NaF toothpaste, (3) weekly 4,000-ppm fluoride solution, (4) a combination of treatments 2 and 3. In the shallow lesions, the 4,000-ppm fluoride solution and the combination treatment enhanced mineral deposition at the lesion front, producing a second, slightly hyperremineralized layer. Similarly, in the deep lesions a second remineralized layer was detected. In all lesions, the fluoride solution treatment showed significantly more remineralization compared to the control and the toothpaste treatment (p<0.05), most of which was formed during the pH cycling. In the demineralization period, the control showed significantly higher mineral loss than all other treatments. These results indicate that a 4,000-ppm fluoride solution might be effective for remineralization of root dentin lesions even over 400 microm depth.

Acetates↗

PubMed1990

Microbiology of root surface caries in humans.

Studies on the microbiology of root surface caries between 1970 and 1975 placed emphasis on Gram-positive pleomorphic filamentous rods, particularly Actinomyces viscosus and Actinomyces naeslundii. Both of these species had been shown to produce root surface caries in experimental animals. Since this time, studies have placed more emphasis on Streptococcus mutans, and S. mutans and Lactobacillus are significant in prediction of root surface caries risk in patients. Subsequent studies confirmed an association between S. mutans and 'soft' or 'initial' root lesions. Thus, it is important when determining the microflora of root surface lesions to make careful characterization of the state of the lesion. A second important aspect of the analysis of bacterial communities associated with root surface caries is better definition of the organisms. Most studies have concentrated on 'target organisms' S. mutans, S. sanguis, A. viscosus, A. naeslundii, Lactobacillus, and Veillonella. However, it has been known for 17 years that the Actinomyces associated with the lesions may be variants of A. viscosus and A. naeslundii. Such strains (intermediate strains) have been described in taxonomic studies of Actinomyces, yet little is known of the differences in physiology of these strains or their relationship to root surface caries. A similar situation exists with oral Streptococcus where new taxonomic divisions are being proposed. Recognition of the potential diversity within the 'target' genera of root surface caries could yield valuable data. Recent studies suggest that this is so, since samples from root surface lesions which contain S. mutans and Lactobacillus show a high isolation of S. mitis 1 and no isolations of A. naeslundii. Careful definition of the lesions of root surface caries and the flora will allow analysis to relate a specific bacterial community to the state fo the lesion and assist in monitoring the control of the lesion through fluoride and antibacterials.

Actinomyces↗

PubMedDate not supplied

Effects of CO2 laser irradiation on tooth-root cementum.

With the aging of the American population and the endemic problem of gingival recession, patients will inevitably suffer from greater exposure of root surfaces and therefore will be more likely to develop root caries. The treatment of root caries is often frustrating. Traditional biomaterials used for the restoration of enamel caries have been less than satisfactory when margins of a cavity are adjacent to cementum. Although topical fluoride gels, toothpastes, and rinses have been used to prevent or to inhibit the development of root caries, there is a problem of access to the proximal surfaces. Consequently, the development of better methods to facilitate the prevention of root caries has become an important issue in dentistry.

Dental Cementum↗

PubMed1993

Cariogenic potential of pooled plaque fluid from exposed root surfaces in humans.

The composition of pooled plaque fluid from exposed root surfaces of five population samples was determined before and at selected times (3, 7 and 15 min) after a 5 and 10% sucrose rinse. Subjects were 45-65 yr old, had exposed, sound root surfaces, and were grouped according to root caries status [caries-free (CF), no root caries history; caries-positive (CP), recorded root caries experience]. Samples were obtained only from the sound surfaces of the CF and CP subjects after overnight fasting. Plaque samples from each subgroup were pooled under mineral oil and maintained on ice. Plaque fluid was then isolated by centrifugation and analysed for organic acids and inorganic ions (ion chromatography), and pH (microelectrodes). From these data, the degree of saturation [DS(TM)] in plaque fluid with respect to tooth mineral (TM) was calculated. Before exposure to sucrose, plaque fluids from the CF and the CP subgroups had similar ionic compositions. These fluids were also found to be supersaturated with respect to tooth mineral. After exposure to sucrose, a rapid decrease in plaque fluid pH was observed, which corresponded primarily to lactic acid production. For all times examined, mean pH and DS(TM) values were lower and lactic acid concentrations were higher in the CP than the CF samples. Lower values of DS(TM) suggest that plaque fluid from CP subjects had a measurably greater cariogenic potential. Calcium concentrations also increased significantly and to comparable levels in all plaque fluid samples after sucrose exposure, despite lower acid production in CF samples.(ABSTRACT TRUNCATED AT 250 WORDS)

Acetates↗

PubMed1996

The RCI revisited after 15 years: used, reinvented, modified, debated, and natural logged.

