People are living longer and keeping their
natural teeth more than ever before. The advances in tooth retention, the desire
to look one's best, and higher expectations about oral health have raised dental
awareness among older adults.
With the significant increase in the older portion of society, with even
greater increases expected, more older adults will have more teeth that are
susceptible to
root caries. Root caries may emerge as one of the most
significant dental problems among older adults during the next decade. A recent
study conducted by the National Institute for Dental and Craniofacial
Research (NIDCR) showed that over half of older adults have decayed or filled
root surfaces. The frequency of root caries is strongly age-dependent and will
continue to be a major dental problem among the elderly.
Root caries lesions can be caused by new or primary root caries, caries
around existing dental fillings or recurrent caries, and abrasion or erosion of
the root surfaces. Root caries progress quickly due to the relatively soft
nature of the root surface, as well as the risk factors associated with the
incidence of root caries.
Risk factors associated with the high prevalence of root caries among older
adults include decrease salivary flow or xerostomia, exposure of root surfaces
due to periodontal (gum) disease, chronic medical conditions, radiation
treatment for head and neck cancer, physical limitations, and diminished manual
dexterity due to stroke, arthritis, or Parkinson's disease, cognitive deficits
due to mental illness, depression, Alzheimer's disease or dementia, Sjögren's
syndrome (an autoimmune disease), diabetes, poor oral hygiene, multiple
medication use, and changes in dietary habits. One or more of these risk factors
or life changes, which are more common among older adults, can increase root
caries in an individual who has not had dental caries for many years.
Root caries can be a challenge for the dentist to treat depending on the size
and the type of root caries lesion, the extent and rate of caries activity for
that person, the physical and mental condition of the individual, and where the
root caries are located in the mouth. Many root lesions have limited
accessibility and visibility, are often more complicated by pre-existing extensive
dental work, and are difficult to isolate from oral fluids during the
restoration process. Also, many people who have widespread root lesions have
limited tolerance for dental treatment because of medical conditions, illness,
and mental health problems.
