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PubMed1988

Incidence of coronal and root caries in an older adult population.

Incidence rates for new root caries and new coronal caries in noninstitutionalized older adults are unknown. In this study, a representative sample of 451 elderly Iowans received dental examinations at the start of the study and again after 18 months. This dentate cohort had a mean of 0.87 new surfaces of coronal decay per person per year and a mean of 0.57 new surfaces of root decay per person per year. Coronal caries occurred at an annual rate of 1.4 surfaces per 100 susceptible coronal surfaces. Root caries occurred at an annual rate of 2.6 surfaces per 100 susceptible root surfaces. This study shows that both coronal and root caries were active in this older population, indicating a need for emphasis on the prevention and treatment of dental caries in older adults.

Aged↗
PubMed1983

Prevalence of root caries in the adult Finnish population.

A sample of 8000 persons was drawn to represent the Finnish population aged 30 years and over. The participation rate was 89.9%. Root caries was recorded when the lesion was obviously soft and more than half of it was located on cementum. Lesions adjacent to fillings were not included. The reproducibility and the standard of the clinical recordings were tested by reexamining 20% of the studied population 2-6 months after the first clinical examination. The overall prevalence of root caries was 21.6% for men and 14.5% for women. The prevalence increased for both sexes almost consistently with age. Root caries was found 1.6 times more often among men than women. Among men 2.23% and among women 1.19% of teeth were affected by root caries.

Adult↗
PubMed1990

[Prevalence of root caries in a healthy adult population].

An epidemiological study involving 963 subjects aged 25 to 64 years revealed at least one carious and/or filled root surface in 40.2% of all females and in 42.7% of all males. The number of teeth and tooth surfaces affected by root caries increases continuously with age. In relation to the total number of teeth, males display a higher prevalence of root caries than females, with the exception of men aged between 55 and 64. High-risk susceptibility shows no correlation with age, although there are more surfaces at risk in males. Independent of the sex, root caries prevalence is highest in the molars and premolars of the mandible and in the canine of the maxilla; lower incisors are the teeth with the least caries involvement. Labial root surfaces are most frequently affected by caries in the mandible; the prevalence rate is twice as high in males than females. The lingual surfaces of maxillary molars of females and the proximal and buccal surfaces of incisors of males are the most frequently affected tooth surfaces.

Adult↗
PubMedDate not supplied

Coronal and root caries in the older Iowans: 9- to 11-year incidence.

This study reports on coronal and root caries incidence in elderly Iowans between 1987 and 1998. The sample consisted of 74 survivors of the Iowa 65+ Oral Health Study cohort who received oral examinations both in 1987 and between 1996-98. The study found that average untreated coronal and root increments were 0.96 and 0.69 surfaces, filled increments were 18.22 and 1.28 surfaces, and combined increments were 18.3 and 1.27 surfaces, respectively. Therefore, annualized untreated coronal and root increments were 0.10 and 0.07 surfaces, filled were 1.80 and 0.13 surfaces, and combined increments were 1.81 and 0.12 surfaces, respectively. The annualized attack rates were 2.13 for coronal and 0.80 for root caries. Approximately 93% of the subjects developed some new coronal and 43% some new root caries increment. Dental caries still constitute a significant problem since a large proportion of the elderly developed caries during this period. This suggests a need for improved preventive and treatment strategies for this aged population.

Aged↗
PubMed1989

[Prevalence of root caries in women].

An epidemiological study involving 764 women aged from 25 to 64 years revealed at least one carious and/or filled root surface in 40% of all subjects. The number of teeth and tooth surfaces affected by root caries continuously increased with age. Prevalence has tripled after the age of 45. By contrast, the risk of caries shows no dependence on age. The highest root caries prevalence is found in the molars of the mandible and in the canines of the maxilla; the lowest attacked tooth type is in the lower incisors. Root caries is most frequently found on all buccal surfaces of molars in the mandible and on the oral surfaces of molars in the maxilla.

Adult↗
PubMed1996

Five-year incidence rates and intraoral distribution of root caries among community-dwelling older adults.