OBJECTIVES: The purpose of this article is to review the status of the Root Caries Index (RCI) 15 years after it was first introduced in the dental literature as a method for the reporting of supragingival root lesions. This review focuses on the extent to which the RCI has been used by epidemiologic researchers, as well as on the issues concerning the RCI as a useful index that have been raised and debated in the literature by those epidemiologic researchers. METHODS: The debated points are categorized into six issues, including whether: (1) the RCI underestimates the prevalence of root caries by omitting subgingival root caries lesions; (2) the RCI overestimates the prevalence of root caries by using too rigid a definition of when recession can be visualized; (3) the RCI makes the assumption that there is a linear relationship between root caries lesions and the occurrence of at-risk surfaces, i.e., surfaces with recession; (4) the RCI, by ignoring missing teeth, distorts the descriptive epidemiologic picture of root caries; (5) recession is a predictor of root caries versus merely being an antecedent state; and (6) the imprecision of diagnosing gingival recession renders the RCI useless. RESULTS: Given both the evidence from recent studies and the professional interest in subgingival root caries, as addressed in the first debated point, it seems reasonable to modify the RCI to include a separate reporting of subgingival root caries. Of the remaining debated points over the past 15 years, three of these (points #2, #4, and #5 above) seemingly serve to clarify specific aspects of the RCI that were intended as inherent elements of the RCI as originally presented. The question as to whether there is an assumption of a linear relationship between root caries lesions and the occurrence of at-risk surfaces (point #3) is answered in the negative. The final debated point (#6), while addressing a fundamental periodontal tissue measurement issue--namely the reliability of identifying gingival recession--and while theoretically interesting, should not undermine the current use, or utility, of the RCI, but rather suggests the need for improved periodontal diagnostic techniques for the condition of recession. CONCLUSIONS: After 15 years, the RCI appears to be one of the two most common methods of reporting root caries in the epidemiologic literature (along with DFS counts). In fact, the best overall descriptive picture of root caries is achieved when those two reporting methods are presented in the same study accompanied by descriptive presentations of missing teeth and at-risk surfaces. Of all the debated points in the literature, the suggested modification of including subgingival lesions in the RCI leads now to the recommendation to collect subgingival data, but to do so in a manner that allows for separate presentation of supra- and subgingival root caries findings.

Forecasting↗

PubMed1998

Root-surface caries formation: effect of in vitro APF treatment.

To determine the effect of one and four-minute acidulated phosphate fluoride, or APF (Oral-B Minute Gel, Oral-B Laboratories) treatments on artificial caries development in root surfaces, an in vitro study was conducted. The authors created a window of exposed root surface on extracted teeth by applying acid-resistant varnish to the remaining surface. APF treatment was administered and followed by a 24-hour deionized-distilled water rinse. A window of sound root surface that had been protected from the APF treatment was exposed and served as a control. Acidified gel was then applied to the exposed root surfaces to create the artificial caries. The authors found that APF treatment significantly enhanced resistance to demineralization of root surfaces from an in vitro acidogenic challenge. However, there was little difference in effectiveness between the one- and four-minute APF treatment times.

Acidulated Phosphate Fluoride↗

PubMed1990

Root surface caries and associated factors.

The prevalence of root surfaces caries in 208 randomly selected 55, 65, and 75-yr-old Swedes was related to the frequency of coronal caries, the number of remaining teeth and to bacteriologic, salivary, and dietary variables. At least one decayed or filled root surface was found in 89% of the individuals and all of those had also experienced coronal caries. The frequency of root surface caries was positively correlated to the frequency of coronal decay and negatively correlated to the number of remaining teeth and exposed root surfaces. The study shows that the same factors which are associated with enamel caries seem to be of importance in determining the development of root surface caries. The variation in the frequency of root surface caries was best explained by the salivary levels of mutans streptococci and lactobacilli, the percentage of surfaces harboring plaque and the frequency of carbohydrate intake. Other contributory factors were the saliva secretion rate and the buffer capacity.

Aged↗

PubMed1995

[Preventive effect of 10% (NH4)2MoO2F4 solution on artificial root-surface caries in vitro].

