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PubMed1990

The prevalence and pattern of distribution of root caries in a Scottish medieval population.

The prevalence and pattern of distribution of root caries were determined in a Scottish Medieval population. The principal finding was a lower root caries prevalence, compared with that of modern times, with respect to surfaces at risk; this was particularly marked with respect to buccal root caries. A lower intake of refined sugars and the presence of heavy deposits of supragingival calculus are suggested as factors that may be responsible for the observed differences. The common site for the early root caries lesion was just apical to the enamel-cementum junction. Initially, it extended laterally in the form of an elliptical erosion; however, the greater the depth of the lesion, the more circular the outline became.

Adolescent↗
PubMed1994

Root caries histopathology and chemistry.

This paper reviews the histopathology of root surface caries, and the effect of fluoride on the root caries process. The root caries process may be defined as a dynamic equilibrium similar to enamel caries. The caries process produced acid demineralization in exposed root surfaces and resulted in a lesion body when viewed in the light microscope. A relatively intact surface layer was not always present unless root caries was observed. In the absence of fluoride, a significant surface layer was left devoid of mineral but with intact collagen. Fluoride helped to prevent lesion formation and produced radiodense banding within the lesions in in vitro models. Remineralization occurred on the remaining mineral and not on the collagen matrix devoid of mineral. The conversion of active to inactive root caries requires the formation of a mineralized layer and implies the loss of surface tissues and contour in the clinical situation.

Animals↗
PubMedDate not supplied

Role of biodental engineering factors (BEF) in the etiology of root caries.

A preliminary study and hypothesis of the etiology of root caries is presented with appropriate data suggesting that biodental engineering factors (BEF) be introduced into the equation that is generally accepted in the formation of all caries. Principally, because of the rapid progression and location of root caries, BEF in addition to bacterial plaque and suitable substrate contribute to the development of these unique lesions. The dominant and most significant factors recognized by bioengineers are tooth flexure, stress concentration, stress corrosion, and piezo-electricity. All of these factors interplay during the dynamics of occlusal activity causing the loss of tooth substance. A new and revised model is being presented that provides a basis for the etiology of root caries.

Bite Force↗
PubMed1992

Prevalence and intraoral distribution of coronal and root caries in middle-aged and older adults.

This work describes the prevalence and intraoral distribution of coronal and root caries in 326 predominantly white, educated, middle-aged and older adults. Study participants were recruited from Tufts Geriatric Outreach Program, Nutritional Status Study (NSS), and the Forsyth Root Caries Study. Eighty-five percent of participants reported visiting their dentist in the last year. The median number of teeth was 21 in the 65+ age-group, and 40% of participants had coronal caries and 33% had root carious lesions. The mean coronal and root caries (DFS) was higher and the proportion of decayed surfaces to all decayed and filled surfaces (%D/DFS) was lower than in other comparable studies. A comparative analysis of intraoral distribution of coronal and root caries and their relation with age is discussed.

Adult↗
PubMed1995

Human root caries: microbiota in plaque covering sound, carious and arrested carious root surfaces.

The plaque microbiota covering sound or carious root surfaces were studied and compared with that covering arrested root caries lesions. From each of these categories five extracted teeth were examined. The experimental design of the study allowed us to relate the qualitative and quantitative microbial composition to the degree of integrity of the root surface. Plaque was sampled by a newly developed 'mowing' technique. Plaque samples were cultured anaerobically on nonselective Columbia blood agar plates supplemented with 5% hemolyzed human blood and on media selective for Lactobacillus spp. and streptococci of the mutans group. The cultivable microbiota were quantitatively speciated using Rapid ID 32A, Rapid ID 32 Strep, API 20 Strep, API ZYM, and API 50 CH tests and SDS-PAG electrophoresis. Regardless of the state of mineralization, the microbiota on all surfaces resembled marginal plaque associated with gingivitis. In addition to the gram-positive predominant facultative anaerobic genera Streptococcus, Staphylococcus, Lactobacillus and Actinomyces, gram-negative anaerobes, predominantly Bacteroides, Prevotella, Selenomonas, Fusobacterium, Leptotrichia, and Capnocytophaga, showed the highest isolation frequencies. On all surfaces Actinomyces spp. predominated, with streptococci and lactobacilli forming a minor part of the microbiota. With respect to the detected proportions of anaerobes, microaerophiles, Actinomyces naeslundii, Prevotella buccae and Selenomonas dianae, significant differences were observed between the three categories of root surfaces. The total CFU's on both caries-free and caries-active surfaces were significantly higher than on arrested lesions. In general, the results support a polymicrobial etiology for caries initiation on root surfaces, with A. naeslundii, Capnocytophaga spp., and Prevotella spp. making specific contributions to the processes of cementum and dentin breakdown.

