How to prevent root cavities

Dr. Sharon Robinson

Root decay, also referred to as “root caries,” is a cavity that forms on the roots of your teeth.  You can see the roots of your teeth in your mouth if your gums have shrunk from gum disease, brushing improperly or with too hard a toothbrush.  Exposed root surfaces are also more common in older adults.

Cavities on the roots of teeth can start faster and spread quicker than cavities on other parts of the tooth.  The roots of teeth do not have the protective hard enamel on them, so the cavities can get bigger faster.  It’s also harder for the dentist to treat cavities on the roots of teeth, as they can spread to the inside of the tooth where the nerve is, and cause a toothache or infection. A large cavity on the root of a tooth can even lead to the tooth breaking off, which leads to serious pain and infection.

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Root caries is initiated when bacteria and fermentable carbohydrates attack the root surface. Studies have been conducted to identify the microflora responsible for root caries, and was found to be the primary initiating microorganism.

Microorganisms metabolize simple sugars into organic acids, which dissolve through plaque that is harbored on the tooth surface. These acids then pass through the root structure and start the process of demineralization that removes calcium and phosphate ions. This process takes place as the pH reaches the critical value of 6.4 for demineralization of cementum and dentin, and 5.5 for demineralization of enamel. Dramatic effects occur during this process, with the collapse of collagen due to dissolution of inorganic minerals and the formation of cavities.


Treatment of root caries depends on the extent of the lesion into the tooth structure. Removal of the infected area is done and replaced with restorative material like composites.

Why do Older Adults get Root Decay?

Older adults are more likely to get cavities on the roots of their teeth because:

  • They are more likely to have gum problems that expose root surfaces.
  • Root surfaces are softer than the top part of the tooth that is made up of enamel and get cavities faster.
  • Older adults are more likely to take medicines that cause dry mouth. Saliva or spit helps protect teeth from cavities.  When there is less saliva, there is less natural protection from cavities.
  • If your mouth is dry do not suck on hard candies. This makes the cavities get bigger.  Use sugar-free hard candies instead.
  • You may have trouble taking care of your mouth because of arthritis or other medical problem such as loss of eyesight.  This raises the risk of getting root cavities. If you have had a stroke, you may not realize you have food stuck in your mouth, this can also add to your cavity risk. Forgetfulness is a problem too.  Leaving reminder notes for yourself to brush and floss is a good way to improve your oral health.
  • If you have lost some teeth already, it may be harder to chew certain foods. You may choose foods that are easier to chew and are softer.  It is very important to brush your teeth after meals with soft food that have starch like bread, potatoes and pasta.  These soft foods contribute to cavities just like sugar.


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