Occurrence Of Root Caries Research Articles

Veillonella parvula promotes root caries development through interactions with Streptococcus mutans and Candida albicans.

Root caries is a subtype of dental caries that predominantly impacts older adults. The occurrence and progression of root caries are associated with the homeostasis of dental plaque biofilm, and microbial synergistic and antagonistic interactions in the biofilm play a significant role in maintaining the oral microecological balance. The objective of the current study was to investigate the role of Veillonella parvula in the microbial interactions and the pathogenesis of root caries. The analysis of clinical samples from patients with/without root caries revealed that Veillonella and V. parvula were abundant in the saliva of patients with root caries. More importantly, a significantly increased colonization of V. parvula was observed in root carious lesions. Further invitro biofilm and animal study showed that V. parvula colonization increased the abundance and virulence of Streptococcus mutans and Candida albicans, leading to the formation of a polymicrobial biofilm with enhanced anti-stress capacity and cariogenicity, consequently exacerbating the severity of carious lesions. Our results indicate the critical role of V. parvula infection in the occurrence of root caries, providing a new insight for the etiological investigation and prevention of root caries.

Candida albicans promotes tooth decay by inducing oral microbial dysbiosis.

Candida albicans has been detected in root carious lesions. The current study aimed to explore the action of this fungal species on the microbial ecology and the pathogenesis of root caries. Here, by analyzing C. albicans in supragingival dental plaque collected from root carious lesions and sound root surfaces of root-caries subjects as well as caries-free individuals, we observed significantly increased colonization of C. albicans in root carious lesions. Further in vitro and animal studies showed that C. albicans colonization increased the cariogenicity of oral biofilm by altering its microbial ecology, leading to a polymicrobial biofilm with enhanced acidogenicity, and consequently exacerbated tooth demineralization and carious lesion severity. More importantly, we demonstrated that the cariogenicity-promoting activity of C. albicans was dependent on PHR2. Deletion of PHR2 restored microbial equilibrium and led to a less cariogenic biofilm as demonstrated by in vitro artificial caries model or in vivo root-caries rat model. Our data indicate the critical role of C. albicans infection in the occurrence of root caries. PHR2 is the major factor that determines the ecological impact and caries-promoting activity of C. albicans in a mixed microbial consortium.

How Root Caries Differs between Middle-aged People and the Elderly: Findings from the 4th National Oral Health Survey of China.

To investigate the differences in distribution of root caries and related factors between middle-aged and elderly people in China. In this cross-sectional study, a multistage, cluster strategy was used to recruit 4,410 participants (2,197 males and 2,213 females) aged 35 to 44 years and 4,431 participants (2,222 males and 2,209 females) aged 65 to 74 years from all 31 provinces, autonomous regions and municipalities of the mainland of China. The survey was conducted according to the basic methods proposed by the World Health Organization (WHO). Sociodemographic information, oral health behaviour, attitude and knowledge, history of dental prophylaxis and general health condition were collected with a closed questionnaire. A great increase in the occurrence of root caries in Chinese adults from 35 to 44-year-old to 65 to 74-year-olds, with the prevalence (DFR ≥ 1) from 25.4% to 61.9% and with the mean DFR score from 0.54 ± 1.34 to 2.63 ± 3.75. Filling rates were also very low, only 1.8% and 3.0%, respectively. Females and residents of rural areas were more likely to suffer from root caries. In both the middle-aged group and the elderly group, root caries related to gender, education level, sweet food/drinks consumption, oral health knowledge and status of root surface explosion. In 35 to 44 year olds, toothbrushing is a significant protection factor (OR = 0.88, 95%CI 0.81 ~ 0.96), while using toothpicks is a risk factor (OR = 1.06, 95%CI 1.02 ~ 1.10). In 65 to 74 year olds, not having dental had scaling in the past 12 months is a risk factor (OR = 1.66, 95%CI 1.09 ~ 2.53). Root caries among middle-aged people and elderly people in China have different risk factors and need more attention in future research to develop proper prevention.

Contextual and Individual Determinants of Root Caries in Older People

The aim of this study was to identify the association of the presence of root caries in older people with contextual and individual determinants using a multilevel model. Data from the National Survey of Oral Health collected in Brazil were used. A sample of older Brazilians (aged 65-74 years) was included and selected through multistage probability cluster sampling, using probability proportional to size. Contextual variables of municipalities and individual variables of older people were included. Descriptive, bivariate, and multilevel analyses were conducted. Of the 3,926 older people included in the study, 934 (21.8%) had at least 1 tooth with root caries. There seemed to be no pattern of involvement between the anterior and posterior teeth in the dental arches. Multilevel analysis showed a higher presence of root caries among older people resident in municipalities that were noncapital cities (OR = 1.50), who were over 70 years of age (odds ratio, OR = 1.22), had nonwhite skin color (OR 1.35), had coronal caries (OR = 5.58), were dissatisfied with their teeth and mouth (OR = 1.47), and had self-perceived dental treatment needs (OR = 1.33). Contextual and individual determinants were associated with the occurrence of root caries in older people. Lesion presence demonstrated a profile of social inequality.

