Root caries Flashcards
what is root caries
caries on an exposed root surface rather than on the crown
what is the surface of the root
cementum (not enamel)
what is cementum composed of
principally of dentine
what are the main bacteria that cause caries
streptococcus mutans
lactobacillus spp
actinomyces spp
what 3 things are required for caries
suceptible tooth surface
fermentable carbohydrates
time
what is a protective factor in the mouth
saliva
what does salvia contain
calcium phosphate ions lowers critical pH pro mineralisation state (required for fluoride to enter hydroxyapatite) also contains antibacterial effects buffering systems
what is in the buffering system of saliva
bicarbonate
phosphate
protein systems
balance the pH after acid attack
what is root caries more prevalent in
older patient
due to gingival recession
what can root exposure occur from
periodontitis hard brushing orthodontic treatment poly pharmacy oral hygiene poor manual dexterity hypo salivation drug addition systemic diseases decrease saliva quality diet
what is polypharamcy
many drugs taken as you age
could cause dry mouth
what can cause hyposalivation
radiotherapy
autotimmue disorders
smoking
idiopathic
what does demineralisation of the root surface lead to
soft consistency
what can lead to darkening of the root surface
extrinsic staining into softened more porous dentine
main bacteria in caries
mutans streptococci
lactobacilli
actionmyces
what is more common in root caries compared to normal caries
action Myles
- due to proteolytic effect
Detection of caries
not enamel so therefore there will be no white spots
need to look for aspects in dentine
- texture and appearance of root surface
- plaque accumulation
resulting lesion from coronal caries
spreads along the ADJ around the necks of teeth, encircles the tooth
- advanced lesion may spread to the pulp
- can spread coronally to enamel and cause delamination
what are radiographs useful for
determine bone support and the presence of any periapilca radiolucnecies
what are radiographs not useful for
buccal palatal or lingual or occlusal caries,
behind lesion will be sound dentine therefore caries may not show up well
active lesion root cares
lighter matt colour
softer/rougher surface
gingival inflammation/plaque buildup
inaccessible area
arrested root caries lesion
dark and shiny
harder surface
clean surface
what is the best indicator of cries
past caries experience
root caries management
prevention
operative control
non operative caries control
oral hygiene instructions plaque control diet advice fluoride casein phosphopeptide antimicrobial agents
what does casein phosphopeptide do
amorphous calcium phosphate
- helps remineralisation by placing on the tooth
examples of antimicrobial agents
chlorhexidine
xylitol
when do we need to restore the caries
when it is cavitated
or no longer cleansable
what is the the aims of operative management of carious lesions
aid plaque control and caries activity
protect the pulp dentine complex and arrest the lesion by sealing it
restore function form and aesthetics of the tooth