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PubMed2000

Number of teeth and risk of root caries.

OBJECTIVE: This study aimed to investigate the association between number of natural teeth and prevalence of root caries. DESIGN: A cross-sectional design was adopted. A stratified multi-stage purposive sampling method was used to select a wide range of elderly people from all social classes, educational levels and sexes. Data was collected through interviews and clinical examinations. SETTING: Urban area in Chiang Mai-Thailand. PARTICIPANTS: 549 elderly dentate aged 60-74 years. MAIN OUTCOME MEASURES: Teeth with decay and filled roots (DF-T). RESULTS: The prevalence of root caries was 18.2% with a mean DF-T of 0.58 (S.D. 2.02). Results of multiple logistic regression showed that number of teeth, DMF-S scores, sex, and socio economic factors were statistically significantly associated with root caries (P < 0.05). Adjusted odds ratios demonstrated a 14% increase in the chance of having root caries when the number of teeth increased one unit. Similarly, a 3% increase was observed for each unit increase in the DMF-S scores (p < 0.001). Being male, having more than four years of education and earning more than 1500 baht/month increased the chances of root caries by 76%, 139% and 85% respectively (p < 0.001). Recession and age were not statistically significantly associated with root caries. CONCLUSIONS: Having more teeth, higher DMF-S scores, earning more than 1500 baht/month, having more than 4 years of education and being male increased the likelihood of having root caries.

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PubMed1999

A cross-sectional study into the prevalence of root caries in periodontal maintenance patients.

The aim of this cross-sectional study was to investigate cross-sectionally the prevalence and several risk indicators of root caries in 45 periodontal maintenance patients, who had been actively treated for adult periodontitis 11-22 years ago. These patients were part of a routine 3-6 monthly maintenance schedule. Active and inactive root caries and root fillings were recorded, as well as coronal caries experience. Plaque and bleeding scores, number of exposed root surfaces, rate of saliva secretion, saliva buffering capacity, mutans streptococci counts and Lactobacilli were also scored. From the total of 45 study subjects, 37 patients (82%) showed root lesions (root caries and/or root fillings), while only 8 patients were free of any root lesions. On average, there were 4.3 root lesions per patient (range 0-19) in the present study. 10 patients had active root caries lesions. Of all damaged root surfaces, 9% were active lesions, mostly located on mandibular teeth at lingual and vestibular sites: 40% were inactive lesions often detected at vestibular sites. The remaining damaged root surfaces (51%) were restored; they were equally divided over both jaws. A higher number of root lesions was observed in those patients with >106 mutans streptococci/ml saliva. Although the actual number of lesions per patient was low in relation to the large number of sites with gingival recession, the results from this cross-sectional study in periodontal maintenance patients indicate that: (1) root caries can be regarded as a complication in periodontal maintenance patients; (2) the individual number of root lesions correlate with individual dental plaque scores; (3) a high number of root lesions is associated with high counts of salivary mutans streptococci; (4) no relation between root caries and coronal caries experience, salivary secretion rate or salivary buffering capacity seems present. Therefore, repeated oral hygiene instructions and adjunctive preventive measures including diet counseling and fluoride rinses, as well as fluoride and chlorhexidine varnishes, should be advocated in high-risk patients.

Adult↗
PubMedDate not supplied

Relationship of removable partial denture use to root caries in an older population.

The pattern and severity of root caries in a selected older population, living in the community and attending a general dental practice in Bexhill, East Sussex, England, is reported. A total of 146 patients were examined to determine the relationship among removable partial dentures, their design, and root caries. Of those patients, 57% wore removable dentures and had a higher prevalence of exposed root surfaces and root caries, particularly on abutment teeth. In addition, root caries lesions on abutment surfaces were found to be larger and more active than those on nonabutment surfaces.

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PubMed1995

Three-year root caries incidence and risk modeling in older adults in North Carolina.

OBJECTIVES: The purposes of this study were to describe the incidence of root caries and to identify its risk factors in a representative sample of older adults. METHODS: Root caries incidence was estimated and multivariate risk assessment models were developed to identify predictors for root caries in a three-year follow-up study of 234 black and 218 white noninstitutionalized adults aged 65 and older residing in North Carolina. RESULTS: During the observation period, 29 percent of blacks developed root caries, compared to 39 percent of whites (P < .05). The mean net DFS increment per person was 0.55 +/- 0.13 root surfaces for blacks vs 0.80 +/- 0.21 for whites (P > .32). Multivariate logistic regression analysis indicated that blacks wearing a partial denture, having some root fragments, having an average gingival recession > or = 2 mm, and being free of P. intermedia were at greater risk for developing new root caries. The model for whites showed that retired people with their most severe gingival recession > or = 4 mm, an average probing pocket depth > or = 2 mm, and taking antihistamines were more likely to develop new lesions. CONCLUSIONS: These findings suggest that older blacks had less risk of root caries than whites, and in both groups indicators of poor periodontal status increased the risk of root caries.

