Root caries: The challenge in today’s cariology

Today, we call root caries “the revenge of conservative dentistry”. We preserve teeth so much longer than 30 years ago, however, root caries may destroy every success within years. Therefore, we urgently need appropriate concepts to fight against it.

Primary caries, i.e. coronal caries beginning with enamel lesions has not completely diminished in the haze of effective prevention programs, however, it was significantly reduced during the last 30 years. Simultaneously, keeping teeth longer in the mouth through prevention in Cariology and Periodontology, vulnerable root surfaces are more and more prone to decay, leading to increasing numbers of root caries lesions. These are terrible encounters for every dentist, because

1. people are older and less compliant,
2. elderly people tend to eat and drink more sugar due to less tasting quality, and
3. the defects are extremely hard to access and even harder to restore.

The present webinar covers the aspects prevention, compromise and restoration.

Without effective preventive measures, root caries is not manageable. When we just focus on restoration, we will definitely fail. So prevention is No. 1, consisting of the right oral hygiene together with accompanying measures such as fluoride or calcium sources.

In many cases, compromises are standard in oral health care, and there is not too much of a difference between very young and very old patients. So also varnishes or silver diamine fluoride solutions may be applicable.

The restoration of root caries lesions is the last aspect in this cascade. Ultra-hard circumstances will lead to glass ionomer cements, somewhat better clinical conditions may allow to go the adhesive way with special matrice tricks and special restoratives such as injectable resin composites.

Learning Objectives:

• Intelligent treatment planning always starts with prevention
• Recognizing when compromises are the better option
• Managing root caries with glass ionomer cements
• Highly esthetic management using resin composites