The aim of this study is to determine the preventive effect of F-Mo preparation on artificial root-surface caries. 60 premolar teeth extraced for orthodontic purpose were divided into five groups. A window was prepared on every tooth. They were treated by 10% (NH4)2MoO2F4, 38%Ag (NH4)2F, 2% NaF, 7.3% (NH4)2MoO4 and deionized water for 2 minutes and three times. They were then put in the fluid contained cariogenic bacteria for 96 hours to produce root caries. The root surface lesion of every tooth was examined and analysed by micro-radiography, SEM and spectrum. The result showed that the lesion depth of the groups treated by 10% (NH4)2MoO2F4 and 38%Ag (NH4)2F were significantly smaller than the other groups, and the surface of windows are more integrate and smooth, and mean mineral concentration is more higher than those of the other groups. It can be concluded that 10% (NH4)2MoO2F4 solution has greater inhibit effect to the development of root caries, so as the 38% Ag(NH4)2F solution. But the former discolored the tooth much less than the latter.

Administration, Topical↗

PubMed1994

Recent advancements in the treatment of root surface caries.

The aim of the paper is to present a review focusing on the magnitude of the problem of root caries. In addition, consideration of the aetiology and characteristics of root surface caries pathology is given as a guide to the appropriate use of operative or non-operative treatment alternatives.

Dental Restoration, Permanent↗

PubMed1989

Caries on root surfaces exposed following gingivectomy in conventional rats infected with Streptococcus sobrinus and Actinomyces viscosus.

To study the ability of bacteria associated with coronal caries to initiate root surface caries, a rat model was used. Root surfaces were exposed by gingivectomy in rats fed a caries-promoting diet and orally inoculated with either Actinomyces viscosus M-100, Streptococcus sobrinus (mutans) 6715, or both. A fourth group received a diet containing antibiotics. The animals were sacrificed 64 days following the gingivectomy performed on the right molar quadrants. Gingivectomy significantly increased exposed lingual root length and root caries incidence. There were no caries on non-gingivectomy root surfaces. Root surface caries incidence in the groups inoculated with A. viscosus and A. viscosus plus S. sobrinus did not differ. For both these groups, root caries incidence was significantly greater than that for the group inoculated with S. sobrinus alone. Root caries incidence in this latter group did not differ from that in the control group.

Actinomyces↗

PubMed1990

Association of the microbial flora of dental plaque and saliva with human root-surface caries.

Dental plaque was obtained from one or two sound root surfaces of subjects with different degrees of root-surface caries experience. From subjects with root-surface caries, plaque samples were also obtained from either one incipient or one more advanced lesion. Proportions of the total flora were determined for total streptococci and different streptococcal species, total and different Actinomyces species, and lactobacilli. A sample of saliva was obtained from about one-third of the subjects for determination of the concentrations of mutans streptococci and lactobacilli. The main observations were: (1) Subjects without root-surface caries or restorations (group I), as compared with subjects with root-surface caries with or without restorations (group II), were characterized by having a lower prevalence and proportion of mutans streptococci and a higher prevalence and proportion of A. naeslundii in plaque on sound root surfaces; (2) subjects in group I also tended to have a lower salivary concentration of mutans streptococci and lactobacilli than subjects in group II; (3) dental plaque on sound surfaces in group II subjects contained a lower proportion of mutans streptococci than plaque associated with incipient or advanced lesions; and (4) the prevalence and proportion of lactobacilli in plaque associated with sound as well as carious root surfaces were very low. The data reinforce findings from other studies and indicate that, as for coronal caries, the plaque and saliva populations of mutans streptococci specifically are correlated positively with the presence of root-surface caries.

Actinomyces↗

PubMed2005

Coaggregation profiles of the microflora from root surface caries lesions.

Bacterial coaggregation reactions between different species and the auto aggregation of the same species are associated with the initiation and development of dental plaque and biofilms. As no such data is available on isolates from root caries lesions, we evaluated, by a visual, semi-quantitative scoring system and a spectrophotometric, quantitative assay, the coaggregation of 22 different wild-type microbial species comprising ten bacterial genera and a single Candida spp. The quantitative coaggregation assay we used proved to be a more sensitive method than the semi-quantitative, visual evaluation as the results yielded the percent coaggregation. Fusobacterium nucleatum, Lactobacillus acidophilus, Streptococcus bovis II/2 and Gemella morbillorum were observed having higher degrees of autoaggregation than the other examined strains. Significant levels of inter-species coaggregation was seen between: (1) Actinomyces spp. and Veillonella spp.; (2) Actinomyces israelii and Peptostreptococcus prevotii; (3) Campylobacter gracilis and Actinomyces spp.; (4) Prevotella intermedia and nine different species; and (5) Fusobacterium nucleatum and six other species. The single Candida albicans isolate did not coaggregate to a significant extent with any of the 21 bacterial isolates studied. Scanning electron microscopy observation of the coaggregation interactions between bacterial pairs having strong coaggregation reactions revealed varying adhesive patterns. Our findings on coaggregation amongst these isolates imply existence of multiple interactions between the coaggregation-inducing bacterial species in root caries. In particular, Actinomyces spp., Veillonella spp., Prevotella spp. and Fusobacterium spp. appear to play a significant role in this context.