Dental diseases and their treatment in the older population

Demographic changes and an increasing number of older adults is a big challenge for the oral health care in all the Nordic countries. The risk for dental diseases increases in older populations because morbidity, and reduced daily functioning and cognition complicate oral hygiene practices and the ability to organise dental visits. Futher, many morbidities and multiple drugs have effects on salivary flow which increases the risk for dental caries. On the other hand, aging itself has effects on the immune system, increasing the severity of periodontitis and the prevalence of oral mucosal diseases, for example. Consequently, dental diseases seem to be concentrating in older age groups. This article aims to provide a comprehensive overview of the unique aspects of dental diseases among older people, emphasizing the occurrence of root caries and periodontal diseases, which are the main dental diseases that typically involve a large number of dentate older people. It also attempts to describe management strategies and highlights minimally invasive treatment concepts for older people.

Relationship between root caries and alveolar bone loss in the first wet-rice agriculturalists of the Yayoi period in Japan

Objective The people of the Yayoi period (5th C b. c.–3rd C a. d.), who were the first wet-rice agriculturalists in ancient Japan, had carious lesions that were most frequently located on the root surfaces of their teeth. Root surface exposure is a prerequisite for this type of decay, and alveolar bone loss is the main cause of such exposure. Therefore, we identify the factors associated with root caries, and examine the relationship between root caries and alveolar bone loss in the people of the Yayoi period. Materials and methods This study was performed using 263 sets of ancient skeletal remains that are believed to be from the Yayoi period and that were excavated at 49 archaeological sites in western Japan. Using 5010 teeth found among the remains, we analysed the relationship between the prevalence of root caries and the cemento-enamel junction–alveolar crest (CEJ–AC) distance. Results The prevalence of root caries and the mean number of teeth with root caries per person were significantly correlated with age, the presence of coronal caries and the mean CEJ–AC distance per person. We also found that as the mean CEJ–AC distance per tooth surface increased, the percentage of the root surface affected by caries increased. Moreover, after excluding the lingual (palatal) side, the mean CEJ–AC distance per surface was significantly greater for those tooth surfaces with root caries. Conclusion We present the first evidence that the occurrence of root caries correlated with the CEJ–AC distance in the Yayoi people of Japan.

Root caries in areas with and without fluoridated water at the Southeast region of São Paulo State, Brazil

This study aimed to investigate root caries prevalence in areas with and without water fluoridation at the Southeast region of São Paulo State, in the adult population, employees of public and private schools, and elderly population. Epidemiological surveys were conducted according to the World Health Organization guidelines (1997), including 1,475 dentate individuals aged 35 to 44 years and 65 to 74 years, living in cities representing the southeast of São Paulo State, with (n=872) or without (n=603) fluoridated water supply. Statistical analysis was performed by Mann-Whitney and Chi-square tests at a significance level of 5%. The prevalence of root caries was 15.6% for the 35-44-year-old age group and 31.8% for the 65-74-year-old age group. There were no statistically significant differences (p>0.05) in the occurrence of root caries according to water fluoridation, although individuals living at non-fluoridated areas presented higher percentage of missing teeth; also, there was higher mean number of intact roots at fluoridated areas (p<0.05). Most individuals with gingival recession, both adults and elderly, did not have root caries experience. In this study, root caries prevalence was lower in areas with fluoridated water. Due to the reduced prevalence of edentulism and increased number of people keeping their natural teeth for a longer period, a future increase in root caries is expected, highlighting the importance of studies related to water fluoridation and its relationship with the oral health of adults and elderly, especially referring to tooth root.