The 5-year incidence and intraoral distribution of decayed and filled root surfaces were evaluated in 379 black and 323 white residents of North Carolina aged 65 and older. During the period of study, approximately 39% of blacks developed at least one root DFS compared with 52% for whites (Wald X(2) test, p = 0.062). When the results were calculated using the net root DFS increment, blacks did not have significantly higher rates than whites over the 5-year study period (0.52 surfaces/person versus 0.42 surfaces/person, Survey Regression, n = 363, p = 0.708). However, for blacks, the 5-year incidence density rate of root DFS was 0.26 per 60 surface-months at risk, and for whites the rate was 0.19 new root DFS per 60 surface-months (incidence density ratio = 1.33, 95% CI = 1.01-1.76, p = 0.047). Intraoral distribution patterns for root caries incidence revealed that the approximal surfaces of the anterior teeth were involved most frequently, particularly in the mandible and maxilla in whites, followed in decreasing order by the buccal surfaces of the lower anteriors and the mesial surfaces of the upper anteriors in blacks. Although root caries incidence rates were obviously low, there were significant differences in the occurrence of caries between blacks and whites. The pattern of occurrence was similar for both races with root surface disease being concentrated in the approximal surfaces of the anterior teeth in a small proportion of affected individuals, with whites presenting more filled root increments than blacks. These findings suggest a need for more caries treatment in blacks and increased monitoring of this population since they are at a higher risk for root caries.

Black or African American↗
PubMed1985

Natural root caries: a histologic and microradiographic evaluation.

The purpose of this study was to obtain information about the detailed histopathology of naturally occurring root caries. Fifty extracted human teeth exhibiting some degree of root caries were sectioned longitudinally and examined with transmitted light, polarized light and microradiography. The occurrence of the histological zones of dentinal caries was tabulated and revealed a lesion body in all cases. Light microscopy showed the same basic features as microradiography and was most useful when the sections were imbibed in quinoline. A structureless area below the main body of the lesion was observed in 77% of the cases when using quinoline. This fluid more clearly defined the extent of the lesion and may show a "phenolic reaction" when using polarized light microscopy. Partial radiopaque surface layers were observed in almost 80% of the sections. This study has described the detailed histopathology of root caries, and aids in the development of model systems to evaluate this emerging dental health problem.

Dental Caries↗
PubMedDate not supplied

The effects of the combination of chlorhexidine/thymol- and fluoride-containing varnishes on the severity of root caries lesions in frail institutionalised elderly people.

OBJECTIVES: To compare the clinical effects of a fluoride-containing varnish (Fluor-Protector) in combination with a chlorhexidine-containing varnish (Cervitec) on existing root caries lesions in a group of frail elderly subjects. METHODS: A randomised double blind longitudinal study was utilised. Subjects (n = 102) were randomly allocated to a Test or Placebo group. All leathery and soft root caries lesions in all subjects were coated with Fluor-Protector while the lesions in the Test group were also coated with Cervitec and the lesions in the Placebo group were coated with a Placebo varnish. Treatments were repeated five times in a 12-month period. Clinical parameters associated with root caries, measurements of individual lesions and salivary levels of caries associated bacteria were made at intervals. RESULTS: The clinical severity of the lesions in the Test group did not change significantly during the 12-month study period. In the Placebo group the mean lesion width and lesion height and length of exposed root increased significantly and the lesions were significantly closer to the gingival margin. There were no significant changes in the salivary levels of caries-associated microorganisms after 12 months although, in both groups, there was initially a significant reduction in the salivary levels of mutans streptococci. CONCLUSIONS: The combination of Fluor-Protector and Cervitec is a useful, simple, quick and non-invasive method for the control and management of existing root caries lesions. The procedure could be performed by a dental hygienist and may be usefully applied in other high-risk groups including persons with Parkinson's disease, debilitating neuromuscular conditions and dry mouth from whatever cause.

Aged↗
PubMed2004

Remineralisation study of artificial root caries lesions after fluoride treatment. An in vitro study using electric caries monitor and transversal micro-radiography.

AIMS: To evaluate and compare remineralisation of root caries lesions after in vitro treatment with various fluoride (F) agents using an Electric Caries Monitor (ECM) and Transversal Micro-Radiography (TMR). MATERIALS: Permanent human teeth were extracted and root surface specimens were sectioned, prepared (n = 35), and randomly allocated into seven different experimental groups (groups 1-7). METHODS: Root surfaces were demineralised in an acidified gel (pH = 5.0) for 3 weeks followed by various F treatments and stored in a standardised remineralising solution at 37 degrees C for 6 weeks. The root surfaces were treated twice daily with different dentifrice slurries for 2 min, either with a neutral placebo dentifrice without F (group 5); or a neutral sodium fluoride (NaF) 1400 p.p.m. F dentifrice (group 1); or a neutral 1250 p.p.m. F dentifrice (group 6); or an acid dentifrice (pH 4.7) with 1400 p.p.m. F containing amine fluoride (AmF) (groups 3 and 4) or a 1250 p.p.m. (pH 4.7) AmF dentifrice (group 6). In groups 1, 2, 5, 6, and 7, the root surfaces were additionally rinsed for 2 min with a neutral non-F placebo solution. In groups 3 and 4, rinsing were performed for 2 min with an acid (pH 4.7) 250 p.p.m. F solution, containing 125 p.p.m. F as AmF and 125 p.p.m. F as potassium fluoride (KF), once or twice per day respectively. ECM was used to measure electrical resistance on root surfaces at baseline and after 3 and 6 weeks respectively. TMR technique was used to measure and compare root surface lesion depths and mineral loss. RESULTS: Six weeks daily treatment with a dentifrice slurry containing AmF followed by rinsing with a combination of equal amounts of AmF and KF solution twice a day showed a statistical significant higher ECM values compared with the other groups. TMR data measuring lesion depths and mineral loss reduction supported the results of the ECM findings. CONCLUSIONS: Daily application of a dentifrice slurry containing 1400 p.p.m. F as AmF combined with twice daily rinsing with a 250 p.p.m. F solution containing equal amount of AmF and KF significantly remineralise primary root caries lesions in vitro. ECM and TMR are valuable complementary methods in order to analyse the remineralisation processes.

