Root lesions

In the elderly, but increasingly also in middle-aged patients, root lesions are a major problem in everyday practice. Formerly, the cause of these root destructions was usually caries attack due to a failure of patients to practise adequate oral hygiene measures. However, with increasing dental motivation and health consciousness, patients--for example in the USA, Scandinavian countries and Switzerland--cause such lesions by vigorous, badly controlled brushing, often in combination with the consumption of 'healthy' vegetarian, erosive diets. The former problem of carious root destruction due to neglect thus seems to be gradually being replaced by the problem that self-care is not yet thoroughly understood, is exaggerated and is technically inadequate. Faulty brushing may result in severe damage to those gingival sites that require attention cariologically as well as periodontologically. To exploit all possibilities of (secondary) preventive management of patients, careful investigation and analysis of the clinical signs is required to identify the aetiology of the lesions in each case. Fortunately, therapeutic management of root lesions, regardless of their aetiology, is facilitated by modern restorative techniques and materials.