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PubMed1990

Adult root caries survey of two similar communities with contrasting natural water fluoride levels.

For a comparative study of root caries, 502 adult lifelong residents of a naturally fluoridated community (1.6 ppm F) and 465 such residents of a nearby, comparable nonfluoridated community (0.2 ppm F) were examined. Substantially fewer carious lesions were found among adults in the fluoridated community relative to the nonfluoridated community. This was observed in virtually all age- and gender-specific groups. Given a cross-sectional design and considering only exposed root surfaces, root caries was related to age. In addition, the data from this study show that the number of root caries lesions is underestimated but that root caries prevalence is overestimated by the standard Root Caries Index (RCI). A less restrictive form of the RCI may lead to more valid estimation of root caries prevalence.

Adolescent↗
PubMed2003

Factors associated with root caries incidence in an elderly population.

OBJECTIVE: To identify baseline factors associated with future root caries development in an elderly population. BASIC RESEARCH DESIGN: Oral health and general health status examinations were carried out at baseline and after one and two years. In order to identify risk predictors of root caries with a different degree of robustness, three multiple logistic regression analyses where the dependent variables were one, two and three or more disease events were performed. PARTICIPANTS: Six hundred noninstitutionalised adults aged 70 in Niigata, Japan took part in the baseline examination. A total of 373 subjects were followed up for two years and identified as dentate at the two-year examination. RESULTS: During the period of study, 35.9% of subjects developed at least one new root caries lesion. The mean number of new root caries lesions per subject was 0.9 (sd = 1.7). Logistic regression analyses indicated that having one or more root D surface and mean LA > or = 3.6 mm were the most robust risk predictors, having two or more prosthetic crowns, non use of interdental brushes or dental floss and LB > or = 10(5) CFU/ml were moderately robust risk predictors, and a Body Mass Index < 20 was the least robust risk predictor. CONCLUSIONS: These findings suggest that oral health status is a good risk predictor, and poor general health indicated by a low Body Mass Index may also contribute to root caries occurrence in this elderly population.

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PubMed1994

The distribution of root caries in community-dwelling elders in New England.

An in-home examination of a probability sample of elders aged 70 and older living in the six New England states was conducted to estimate the prevalence and extent of root caries. Oral examinations were conducted by the visual-tactile method using a portable lamp, explorer, and a mouth mirror. Fifty-two percent of the study participants showed root caries experience and 22 percent had untreated root caries. In contrast to previous studies, this analysis showed that buccal root surfaces were no more likely than proximal surfaces to be affected by root caries. Logistic regression analysis showed that gingival recession and number of teeth were positively associated with root caries, while better oral hygiene maintenance and regular dental visits were negatively associated with root caries lesions (all factors: P < .05). The prevalence of root caries was found to increase with higher numbers of teeth except for a minority subgroup--i.e., those who retained 25 or more teeth. This study provides much-needed data on prevalence and extent of root caries in a probability sample of the oldest old in an entire region of the United States.

Age Distribution↗
PubMed1991

[Tooth health and periodontal condition in adults with and without root caries].

In a population sample of 2261 men and women aged between 35 and 74 years the prevalence of root caries increased for both sexes consistently with age and ranged between 49 and 73%. In the mean 1.8 to 2.9 teeth were affected. Subjects with root caries had fewer teeth, more teeth with untreated coronal caries, and more teeth which needed conservative treatments. The number of extractions required was the same in subjects affected by root caries. In the age older than 65 years subjects affected by root caries had more teeth in the average of 2 teeth and significantly more fillings in their teeth. If a DMF/T-index of 15 to 19 was recorded nearly half of all subjects were affected by root caries. In individuals with root caries lesions aged between 35 and 54 years significant severe periodontal disease were seen.

Adult↗
PubMed1990

Human root caries: histopathology of advanced lesions.

The histopathology of human root caries was examined in extracted teeth. The present study details several stages of advanced carious lesions in root dentin. Lesions of different severities were assessed by different optical methods. Four major root caries patterns were defined and significant differences between coronal and root caries elucidated. The patterns were distinguishable by (1) their location at the exposed root surface, (2) their mode of spreading towards the root canal and over the root surface, (3) their mode of bacterial spreading in dentin and (4) the role of dentinal defense mechanisms. In addition, a comparison of clinical and histological classification of lesions revealed that the carious process extended much deeper towards the root canal and had a higher degree of both bacterial infection and dentin demineralization than could be predicted by clinical examination.

Adult↗
PubMed1997

Partial dentures as an independent indicator of root caries risk in a group of older adults.

