Root surface decay

Root surface decay

Tooth decay affects many people of all ages. However, root surface decay is the decay beginning on the dentine root surface of the tooth rather than on the crown of the tooth that is covered in enamel. Root decay invades the root very quickly and can lead to tooth loss in a mater of months.

Root caries is most common in older patients who have experienced gum recession revealing the root surface dentine to the environment of the mouth. This is a major problem nowadays as we live longer and keep our teeth longer and therefore teeth are exposed to the mouth environment for far longer than in years past.

Gum recession occurs in many people, as they get older. It is a common result of gum disease where bone is destroyed due to chronic inflammation that results from leaving deposits of bacterial plaque on the teeth around the gum margins. The gum becomes inflamed due to the production of toxic bacterial waste products and that in turn leads to the gum becoming detached from the tooth surface exposing additional root surface to the oral environment.

WHAT IS ROOT DECAY

The root of the tooth is normally covered by gum but when the gum creeps back following the loss of the supporting bone beneath, and exposes the root to the mouth, bacteria can digest the sugars in your diet and produce acids that then attack the tooth surface. The exposed root surface being dentine is far softer then the enamel that covers the crown of the tooth and therefore decay progresses far more quickly on the root surface into the deeper root structure and can involve the pulp of the tooth leading to infection, abscess formation and tooth loss in a matter of months.

THE CAUSE OF ROOT DECAY

The plaque bacteria consume sugars from your diet and convert them into acids that attack the tooth surface causing demineralisation, (thinning of the mineral content of the tooth) creating cavities. Plaque is most commonly found around the gum margins and between teeth in those sites where cleaning is more difficult and this makes these sites the danger spots for tooth decay.

RIST FACTORS FOR TOOTH (CROWN AND ROOT) DECAY

Poor oral hygiene, regular sugar-containing food,  carbonated and other soft drinks including sports drinks, infrequent dental checks, increasing age, gum disease, crooked teeth, smoking, a dry mouth (often as a result of medications for blood pressure, anxiety and depression), dementia and poor cognitive function where the patient in care relies on assistance to maintain personal hygiene, are all risk factors that play a part in the cause of dental disease in patients.

WHAT ARE THE SIGNS OF ROOT DECAY?

Often root decay is seen as brown or yellow discolouration of the tooth or root surface. It may be rough or even look like a dark deposit on the tooth or a dark cavity. Frequently, a soft white or yellow deposit of plaque can be seen covering the area of decay. This masks the lesion and makes it more difficult to detect. Close inspection in the presence of good lighting and saliva control may be required to more accurately assess the degree of dental decay.

HOW TO PREVENT ROOT DECAY

It is clear that if you carry out good oral hygiene practices at home every day brushing effectively and using a fluoride toothpaste, and have your teeth checked on a regular basis by a dentist, then you will be less likely to suffer from tooth or root decay or gum disease.

DENTAL CARE AND THE ELDERLY PATIENT

Patients who are living in nursing homes often rely on carers to provide them with assistance in many aspects of their lives. One area that can be difficult is maintaining a high standard of oral hygiene. Difficulty in successful oral care frequently stems from poor manual dexterity that may be the result of arthritis or difficulty in the use their hands performing detailed movements, as in Parkinson’s Disease and other neurological degenerative conditions. Some patients may suffer from decline in their cognitive function or may suffer from one of the various forms of dementia. These various medical conditions place the entire responsibility for oral hygiene on their care team.

DENTAL HEALTH INFORMATION FOR CARERS

Carers need to be taught how to maintain good oral cleaning for their patients. As the number of older people in nursing care increases, this aspect of patient care will assume a higher priority in overall patient care, but education of carers needs to be addressed.

Family may need to discuss the need to ensure good oral care for their elderly relatives with the nursing team manager. It is also worth checking what arrangements exist for the examination and treatment of patients for dental disease and dental care and if they have arrangements in place for dentist visits to the care facility.

Contact the friendly team at NQ Surgical Dentistry today on (07) 4725 1656 or call in to see us at 183 Kings Rd, Pimlico QLD 4812