Actinomyces↗
PubMed1993

Root caries susceptibility in periodontally treated patients. Results after 12 years.

The aim of the investigation was to study the individual susceptibility to root caries in periodontally treated patients in a long-term follow-up of 12 years. Age, plaque score, salivary counts of lactobacilli and mutans streptococci, salivary secretion rate and buffer effect, oral sugar clearance time and dietary habit index were tested as possible predictors for root caries incidence. During the whole observation period of 12 years, new root caries lesions were recorded in 24 of a total of 27 patients. In 8 of these, the root caries incidence was between 1 and 5, in 7 between 6 and 9 and in 9, 12 or more new DFS. However, the annual mean number of new DFS was rather low. 13 patients with > 5 new DFS% during the 3rd 4-year period (years 9-12) differed significantly from 14 patients with < or = 5 new DFS% in salivary mutans streptococcus counts (p < 0.01), plaque scores (p < 0.001) and new DFS% during the 2nd 4-year period (years 5-8) (p < 0.001). Simultaneously, risk values among the variables tested at the 8-year examination were about 3 x more prevalent in patients that developed > 5 new DFS% in years 9-12 than in those with < or = 5 new DFS%. During the whole 12-year observation period, smokers had significantly more root caries than non-smokers (p < 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗
PubMed1993

Relationships between mutans streptococci and perceived treatment need of primary root-caries lesions.

A total of 447 primary root-caries lesions from 169 dental patients was studied to determine the relationships between mutans streptococci and the perceived treatment need of primary root-caries lesions. Samples of this altered dentine for microbiological culture were obtained. Lesions were classified into 5 treatment categories: soft and restore, leathery and restore, leathery and debride of caries, leathery and treat chemotherapeutically, and hard, to receive no treatment. The total numbers of mutans streptococci decreased significantly with decreased treatment need. The percentage of mutans streptococci from lesions requiring no treatment was significantly less than from lesions requiring treatment. The frequency of isolation of mutans streptococci was significantly greater from lesions requiring more treatment. Significantly more lesions containing > 10(2) mutans streptococci were distributed in the groups with a greater perceived treatment need or with larger dimensions occluso-gingivally and/or mesio-distally or bucco-lingually or with a closer proximity to the gingival margin.

Adult↗
PubMed2004

Comparative fluorescence spectroscopy of root caries lesions.

In this study, the light-emission properties of carious and sound root surfaces were investigated under a wide range of excitation wavelengths. Human molar teeth with exposed root surfaces containing light- and dark-discolored root caries (n = 3 of each) were selected. Emission spectra were recorded from carious and corresponding sound root surface areas from each tooth by using a fluorescence spectrophotometer at excitation wavelengths from 360 nm up to 580 nm, in steps of 20 nm. The spectra were corrected for fluctuations in detector sensitivity and excitation light intensity, and normalized to peak intensity. Excitation spectra were recorded for selected emission wavelengths that showed maximum intensity. Light- and dark-discolored root surface caries showed distinct fluorescence emission bands between 600 and 700 nm that were not present in sound root surface areas. These bands were strongest for excitation wavelengths between 390 and 420 nm. The excitation spectra of root caries revealed maximum excitation at around 405 nm, which is equivalent to the Soret band of porphyrin compounds. The emission spectra of both types of root caries lesions were shifted towards longer wavelengths (red shift at half maximum) when compared to the spectra of corresponding sound root surfaces. The red shift for dark-discolored root caries was higher than for light-discolored lesions at all excitation wavelengths.

Color↗
PubMed1993

Relationships between yeasts and primary root-caries lesions.

A total of 447 primary root-caries lesions from 169 dental patients was studied to determine the relationships between their clinical severity and the number and frequency of isolation of yeasts. Yeasts were isolated more frequently from soft lesions, from lesions at the gingival margin and from lesions deemed to require restoration. These associations may be due to the aciduricity and acido- genicity of yeasts but the relatively low numbers found do not support a pathogenic role for yeasts in the aetiology of root caries: at best they may be marker organisms of the most severe disease.

Analysis of Variance↗
PubMed2004

Root caries prevalence in a group of Brazilian adult dental patients.

