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09 October 2019

Dental root caries: risk predictors

Giulia Palandrani

Root caries results from the dissolution of minerals in dentine by the acids produced by bacteria, since dentine have a much lower mineral content when compared to enamel, the risk factors associated with the development of root caries and coronal caries may be different. It is estimated that one-third of the geriatric population is subjected to root caries. Since people are retaining more teeth the management of this dental disease in older adults will become an important dental public health issue because of the high need for prevention and treatment.
The aim of this systematic review was to identify the risk predictors of new root caries and to describe their relationship with the incidence and increment of new root caries.  

The electronical research was done in different databases using different key words such as “root caries”, “root decay”, “risk factor”, “risk predictor”, “adult” and “elder” . The inclusion criteria were:
1) papers on longitudinal observational studies;
2) reporting on at least one risk predictor of root caries;
3) the publication date was between 1 January 1990 and 31 January 2019.    

The review includes 19 papers, 4 were classified as high quality, 13 as moderate quality and 2 as low . Risk predictors of root caries: 
Socio-demographic factors: 
Ten studies had assessed the correlation between DF-root and socio-demographic factors.  Among the 5 studies that investigated the association between gender and root caries, only 1 study found a higher male predilection. Regarding ethnicity and race, 1 study reported that Asians had the highest risk for developing new root caries compared with Caucasians, African-Americans and the Hispanics while another study did not. Among the 5 studies that included education level, only 1 reported a negative correlation with the incidence of DF-root . 

General health factors
Six studies assessed the correlation between DF-root and general health factors. Among the 3 studies assessing medication factors, 2 pointed out that taking medicine increased the incidence of DF-root. General health behavior A positive correlation between the use of tobacco and new DF-root was reported in 5 of the 7 studies. Fluoride exposure Only 1 study assessed the correlation between use of fluoride and root caries. The authors reported that people who avoided fluoride product had the highest risk of developing new DF-root.

Oral clinical parameters
Three studies found that having more root surfaces with recession or more gingival recession was associated with a higher incidence of DF-root. As the amount of gingival recession increases with age among older adults, this can partly explain why age was consistently reported to be a predictor of root caries. Regarding oral hygiene or plaque on root surfaces, 4 of the 5 studies found a positive correlation

Salivary parameters 
Two of 4 studies found a higher risk of developing new DF-root among people who had a lower salivary flow.  

According to this review is possible to say that people who are older, in lower socio-economic status or tobacco users, and those with more caries experience, gingival recession and poorer oral hygiene are at higher risk of developing new root caries. 

For additional informations: 
Risk predictors of dental root caries: a systematic review. 

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