Occurrence of root caries in relation to specific dental health habits (Oral hygiene practice) in adult population (30-70) years in Mosul city, Iraq

This study was designed to evaluate the relationship between the occurrence of root surface caries (RSC) and a subject's dental health habits such as the frequency of tooth brushing and the use of other cleaning aids such as chewing stick and the dental floss in the adult population aged(30-70) years in Mosul city. A sample of (1270) subjects [719 (56.6%) males and 551 (43.4%) females] were collected randomly from different eight factories, seven primary schools, eight secondary schools and five colleges from Mosul University. According to age, the sample was divided into four age groups (30-39, 40-19, 50-59 and 60-69 years). The results of the study revealed that subjects with RSC in the young age group (30-39 years) claimed to brush their teeth once a day and twice a day or more, whereas subjects with RSC in the old age group (60-69 years) claimed to brush their teeth infrequently. Statistically, the differences between subjects with and without RSC were significant for all age groups. The study showed that generally subjects with and without RSC who claimed never use other cleaning aids reported higher percentage that those who used other cleaning aids. Indeed, those who claimed to use chewing stick displayed high rate than those who use dental floss. It was concludedthat dental health behavior influence root caries occurrence and that caries on root surface is associated with poor dental health habits

Salivary Findings, Daily Medication and Root Caries in the Old Elderly

Root caries is one of the main dental problems among the dentate old elderly. The aim of our study was to evaluate the occurrence of root caries in 196 dentate elderly (mean age 79.3) in relation to their salivary flow rate, buffering capacity and salivary microbial counts. These subjects participated in the oral health component of the Helsinki Aging Study in 1990–1991. Clinical oral examinations included assessment of the state of root surfaces and salivary flow rates, both paraffin-wax-stimulated and unstimulated. Salivary buffering capacity and the growth of salivary mutans streptococci, lactobacilli and yeasts were determined by means of commercially available kits. Root caries occurred in 52% of men and in 35% of women (p < 0.05). Number of decayed (DRS) and decayed or filled (DFRS) root surfaces correlated (r = 0.16 to 0.26) with salivary microbial counts. No correlation appeared between DRS and subjects’ salivary flow rates. Basic estimates on the association between DRS and salivary findings showed that microbial counts only produced significant odds ratios, from 2.0 to 3.5. However, in a log-linear model high salivary mutans streptococci and yeast counts together with male gender were associated with greater occurrence of root caries.

Association between root caries occurrence and periodontal state.

To analyze the occurrence of root caries in relation to the periodontal state, we examined clinically a representative sample (n = 4,777) of Finish adults, aged 30 years and older. Our definition of root caries included primary decay on root surfaces, and a subject's periodontal state was described according to the presence or absence of gingival inflammation or periodontal pockets and subgingival calculus and/or overhangings. Subjects with a healthy periodontium seldom (4%) had any caries on root surfaces, whereas 15% had caries in conjunction with gingival inflammation, and 17% in conjunction with deepened pockets. The deeper the pockets, the greater the frequency of root caries for men, but not for women. Subgingival plaque retention showed a strong association with root caries. As the study population represented Finnish adults, the results can be generalized with reasonable confidence.

Epidemiology of root caries

Many epidemiological studies have been conducted on a variety of populations. Unfortunately, comparison of the prevalence data, and to a lesser degree of the incidence data, between the various studies is of little use due to the lack of standardised diagnostic criteria, reporting methods and population diversity. In the few incidence studies which have been conducted around 30-40% of people developed root caries, although many adults in the population appear to have been affected by root caries. Many risk factors associated with the occurrence of root caries have been identified and these include oral, medical, mental, behavioural and psychosocial conditions.

Occurrence of root caries in relation to dental health behavior.

We studied the relationship between the occurrence of untreated root caries and a subject's dental health habits, such as the frequency of tooth-brushing, the avoidance of sugar, and regularity of dental visits. A representative sample of 5028 adults was examined. Information on dental health habits was collected by professional interviewers one to six weeks before the clinical examination. A high frequency of tooth-brushing was strongly related to a low occurrence of root caries. The use of sugar in coffee or tea was strongly associated with root caries occurrence among men. The use of sweets was related to root caries occurrence moderately in men but not at all in women. Regular dental check-up behavior was strongly related to an infrequent occurrence of root caries. It was concluded that dental health behavior influences root caries occurrence and that caries on root surfaces is associated with poor dental health habits. Age and gender differences in root caries occurrence, reported earlier, may relate to different dental health behavior of women and men.

Epidemiology of root caries.

Over a dozen studies have been conducted on the prevalence of and factors associated with root caries, yet our knowledge of this disease process remains limited. This is due, in large part, to a lack of consistency of reporting among the studies undertaken and the wide spectrum of population groups investigated. Nevertheless, the occurrence of root caries is between 20 and 40 percent in healthy, urban adults. Certain population groups such as the institutionalized elderly and patients with periodontal disease tend to exhibit much larger prevalence rates. New root caries develops slowly and tends to be concentrated in a few individuals, usually on the buccal and proximal surfaces of teeth. It is generally accepted that only roots with gingival recession are susceptible to root caries and that age, sex, oral hygiene, diet, saliva, systemic fluoride and previous carious experience have been shown to be associated factors. The next wave of investigations of root canes should focus on testing hypotheses relating to causation so that efficacious preventive and treatment procedures can be developed.