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Caries Process and Prevention Strategies: Demineralization/Remineralization
Older People Root Caries

Course Author(s): Susan Higham, BSc, PhD, CBiol, MRSB; Chris Hope, BSc (Hons), PhD, FHEA; Sabeel Valappil, BSc, MSc, PhD, PGCertEd, FHEA; Phil Smith, BDS, MDS, PhD, FDS, DRD, MRD, FDS (Rest Dent) RCS (Edin), FHEA

Older People Root Caries

With age, the gingival tissues recede below the edge of the enamel, exposing the dentin or cementum. These layers are much more soluble than enamel, and, therefore, more susceptible to acid attack.1 This is why root caries are more prevalent in geriatric patients.16 In this population, decreased salivary flow due to age or medications, and a change in diet to softer foods, can make root caries difficult to manage. The following Table summarizes the differences between enamel caries and root caries:

Table 1. Differences Between Enamel Caries and Root Caries
Enamel Caries Root Caries
Intact tissue mineral content (by volume): 85% to 87% 45%
Etiology: Plaque Plaque and recession
Result of acid attack: Acid dissolves subsurface; white spot lesion Acid dissolves surface; subsurface sticky or tacky
Physical changes: Complete dissolution = cavitation Complete dissolution = contour changes
Remineralization potential: Possible if outer area is intact Mineral content can be increased if collagen layer still present
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