Amines↗
PubMed1988

The effects of different levels of dietary sucrose on root caries subsequent to gingivectomy in conventional rats infected with Actinomyces viscosus M-100.

Three groups of weanling, Sprague-Dawley-derived rats were inoculated with Actinomyces viscosus M-100 and fed powdered diet containing either 67%, 5%, or 0% confectioner's sugar. Two further groups were fed diet containing 5% confectioner's sugar and inoculated with Streptococcus sobrinus 6715 or S. sobrinus 6715 plus A. viscosus M-100. The most coronal 1 mm of gingiva was removed from maxillary and mandibular right molar quadrants (gingivectomy), and the animals re-inoculated following gingivectomy. The animals were killed 64 days following gingivectomy, and the lingual surface of mandibular first molar roots was measured for exposed root-surface area and root caries. In the groups of rats infected with A. viscosus M-100, root caries area was significantly greater in the group fed diet containing 67% confectioner's sugar. Sucrose level did not significantly affect the amount of exposed lingual first molar root area regardless of whether the tooth had been subjected to a gingivectomy. In the groups of rats receiving diet containing 5% confectioner's sugar, there were no significant differences in root caries area or exposed root-surface area, regardless of the infection status of the animals. In the rat model presented here, a high level of dietary sucrose was a necessary condition for the initiation of root caries in the absence of other readily fermentable carbohydrates.

Actinomyces↗
PubMed2006

Prevalence of root caries in a selected population of older adults in Japan.

In this study, the prevalence of root caries in a sample of Japanese elders was investigated along with various aetiological factors. Two hundred and eighty-seven independently living elderly people over the age of 60 years were examined for the prevalence of active, inactive, and filled root lesions as well as the number of teeth. General health, oral status and brushing habits were surveyed, and salivary flow was determined in terms of flow rate and subjective feeling of dry mouth during eating. About 39% of the subjects had one or more decayed roots and 53.3% had at least one decayed or filled lesion. Root caries was seen most frequently on canine teeth followed by the first premolar. The number of decayed or filled lesions increased with increasing number of residual teeth (Kruskal-Wallis test, P = 0.033), however, there was no association between the proportion of teeth with root decay and the number of teeth. For subjects with 20 or more teeth, the number of decayed roots is likely to be lower in subjects who reported brushing frequently (P = 0.058), and higher in subjects with low salivary flow (P = 0.059) or subjective feeling of dry mouth (P = 0.052) (Chi-squared). The presence of decayed lesions is likely to be related to dry mouth (P = 0.057, odds ratio 3.13) and brushing frequency (P = 0.088, odds ratio 1.76) (Multiple logistic regression analysis). The results indicate a high frequency of root surface caries in this Japanese community-dwelling older population. Oral hygiene status and low salivary flow or perceived dry mouth were potential risk factors for disease.

Age Distribution↗
PubMed1993

Root caries: some clinical aspects.

This paper has discussed some aspects of root surface caries which are of special relevance to the clinician. Epidemiological studies have suggested that root caries is not inevitable after gingival recession, but a small number of patients show a propensity for development of new lesions. Several risk factors have been identified. Thorough prophylaxis is essential for accurate diagnosis of root caries lesions, and radiographs can identify lesions which would otherwise be difficult to detect. The activity of any particular lesion can only be evaluated by observation at successive examinations. Fluoridated water may have a role in the prevention of root caries, but the evidence is not conclusive. Other forms of topical fluoride have been demonstrated to be effective. Cleansable and accessible lesions can be arrested with good oral hygiene and topical fluoride therapy. Teeth which require restoration may be restored with GIC, but limitations of the material make this unsuitable for all but readily accessible lesions, or where margins are supragingival. Clinicians should not rely on the fluoride released from GIC in situations where another material may provide a better restoration; in many situations, amalgam may be the material of choice. The longevity of bonded amalgam restorations has not been established, and conventional methods of amalgam retention remain a requirement of every restoration.