OBJECTIVES: To estimate the independent association between the wearing of removable partial dentures (RPD) and the presence of root caries in a population of older adults. DESIGN: Multivariate logistic regression modeling of root caries prevalence using different measures of root caries as dependent variables. The model included measures of disease history as indicators of historical risk. SETTING: Data collected in the field from three areas of England. SUBJECTS: Random sample of adults aged 60 years and over, drawn from lists of patients registered with general medical practitioners. INTERVENTION: Field measurements of a range of oral health variables including oral disease, disease history, oral status and various social and demographic measures. MAIN OUTCOME MEASURES: The presence of root caries, unsound and sound root restorations. RESULTS: Of the five different models of root caries prevalence which were used, RPDs featured as an independent risk indicator for root surface caries in the three which were related to the presence of untreated disease. The odds ratios for the contribution made by RPDs were all over 1.6, and when considered alone was in excess of 2 in one model. These models were generally well fitting. RPDs did not feature as a risk indicator in the two models which related only to the presence of root surface restorations. CONCLUSIONS: In this study, where RPDs were present, the odds of untreated disease being present increased substantially.

Age Factors↗
PubMed1993

Future directions for root caries research.

Interest among researchers in the diagnosis, aetiology, prevention, and treatment of root caries has increased substantially over the past two decades. However, there are some fundamental problems impeding the advancement of the field which remain to be addressed and resolved. A universally acceptable definition of root caries is not yet available. The relationship of root caries to coronal caries has not been established. The underlying disease process is still not clearly understood. The optimal utilisation of preventive/therapeutic agents for the treatment or prevention of root caries has not been determined. New treatment materials and preventive agents have not yet been tested in controlled clinical trials. These are a few of the issues and problems which we address in this paper.

Humans↗
PubMed1986

Root caries in an optimally fluoridated and a high-fluoride community.

The purpose of this study was to measure the prevalence and distribution of root caries in two New Mexico communities. One community, Deming, had a natural fluoride concentration of 0.7 mg/L in its drinking water, optimum for its climate. The other, Lordsburg, was naturally fluoridated at 3.5 mg/L, five times the optimum. Dental examinations were carried out on 151 adults in Deming (mean age, 39.8 years) and 164 in Lordsburg (mean age, 43.2 years); only persons born in the communities were included. Prevalence of root caries was 23.8% in Deming and 7.3% in Lordsburg; mean number of lesions was 0.69 in Deming and 0.08 in Lordsburg (p less than 0.0001). Although there was more gingival recession in Lordsburg, Root Caries Index scores were five times greater in Deming. Root caries was more prevalent in older age groups, and was correlated with coronal caries experience in both communities. Root caries was correlated with plaque and calculus scores in Deming only. Logistic regression showed that city of residence was the major predictor of root caries, with other significant predictors being age, education, gingival recession, and loss of periodontal attachment. When combined with previous research, these results confirm that root caries experience is directly related to the fluoride concentration in the drinking water.

Adult↗
PubMed1989

[Gingival recession, root caries and its prevalence].

In our study 150 referred patients were assessed for the presence of gingival recession and root caries. The mean age of the patients was 40 +/- 9 years. On average they failed 6.8 teeth. Gingival recession was present in all patients, with mean value of 55.5% denuded dental root surfaces, the most frequently expressed on buccal root surfaces. Number of denuded dental root surfaces increases with patient's age. The root caries lesion was found in 75% of patients. Patients had on average 5.7 treated and untreated caries lesions. The number of root caries lesions increases with age of the patients as well. The mean Index of total root caries was 9.4%. Most frequently root caries of lower molars and premolars was found, mostly on the buccal surfaces, rather than on approximal and lingual surfaces.

Adult↗
PubMed1994

A comparison of primary root caries lesions classified according to colour.

Three hundred and ninety-five primary root caries lesions in 117 patients were included in this study. Each lesion was clinically characterised (colour, dimensions, distance from gingival margin and texture) and a sample of infected or altered dentine was taken using a standardised sampling procedure. The relationships between the colour and the microflora, texture, physical dimensions and distance from the gingival margin of the lesions were investigated. Lesions in each colour group (light brown, yellow, dark brown and black) were identified in each texture category (soft, leathery and hard), except for black lesions which were recorded as only soft or leathery. Black soft and black leathery lesions had a significantly greater area and harboured more lactobacilli than all other types of lesions while black leathery lesions also harboured significantly more yeasts. There were no significant differences in the number of bacteria or mutans streptococci isolated from soft or leathery lesions irrespective of lesion colour. Overall, these data indicate that the colour of primary root caries lesions is not a reliable indicator of primary root caries activity. Assessment of the clinical severity of primary root caries lesions requires consideration of lesion texture and the distance of the lesion from the gingival margin rather than the colour of the lesion.

