[Dental caries in the elderly. 2. Root caries. Symptoms and treatment guidelines]

Guidelines for treatment of root surface caries in the elderly are presented. Caries susceptibility of these surfaces may be reduced by the absorbtion of fluoride and other minerals from the oral fluids. Early signs of root caries are a matte appearance and a softening of the root surface. Discoloration and cavity formation appear later. Insufficient filling margins on the root and the cemento-enamel junction are typical sites for root caries development. Early diagnosis through thorough clinical examination is important, since preventive treatment of primary root caries lesions has a better long term prognosis than restorative treatment. Glass-ionomers are a natural choice for the restoration of root caries lesions. Fluorides are efficient for root caries prevention in the elderly dental patient. An annual caries increment exceeding 2 lesions is considered indicative of a reinforced prophylactic program; when exceeding 5 lesions, the patient should be examined after a few months, to ascertain stop in caries progression.