Root caries

Question 1

what is root caries

Answer 1

caries on an exposed root surface rather than on the crown

Question 2

what is the surface of the root

Answer 2

cementum (not enamel)

Question 3

what is cementum composed of

Answer 3

principally of dentine

Question 4

what are the main bacteria that cause caries

Answer 4

streptococcus mutans
lactobacillus spp
actinomyces spp

Question 5

what 3 things are required for caries

Answer 5

suceptible tooth surface
fermentable carbohydrates
time

Question 6

what is a protective factor in the mouth

Answer 6

saliva

Question 7

what does salvia contain

Answer 7

calcium 
phosphate ions
lowers critical pH
pro mineralisation state (required for fluoride to enter hydroxyapatite)
also contains antibacterial effects
buffering systems

Question 8

what is in the buffering system of saliva

Answer 8

bicarbonate
phosphate
protein systems
balance the pH after acid attack

Question 9

what is root caries more prevalent in

Answer 9

older patient

due to gingival recession

Question 10

what can root exposure occur from

Answer 10

periodontitis
hard brushing
orthodontic treatment
poly pharmacy 
oral hygiene
poor manual dexterity 
hypo salivation
drug addition
systemic diseases
decrease saliva quality 
diet

Question 11

what is polypharamcy

Answer 11

many drugs taken as you age

could cause dry mouth

Question 12

what can cause hyposalivation

Answer 12

radiotherapy
autotimmue disorders
smoking
idiopathic

Question 13

what does demineralisation of the root surface lead to

Answer 13

soft consistency

Question 14

what can lead to darkening of the root surface

Answer 14

extrinsic staining into softened more porous dentine

Question 15

main bacteria in caries

Answer 15

mutans streptococci
lactobacilli
actionmyces

Question 16

what is more common in root caries compared to normal caries

Answer 16

action Myles

- due to proteolytic effect

Question 17

Detection of caries

Answer 17

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

Question 18

resulting lesion from coronal caries

Answer 18

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

Question 19

what are radiographs useful for

Answer 19

determine bone support and the presence of any periapilca radiolucnecies

Question 20

what are radiographs not useful for

Answer 20

buccal palatal or lingual or occlusal caries,

behind lesion will be sound dentine therefore caries may not show up well

Question 21

active lesion root cares

Answer 21

lighter matt colour
softer/rougher surface
gingival inflammation/plaque buildup
inaccessible area

Question 22

arrested root caries lesion

Answer 22

dark and shiny
harder surface
clean surface

Question 23

what is the best indicator of cries

Answer 23

past caries experience

Question 24

root caries management

Answer 24

prevention

operative control

Question 25

non operative caries control

Answer 25

``` oral hygiene instructions plaque control diet advice fluoride casein phosphopeptide antimicrobial agents ```

Question 26

what does casein phosphopeptide do

Answer 26

amorphous calcium phosphate | - helps remineralisation by placing on the tooth

Question 27

examples of antimicrobial agents

Answer 27

chlorhexidine | xylitol

Question 28

when do we need to restore the caries

Answer 28

when it is cavitated | or no longer cleansable

Question 29

what is the the aims of operative management of carious lesions

Answer 29

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