Actinomyces↗
PubMed1992

Oral sugar clearance and root caries prevalence in rheumatic patients with dry mouth symptoms.

The relationship between root caries, oral sugar clearance, salivary flow rate, and salivary counts of mutans streptococci, lactobacilli and candida has been studied in a group of 22 rheumatic patients (age range 40-72 years). The study group comprised all subjects volunteering for a clinical trial on relief of dry mouth symptoms. The median salivary flow was 0.09 ml/min at rest and 0.9 ml/min during chewing stimulation. The median sugar clearance time was about 5 min in the sublingual area and 16 min in the lower buccal vestibule. For subjects with 0-2 root caries lesions the clearance time at both sites was shorter than for subjects with 3 or more lesions (p < 0.05). A long oral clearance time was significantly correlated with age, root caries (DS and DFS), low resting salivary flow, and high salivary counts of mutans streptococci. It is concluded that root caries in rheumatic patients with low salivary flow is significantly related to oral sugar clearance time.

Adult↗
PubMed2005

Root caries in periodontally treated patients in relation to their compliance with suggested periodontal maintenance intervals.

The purpose of this study is to investigate the correlation between the degree of patient compliance with the suggested periodontal maintenance treatment intervals and the new root caries development 5 years after the completion of the active periodontal treatment. The percentage of root surfaces with new root caries was low for both the erratic and the complete compliance patient groups. Erratic compliance with the suggested maintenance intervals 5 years after the active periodontal treatment leads to greater root caries prevalence, greater percentages of patients and root surfaces with new root caries, greater root caries prevalence for smokers, and greater percentages of new defects in root surfaces with further clinical attachment loss and plaque retention. The prevention of root caries development is based on the daily plaque removal and the high patient compliance with the therapist's suggestions for periodontal maintenance intervals.

Adult↗
PubMedDate not supplied

Dietary and salivary factors associated with root caries.

In this pilot study, dietary habits, microbial factors, and salivary factors in 20 older adults who had active decay on root surfaces were compared with those of 20 adults who had inactive or no root caries. In this case-control study, the groups were matched by sex and were of similar age. Subjects using medications known to induce dry mouth were excluded. Subjects completed a nutrition interview and a four-day food diary. Stimulated whole saliva flow rate, buffering capacity, levels of salivary lactobacilli with use of the Dentocult method, and S. mutans cultured on MSB agar were determined. The root caries group had a greater mean number of eating occasions per day (6.1 vs. 4.6), more frequent exposures to fermentable carbohydrates (5.8 vs. 4.2), and higher average daily sugars intake (133 g/day vs. 105 g/day) than the control group. Root caries subjects had significantly higher lactobacilli counts and less salivary buffering capacity. Within the root caries group, significant correlations were found with Root Caries Index and lactobacilli (r = 0.56) and S. mutans counts (rs = 0.50). These results show that frequent intake of simple sugars, high lactobacilli counts, and low saliva buffering capacity may be risk factors associated with root caries in older adults.

Aged↗
PubMed2003

Non-invasive management of superficial root caries lesions in disabled and infirm patients.

UNLABELLED: In disabled and infirm patients with limited, if any, capacity for independent oral self-care, it is difficult to control progression of root caries lesions. OBJECTIVE: To evaluate the effect of non-restorative cariostatic treatment on progression of active superficial root caries lesions (n = 56). DESIGN: Pilot study. SETTING: Department of Cariology, Institute of Odontology, Karolinska Institutet, Huddinge. SUBJECTS: 15 physically-dependent patients. INTERVENTION: The patients were allotted to one of the following groups. Group 1, professional tooth cleaning and application of tap water flavoured with eucalyptus oil; Group 2, professional tooth cleaning and application of Cervitec, (1% chlorhexidine in thymol-containing varnish), Group 3, professional tooth cleaning and application of Cervitec and Fluor Protector (varnish containing 0.1% fluoride). Every three months for 18 months, each subject received the treatment twice within a 10-day interval. MEASUREMENTS: The status of the 56 root caries lesions was evaluated every six months using a root caries index based on visual and tactile criteria. The examiners were blind to which treatment group the patients belonged. RESULTS: In most subjects (14 out of 15), progression of root caries lesions was arrested. No statistically significant differences could be demonstrated between the three treatment groups. However, regardless of treatment regimen, there was a statistically significant difference between the greater number of subjects exhibiting no progression of root caries lesions and those with lesion progression, at 6 (p = 0.022), 12 (p = 0.006) and 18 months (p < 0.001). CONCLUSION: This pilot study suggests that in disabled and infirm patients regular professional tooth cleaning with a fluoride containing paste, with or without supplementary varnishing with chlorhexidine-thymol and/or fluoride can prevent further progression of existing superficial root caries lesions.

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