Age Factors↗
PubMed1991

Root caries: some facts and treatment methods.

It has been projected that by the year 2000 every fifth person in the United States will be 65 or older, and root caries will create special restorative needs for this population. This article discusses the characteristics of root caries, the clinical conditions that should be anticipated in diagnosing it, their histologic and bacteriologic aspects, the misleading factors in radiographic diagnosis, the specific and general treatment concepts, the advantages and disadvantages of the popular restorative materials, and the principles applied in specific patients requiring restorations for root caries.

Dental Caries↗
PubMed1991

[Root caries incidence with regular use of AmF/SnF2 mouth rinse].

The caries protective effect of an AmF/SnF2 mouth rinse solution on exposed root surfaces was examined in 49 patients who had undergone periodontal surgery. The experimental group (EG, 19 patient) rinsed 1x/d using the F- rinse solution. The control group (KG) consisted of 30 patients. The trial was carried out over a period of 16 months. In addition to a complete periodontal status the root caries index (RCI) was recorded. Although the baseline values were comparable in both groups, there was a lower incidence of root caries in the EG at the end of the clinical trial. This clinical study shows that there is a lower root surface caries incidence after long-term application of the AmF/SnF2 rinse solution.

Adult↗
PubMed1996

Incidence of root caries in an older Canadian population.

This paper reports the results of a longitudinal study of Canadians aged 50 years and over which was designed to estimate the three-year incidence of root caries. At baseline, 699 randomly selected dentate subjects were clinically examined and 493 were examined again after three years. Over this period 27.4% had one or more root DFS increments and the mean DFS increment was 0.6 per person. Because DFS increments overstate root caries incidence DS increments were also calculated. Relatively few baseline variables were associated with either DFS or DS increments. In logistic regression analyses, age was the only variable associated with one or more root DFS increments, while age, dental visiting pattern and wearing a partial denture were associated with one or more root DS increments. In both cases, the predictive power of the models was poor but improved marginally when baseline root caries experience was also entered as an independent variable.

Age Factors↗
PubMed1993

Epidemiology of root caries.

Many epidemiological studies have been conducted on a variety of populations. Unfortunately, comparison of the prevalence data, and to a lesser degree of the incidence data, between the various studies is of little use due to the lack of standardised diagnostic criteria, reporting methods and population diversity. In the few incidence studies which have been conducted around 30-40% of people developed root caries, although many adults in the population appear to have been affected by root caries. Many risk factors associated with the occurrence of root caries have been identified and these include oral, medical, mental, behavioural and psychosocial conditions.

Adolescent↗
PubMedDate not supplied

[Prevalence of root caries and periodontal conditions in an elderly institutionalized population from Piracicaba-SP].

Preventive and invasive dental procedures have improved in the last two decades, leading to a greater longevity of teeth. As a result, teeth are more susceptible to periodontal diseases and, consequently, to root caries. The purpose of this study was to verify the prevalence of both periodontal diseases and root caries in an institutionalized population from Piracicaba-SP, Brazil. In this study, 151 subjects, aging 54 to 93 years, were examined. The sample was divided into two groups: a group of subjects aging 50 to 75 years and a group of subjects over 75 years old. The sextants were examined and classified as to periodontal health, periodontal treatment needs, prevalence of gingival recession and root lesions. In conclusion, a high prevalence of root caries was verified. That indicates an increase in the susceptibility to these lesions, which is associated with the aging process.

Age Factors↗
PubMed1995

Dietary models for root caries.

A stepwise multiple logistic regression was computed to assess which of the nutritional variables differentiate the healthy and diseased group of participants in the Forsyth Specialized Caries Center (n = 275). Variables considered as candidates for the model included the consumption per week of sugars, starch, cheese, fruits and fruit juices, noncariogenic foods, and dairy products. Two variables--sugars and cheese--were statistically significant by the stepwise procedure. Increased intake of sugar was associated with being in the root caries group, whereas high intake of cheese was negatively associated with root caries. Thus, cheese seems to have a protective effect after sugar intake is controlled for. Odds ratios were computed to quantify the influence of the variables. An increase of two exposures of sugar per day corresponded with an odds ratio of 1.26. The odds ratio continues to increase with sugar intake so that an increase to five exposures per day gives an odds ratio of 1.79. This model is consistent with past in vitro studies suggesting that cheese protects against caries formation when sugar intake is controlled for and that increasing frequency of sugar intake increases the odds of root caries.

Dairy Products↗