The aim of this study was to measure the caries prevalence in the root surface in a group of Brazilian adults. The prevalence and their intraoral distribution of caries lesions of root surface were assessed in dental patients ranging in age from 35 to 44 and from 50 to 59 years of age of both sexes (n=360). A total of 98.9% had root surfaces with gingival recession and 78.1% had at least one root caries lesion. The prevalence of the disease was analyzed using the Root Caries Index (RCI). The average value was greater for women (18.6%) than for men (13.4%) (p<0.01) and similar in both age groups (p>0.01). The maxillary canines and first premolars and the mandibular molars presented the greatest RCI values. The RCI was greater in the proximal surface of the maxilla and buccal surface of the mandible. We conclude that caries of the root surface are present in the Brazilian population and deserve attention concerning their actual role in the epidemiology of principal oral diseases of the adult population.

Adult↗
PubMed1992

Prediction of root caries in periodontally treated patients maintained with different fluoride programmes.

The aims of the investigation were to evaluate the effect of different fluoride programmes, as adjuncts to professional plaque control every 3-4 months, on root caries incidence in periodontally treated patients and to identify risk factors for root caries development. Ninety-nine individuals, 33-76 years old, who had been treated for periodontal disease were subjected to one of three fluoride programmes during a 2-year period: (1) professional application, 3-4 times/year, of Duraphat (n = 34) or (2) of a 0.4% stannous fluoride gel (n = 33), or (3) daily mouthrinsing with a 0.05% sodium fluoride solution (n = 32). A number of clinical recordings and laboratory tests, used as presumptive risk indicators for root caries, were carried out before and on three different occasions after the periodontal treatment. No statistically significant differences were found between the various fluoride programmes. During the 2-year period, a total of 246 new decayed or filled surfaces (DFS) were recorded, 72 (29.3%) of which were diagnosed as active and 124 (50.4%) as inactive root caries lesions; 50 (20.3%) of the surfaces had been restored. Individuals with > or = 1 new root DFS during the 2 years (n = 50) differed significantly from those with 0 new root DFS (n = 49) as concerns salivary counts of mutans streptococci and lactobacilli, root plaque scores and percentage of exposed root surfaces. Baseline root caries prevalence (r = 0.43) and root plaque scores (r = 0.36) showed the highest correlations with new root DFS.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed2004

Estimating rates of new root caries in older adults.

Although older adults are keeping their teeth longer, no national data are available on new caries in this age group. To characterize the extent of caries among older adults, we systematically reviewed studies on root caries incidence, increment, attack rate, and annual total (root + coronal) caries increment. We used a random-effects model to estimate annual summary measures and their 95% confidence intervals (CI) and tested for heterogeneity. For the 9 studies reporting root caries incidence, the summary measure equaled 23.7% (CI = 17.1-30.2%). For the 9 studies reporting root caries increment, the summary measure was 0.47 surfaces (CI = 0.34-0.61). For the 7 studies reporting total caries increment, the summary measure equaled 1.31 surfaces (95% CI = 1.01-1.61 surfaces). Because of heterogeneity, summary measures should be interpreted with caution. This research suggests, however, that older adults experience high rates of new caries and could benefit from caries-prevention programs.

Age Distribution↗
PubMed1993

Root caries incidence and associated risk factors in middle-aged and older adults.

Data from population-based longitudinal studies required to assess the incidence of root caries and associated risk factors are sparse in the literature. To this end, a group of 130 middle-aged and older adults were examined for root caries at baseline and at a follow-up visit between nine and 24 months (median: 16 months). Dental examinations were conducted by one examiner at a Tufts dental clinic using NIDR defined diagnostic criteria. Fifty percent of subjects in this study population developed one or more new root caries lesions over the follow-up period. Also, an annualised increment of 0.60 (SD: 0.72) decayed and filled surfaces per person was observed for the 45-59 year old group while the 70+ group showed an annualised increment of 1.38 (SD: 1.97) DFS in this study. Multivariate logistic regression analysis identified past root caries experience, high plaque score, and high number of teeth (> = 22) to be positively associated with new root caries (p < 0.05).

Age Distribution↗
PubMed1995

Relationship of diet to root caries.

A Nutrition and Oral Health Study was conducted on 141 middle-aged and elderly adults (54% female and 46% male; aged 47-83 y, mean = 67; 51% college educated; and 89% white). This study reports on the relationship between root caries and diet. Nutritional composition was derived from two 3-d food diaries. Root caries was measured according to the 1985 Adult Survey Diagnostic Criteria of the National Institute of Dental Research. When the individuals were segregated by their root DFS (decayed and filled surfaces) status into highest (> or = 7) and lowest (< or = 1) quartiles, the sucrose consumption was significantly higher in the higher DFS group. Mean energy consumption and mean number of teeth were the same in both groups. When the individuals were segregated by sucrose consumption into highest (> or = 89 g) and lowest (< or = 31 g) quartiles, DFS root status was significantly higher (P < 0.01) in the highest quartile group (7 g) vs the lowest group (4 g). By using data from subjects with two food diaries, a stepwise-linear-regression model for root caries showed that 4.2% of the variance for root caries was explained by sucrose, 2.8% by plaque, 3.8% by total number of teeth, and 5.6% by gingival recession. These data suggest that root caries has a similar dietary etiology to coronal caries.

