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Root Caries: An Epidemic of Age

People are living longer and keeping their natural teeth more than ever before. The advances in tooth retention, the desire to look one's best, and higher expectations about oral health have raised dental awareness among older adults.

With the significant increase in the older portion of society, with even greater increases expected, more older adults will have more teeth that are susceptible to root caries. Root caries may emerge as one of the most significant dental problems among older adults during the next decade. A recent study conducted by the National Institute for Dental and Craniofacial Research (NIDCR) showed that over half of older adults have decayed or filled root surfaces. The frequency of root caries is strongly age-dependent and will continue to be a major dental problem among the elderly.

Root caries lesions can be caused by new or primary root caries, caries around existing dental fillings or recurrent caries, and abrasion or erosion of the root surfaces. Root caries progress quickly due to the relatively soft nature of the root surface, as well as the risk factors associated with the incidence of root caries.

Risk factors associated with the high prevalence of root caries among older adults include decrease salivary flow or xerostomia, exposure of root surfaces due to periodontal (gum) disease, chronic medical conditions, radiation treatment for head and neck cancer, physical limitations, and diminished manual dexterity due to stroke, arthritis, or Parkinson's disease, cognitive deficits due to mental illness, depression, Alzheimer's disease or dementia, Sjögren's syndrome (an autoimmune disease), diabetes, poor oral hygiene, multiple medication use, and changes in dietary habits. One or more of these risk factors or life changes, which are more common among older adults, can increase root caries in an individual who has not had dental caries for many years.

Root caries can be a challenge for the dentist to treat depending on the size and the type of root caries lesion, the extent and rate of caries activity for that person, the physical and mental condition of the individual, and where the root caries are located in the mouth. Many root lesions have limited accessibility and visibility, are often more complicated by pre-existing extensive dental work, and are difficult to isolate from oral fluids during the restoration process. Also, many people who have widespread root lesions have limited tolerance for dental treatment because of medical conditions, illness, and mental health problems.

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Is It Time for New Dentures?

Dentures that fit well can improve your looks and enhance eating and speaking. Talk to your prosthodontist about your current situation and whether you need new dentures. In general, the life expectancy of false teeth is about five to seven years.

Factors that affect the satisfaction and life span of your prosthodontics include:

• General health status
• Significant weight increase or decrease
• Time since loss of teeth
• Denture care and cleaning
• Tobacco and caffeine use
• Shape of your mouth
• Changes in facial and oral muscles
• Variation in skin tone or color

The color match of false teeth to a natural tooth color can seem to change, especially if the natural teeth are darker due to stains or lighter because of past dental treatment. Also, dentures can wear, stain, chip, or fracture over time. Today's denturists are able to modify the look of smiles and gum tissues in order to compliment existing teeth, skin color, or tone.

Dentures, like all manufactured goods, require regular maintenance and eventual replacement. To maintain proper fit, appearance, function, and to avoid any damage to oral structure, a prosthodontist should regularly evaluate your false teeth. The gum and bone tissues that support dentures undergo changes over time and with age. Often, these changes include a good amount of bone shrinkage. Bone shrinkage causes a denture to become loose, less functional, and slip during eating and speaking. Age-related changes in facial muscles, complexion, and lips also will affect the function and appearance of your prosthodontics. Oral hygiene habits, use of tobacco, and drinking coffee or tea will also affect the appearance of a denture, as well as any odors associated with them.

Since dentures are in use every day, for many years, it is reasonable to periodically replace those that no longer fit properly. If you have not visited a denturist recently, if your false teeth slip, have lost their good looks, cause discomfort, or if they are more than five years old, you may need to replace them.

by Denise J. Fedele, D.M.D., M.S.

+Jim Du Molin is a leading Internet search expert helping individuals and families connect with the right dentist in their area. Visit his author page.