dental instruments and oral health

What is Root Decay?

Root decay, also called root caries, is when a lesion develops on the root surface of your tooth. These lesions typically develop close to the gingival (gum) margin. In particular, elderly people are more prone to developing root caries. This is because people are living longer and keeping their teeth longer nowadays. Although, roots can only develop cavities if they become exposed due to periodontal disease or gum recession.

Causes & Risk Factors of Root Caries

Poor oral hygiene is the leading cause of all oral diseases and infections. This includes, but is not limited to, not brushing your teeth regularly and neglecting professional teeth cleanings. Other factors that result in poor oral hygiene include smoking tobacco and not consuming enough fluoride. As a result, you may develop cavities, dry mouth, gum disease, and other oral conditions. In particular, root caries can form over time if your teeth roots become exposed due to long-term neglected dental care. For example, common conditions that may lead to root decay include:

swollen gums due to gingivitis graphic

Advanced Periodontal Disease

The primary cause of root decay is due to periodontal attachment loss. In short, periodontal disease (PD) is a serious form of gum disease that results in permanent damage to the gums, tissues, and surrounding bone. In addition, patients with PD commonly develop gum recession. This condition is when the gums begin to pull away from the teeth, which eventually causes loss of periodontal attachment. In other words, gum recession separates the teeth from the gums. Over time, your teeth roots become exposed, which makes them more susceptible to decay.

set of top and bottom dentures graphic

Poorly Fitted Removable Partial Dentures

If you have partial dentures that do not fit properly, gum recession may develop over time. This is because partial dentures only replace the visible part of your teeth, rather than the entire dental arch. In addition, partial dentures are attached to a metal plate that is secured in the mouth using clasps and hooks that attach to your real teeth. Although, these hooks and clasps commonly irritate the gums, which can lead to inflammation and potentially gum recession. As a result, your teeth roots become exposed, which can lead to decay over time. If your gums are receding due to poorly fitted partial dentures, your dentist can adjust or remake them for you.

dry mouth graphic

Medications & Xerostomia

Many prescription and over-the-counter medications list dry mouth (xerostomia) as a side effect. For reference, xerostomia is a common oral condition when the salivary glands in the mouth do not make enough saliva. Although, saliva is necessary for cavity protection because it helps repair tooth enamel and rinses out plaque. So, if your mouth produces inadequate amounts of saliva, you are more prone to tooth decay. In addition, if you have dry mouth along with periodontal disease and/or gum recession, you are more prone to developing root decay. Medications that may cause dry mouth include antidepressants, muscle relaxants, and decongestants, among others.

Other risk factors associated with root caries in older adults include:

  • Chronic medical conditions, such as diabetes, a previous stroke, Parkinson’s disease, Sjögren’s syndrome (an autoimmune disease), and arthritis.
  • Cognitive limitations that develop due to mental illnesses. This includes chronic depression and Alzheimer’s disease.
  • Radiation treatment for neck and head cancers.
  • Previous root caries.

Symptoms & Possible Complications of Root Decay

if root decay is left untreated, you may develop a serious oral infection or notice the following signs and symptoms:

  • Continuous pain near the affected area that interferes with your daily life.
  • Difficulties eating, chewing, and swallowing.
  • A dental abscess.
  • Pus and swelling around the tooth.
  • Loose teeth.
  • Tooth loss.
  • Broken or cracked teeth.

Diagnosis & Treatment for Root Caries

A dentist uses a visual exam and an x-ray to diagnose root caries during a regular dental exam. When gum recession is present, the root caries are visible to the naked eye. Microbiological tests are also helpful in determining the presence of decay-causing bacteria on teeth roots. Depending on the severity of root decay, your dentist may recommend the following treatments:

Root Surface Remineralization

If the lesion hasn’t progressed too deep, your dentist may recommend remineralization. This treatment involves the use of fluoride mouthwash and toothpaste. Fluoride is essential for caries prevention because it holds onto calcium and phosphate in your mouth, which encourages remineralization.

Root Surface Recontouring

The earliest treatment for root decay involves the removal of softened tissue around the affected tooth. Then your dentist recontours the decayed root structure, which creates a smooth and cleanable surface.

Glass Ionomer with Fluoride Release

For severe root decay, the treatment of choice is a glass ionomer restoration with fluoride release. This type of restoration is used on any tooth in a patient with a high risk for cavities. It also releases fluoride to help prevent future cavities. Benefits include:

  • It does not cause pulpal irritation.
  • It contains 20 percent fluoride.
  • The procedure is relatively simple and aesthetically pleasing.
  • It is anti-cariogenic, antibacterial, and adhesive to root surfaces.