Aged↗
PubMed2001

Reversal of primary root caries using a dentifrice with a high fluoride content.

Root caries is a widespread problem and can be quite serious in older populations. The restoration of root carious lesions is often difficult. Compared to enamel caries, there has been limited research into the pharmaceutical management of primary root caries lesions (PRCLs), and many of these studies have been carried out in vitro, with limited numbers of clinical trials. Fluoride is presently a cornerstone in dentifrice formulations for cost-effective and anticaries therapy. It is generally accepted that fluoride ions promote remineralization of tooth substances and reduce the rate of demineralization. The use of a dentifrice with a high fluoride content may be considered to reverse PRCLs, since more fluoride is required for the remineralization of roots than for enamel. This paper reviews the effects of dentifrices with high fluoride contents on the management of root caries.

Adult↗
PubMed2004

Caries detection and quantification with DIAGNOdent: prospects for occlusal and root caries?

A possible consequence of light absorption as the interaction of electromagnetic radiation with molecules of the tooth's hard substances is, apart from the emission of heat, fluorescence. It was demonstrated that the emission spectra of enamel, dentin, and caries look alike upon excitation with red light; however, fluorescence increases with the process of carious destruction. Based on that, the DIAGNOdent System was developed, which simultaneously injects red light into the tooth surface and detects the resulting fluorescence. Due to this design, clinical application is currently limited to accessible occlusal and smooth surfaces. For occlusal caries detection, it was shown that validity and reproducibility could be optimized over classical diagnostic tests for deep dentin lesions with seemingly intact surfaces. The detection of root caries does not play a relevant role in the directly accessible areas, but estimation of the lesion's activity and progression rate is a prerequisite for differentiated lesion management Excellent reproducibility of the laser fluorescence measurements was confirmed for this scenario. Lesions with a soft surface texture show significantly higher fluorescence values than leathery or hard lesions, and values also increase with increasing cavity depth. DIAGNOdent offers the potential to improve follow-ups and estimation of the prognosis and to support clinical management of primary carious lesions.

Dental Caries↗
PubMed1992

Human root caries: histopathology of arrested lesions.

The histopathology of arrested root caries lesions was examined in extracted human teeth. The main structural characteristics of arrested lesions were the completely mineralized surface area and the formation of a distinct sclerosis of the dentinal tubules. Intertubular dentin was, with the exception of the dentinal tubules, fully mineralized up to the surface. Dentinal tubules near the surface were either filled with ghosts of microorganisms or with crystals of different shapes. Sclerosis of the dentinal tubules was characterized by the presence of three different patterns of intratubular mineralization that occur in distinct regions of the zone of tubular sclerosis. The patterns were distinguishable by the type of crystals and their association with organic structures such as collagenous fibrils or odontoblast processes. It is suggested that arrested lesions are based on (1) the formation of an inner barrier that interrupts the diffusion of substrata from the pulp to invaded bacteria, (2) the formation of an outer barrier by a compact, highly mineralized surface region which blocks the diffusion of products of bacterial metabolism into dentin, and (3) an area of mineralization which extends from the outer barrier toward the root canal within demineralized dentin. The present study demonstrates the considerable potential of caries lesions in dentin to become arrested, and subsequently partially remineralized. These phenomena seem to depend on the severity of an active lesion and its location on the root surface. This should be taken into account when diagnosing root caries lesions. The potential of root caries lesions to become arrested indicates that the treatment concept of active root caries lesions should be reconsidered.

Adult↗
PubMed2003

Association between serum albumin and root caries in community-dwelling older adults.

Recently, associations between dental diseases and the general health condition have been reported. The purpose of this study was to evaluate, by serum albumin concentrations, the relationship between the general health condition and root caries. We randomly selected 763 individuals (600 70-year-olds and 163 80-year-olds) living in Niigata City, Japan. The variables body composition, blood measurements, daily nutrient intakes, and root caries were measured. The relationship between root caries and serum albumin concentration was evaluated. The differences in serum albumin concentrations between subjects with untreated root caries (DT = 0 and DT > 3) were 75.56 mg/dL in 70-year-olds and 202.97 mg/dL in 80-year-olds (p < 0.05, ANOVA). The findings of the present study indicated that a relationship between root caries and serum albumin concentration in these elderly subjects is highly possible.

Aged↗