Root Surface Decay: Why It Happens So Fast

Root surface decay is common in older adults or those with gum recession due to periodontal disease. As our roots are exposed below the gum line, breakdown of the root surface can occur to form a cavity.

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Why does it happen so fast?

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Root surface decay differs significantly from the enamel decay (tooth structure above the gum tissue). Root decay develops more quickly than on the enamel as the cementum composition of the root is softer. Root decay involves both demineralization and collagen degradation, leading to faster progression on root surfaces. As a result, demineralization is approximately twice as rapid on root surfaces as on enamel.

Decay is due to bacteria, but factors that make you more susceptible are due to the root surface being exposed or dry mouth (xerostomia). Many medications can cause dry mouth, which is a higher risk factor due to the reduced saliva production and exposure of the root surface. Older adults experience more limitations with brushing and dry mouth due to changes in medical conditions.

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How do I prevent decay on my tooth root?

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Early detection and prevention is critical in preventing further damage. Prevention of new root caries can be addressed by maintaining good oral hygiene, regular check ups, and fluoride treatment.

The second step of root surface decay is the arrest of existing root caries through placement of silver diamine fluoride application, which in older adults can help prevent damage and maintain their oral health to prevent sensitivity and progression of lost tooth structure.

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References

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1. Interventions for managing root caries | Cochrane Database Syst Rev. 2017 Aug; 2017(8): CD012750. Published online 2017 Aug 7. doi: 10.1002/14651858.CD012750
2. Aging and Dental Health | American Dental Association [internet cited] August 24, 2023
3. What are dentists seeing in older adults? | Journal of American Dental Association [internet cited] 2022  September

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