Aged↗

PubMed1988

Epidemiology of root surface caries in patients treated for periodontal diseases.

The prevalence of root surface caries was estimated in 83 patients surgically treated for periodontal disease and some relating factors were analyzed. The overall root caries index (RCI) was 6.28%. Anterior teeth in the mandible were significantly less affected than other groups of teeth. Root surfaces, divided into subgroups according to surgical treatment and length of exposure, showed no significant differences in RCI. No correlation was found between DFS-index and RCI. RCI increased with age. Concomitantly in older people more time had elapsed between the periodontal treatment and the present clinical examination. Salivary S. mutans counts and a combination of higher salivary S. mutans and lactobacilli counts were good indicators for the presence of root surface caries.

Adult↗

PubMed2004

Caries and periodontal disease of the elderly in Pomerania, Germany: results of the Study of Health in Pomerania.

OBJECTIVE: The aim of this study was to describe the oral health status of older adults living in northeastern Germany. MATERIALS AND METHODS: Representative samples of adults aged 60 years or older were examined as part of Study of the Health in Pomerania, a cross-sectional, population-based study. Data on 1446 subjects aged 60-79 years were evaluated for coronal caries using the decayed/missing/filled teeth (DMFT) index, root caries using the root caries index (RCI), calculus, plaque, bleeding on probing, pocket depth and attachment loss. RESULTS: The prevalence of edentulousness varied from 16% in the 60-65-year-old group to 30% in the 75-79-year-old group, whereas the median number of remaining natural teeth per subject varied from 14 in the youngest age group (60-65 years) to one in the oldest (75-79 years). Among subjects aged 60-69 years, a quarter (26%) of the teeth examined had coronal restoration against 17% in the oldest age group (70-79 years). Coronal caries was found in 2% of the teeth in both age groups. Among teeth with gingival recession, 6% had fillings on root surfaces and 2% had root caries, irrespective of age. In all, 11% of the subjects had at least one untreated coronal lesion and 27% had at least one untreated root caries lesion. Plaque score, calculus score and bleeding on probing were higher in the oldest age group (70-79 years). The prevalence of periodontal disease expressed as the presence of at least one periodontal pocket of 4 mm and more, was higher in men and among the younger subjects (men aged 60-69 years: 85% vs. 71% in 70-79-year-old men; women aged 60-69 years: 71% vs. 62% in 70-79-year-olds). The prevalence of attachment loss of 3 mm or more followed a similar pattern. CONCLUSIONS: It seems therefore that in this population, the major oral health concern is related to caries and the small number of teeth retained among the dentate subjects.

Age Factors↗

PubMed1985

Streptococcus mutans and Lactobacillus detection in the assessment of dental root surface caries risk.

Forty-five subjects contributing 150 root surfaces with gingival recession were sampled seven times over a 32-month period. We calculated isolation frequencies of lactobacilli on selective Rogosa SL agar and S. mutans in a sensitive enrichment broth and on mitis salivarius agar. Both S. mutans and lactobacilli were isolated more frequently from surfaces which became carious than from those remaining caries-free. Isolation frequencies were also higher for caries-free surfaces in caries-active subjects than for caries-free surfaces in caries-inactive subjects. The presence or absence of S. mutans and lactobacilli in samples taken at baseline could discriminate between subjects who were to be root-caries-active and those who were to remain root-caries-inactive during the subsequent observation period. Moreover, if both bacteria were detected or only S. mutans was detected on a root surface at its entry into the study, that surface had a greater risk for developing a root lesion. However, the tests could not predict which root surfaces within the mouths of caries-active subjects were to become carious. Analysis of the data suggests that simple microbiological detection tests may be useful in identifying patients at high risk of root caries.

Aged↗

PubMed1993

[Microbiology of root surface caries].

There are no significant differences between the microflora of root surface caries and enamel caries. However, intact root surfaces and active lesions may show differences in the proportion of microorganisms. S. mutants together with Lactobacillus on the same surface indicate a higher risk for root surface caries.

Dental Caries↗