Root surface caries

Tooth decay is the most common pathology that can occur in teeth.

As the most common form of tooth decay, treatment methods are also varied, constantly evolving and attempting to give the tooth adequate healing and the best possible resistance over time.

Cavities generally occur on the visible surfaces of the teeth because they are exposed to the external environment and aggressors can exert their pathogenicity. Therefore, in children and adults, where the roots are covered by bone and gum, root caries is very unlikely to occur.

The protection that the hard and soft peri dental tissues provide for the root protects it from acid attack, demineralization and caries.

Over time, in adults, especially those with periodontal problems and the elderly, the level at which gum and bone are restored changes. This change can occur suddenly or slowly.

The sudden change in the level of the gum, complemented by root exposure, is more local in younger people.


Among the mechanisms that can lead to gingival recession and root exposure are:

  • Inappropriate use of toothpicks – tooth morphology is unique and varied but overall, it aims to ensure stable contacts and continuity of the dental arches.

Therefore, by using toothpicks in certain areas that can easily retain food, the gingiva can move apically, revealing the root. As a result of this process, the uncovered root, blackened by the gum, will be susceptible to bacterial attack and the result will be caries formation at this level.

  • Incorrect tooth brushing – both teeth and gums need proper care.

If brushing is carried out with horizontal, rough movements and high pressure, the result will be overall migration of the gums towards the apex. Studies have shown that for right-handed people, the tendency is to apply more pressure to the tooth surfaces and soft tissues in the left region.

Thus abrasion, gingival recession, root exposure and root caries in the left hemifacial can be blamed on incorrect brushing.

  • Interposition of foreign objects – objects such as pencils, hairpins or any other objects interposed between the arches can over time lead to deformation of the dental arches and gum recession.

  • Ageing – this is a natural process of bone resorption that occurs with advancing age, even if the gums recede and the roots are exposed, this process is slow, so the teeth are not initially mobile.

Bone resorption and gingival retraction occur across the board, so the roots will have the same degree of exposure at the dental arches.

Root cementum is the counterpart of enamel at root level and has less mineralization, so root caries sets in and progresses more quickly than dental crown caries.


Treatments indicated for affected exposed roots vary according to the stage of development:

Fluoridation in the case of uncovered and demineralized roots without carious cavities

Removal of affected dentine in case of roots with carious cavities

Rigorous hygiene

Restoration of defects with materials that last as long as possible.

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