Root Surface Caries
Caries can affect any surface of the teeth. The most commonly seen caries are found on the crown of a tooth, above the cemento-enamel junction, it is also possible for caries to form on the root surface, below the cemento-enamel junction. Dental root caries has received a great deal of attention in the past few decades. A variety of different patients are at risk for root surface caries. Dentists use several methods of treatment. Root surface caries are also called cemental caries, cervical caries, or radicular caries. (Wilkins) Root surface caries only involves the roots of teeth. The cementum and dentin located just below the crown of the tooth is involved. No involvement of enamel is seen with root surface caries. Bone loss and corresponding gingival recession are the first symptoms to be seen in the caries process. These result in exposed root surfaces, which are more prone to forming caries because caries does not form in the root surface while periodontal fibers are still attached. Clinically, the lesion starts on the root surface. It has been found that root caries spreads in a lateral or circumferential manner, and over time can extend completely around the tooth, undermining the enamel. (Wilkins) In general, root caries have the same etiology as coronal cavities. S. mutans, Lactobacilli, and sometimes, Actinomyces are involved and are found in high numbers in root caries, but there are two main differences between enamel and root surface caries. (Flaitz) These differences cause the lesion on a root surface to be more destructive than that in enamel. First, because the pH at which demineralization will occur is higher for root cementum (approx. pH 6.0) than for enamel (approx. pH 5.0).(Wilkins) Therefore, root cementum has potential for demineralization at an earlier point in time than enamel does. Secondly, once the cementum is demineralized, the dentin contains dentinal tubules which, if present, are potential methods of entry...
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