Hands OnRisk for root caries in older adults
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Background
The risk for dental caries is not limited to children or young adults, but extends throughout the lifespan. Older adults are retaining more teeth, and nearly half of those who reach the age of 75 years have experienced root caries. Root surface cementum is less mineralized than enamel and more susceptible to cavitation, with demineralization beginning at a higher salivary pH. Dentists need to institute better preventive interventions and treatment strategies to address the problem of root
Prevalence and Risk Factors
Twelve percent of adults age 65 to 74 years and 17% of those age 75 years and older have untreated root caries (Fig 1). Rates are even higher among African Americans, Mexican Americans, and those with lower educational achievements.
With aging, altered oral morphology, chronic systemic disease, and decreasing dexterity are common problems that interfere with preventive oral health behaviors. Patients with dementia often have a higher incidence of caries related to their inability to perform or
Caries Risk Assessment
The caries burden may be reduced by a clear understanding of the factors and behaviors that contribute to caries pathogenesis. Caries management by risk assessment (CAMBRA) is a conservative approach to prevention and treatment of dental disease throughout life that has proved effective.
Caries pathogenesis is recognized as an imbalance between the protective and pathological factors in the oral cavity. Assessing caries risk can lead to a therapeutic intervention that can effectively manage the
Clinical Interventions
Diagnosing a carious lesion on a root surface must prompt the consideration of the best course of action. Although no single clinical predictor can assess the activity of a carious lesion, a combination of predictors will increase the accuracy of risk assessment. Visual appearance, lesion location, tactile sensation during probing, and gingival health contribute to an accurate evaluation.
Treatment is hampered by the location of root caries, the tooth’s location in the mouth, and the patient’s
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Reprinted from Geriatric Dentistry: Caring for Our Aging Population (9781118925454/1118925459) with permission form John Wiley and Sons.
Gregory D, Hyde S: Root caries in older adults. J Calif Dent Assoc 43:439-445, 2015
Reprints available from D Gregory; e-mail: [email protected]