Molecular pathogenesis of root dentin caries

Human dentin has a higher content of organic matrix and more non-ideal hydroxyapatite than human enamel. Ultrastructural studies indicate that root caries involves both mineral dissolution and breakdown of the organic matrix. Factors involved in the root caries process seem more complicated than those in enamel caries. Moreover, the distinct roles of acids and enzymes and the sequence of events in the root caries process are not well-understood. Although Streptococcus mutans and Actinomyces viscosus are considered to be major pathogenic micro-organisms of root caries, their roles in degradation of the organic matrix components of root dentin need clarification. The purpose of this paper is to review the basic composition of root dentin and the roles of acids and both endogenous and bacterial enzymes in the root caries process.