Root Cavities: the Basics

Together, periodontal (gum) disease and tooth decay are the leading causes of tooth loss. One especially pernicious form of tooth cavity is the root cavity.

When thinking about tooth decay, most people here in Chicago probably think first of crown cavities. This is decay in the part of the tooth we can see. Root cavities attack the hidden part of the tooth, the root (although signs of them can be visible where the tooth meets the gum.) They are likely to occur when the gum has receded. This can happen as a result of gum disease or even just because a person brushes too hard.

When bacteria can get at it the roots of a tooth, the tooth is in serious trouble because, unlike the crown, the roots don’t have enamel, the hard coating that provides a measure of protection against tooth decay. The roots are only covered with a thin layer of a substance called cementum that affords less protection. As a result, tooth decay often spreads faster. This can attack the nerve, producing severe toothache, and even result in the tooth breaking off if the roots are too greatly damaged.

The bottom line is that if left untreated for too long, root cavities, like other forms of tooth decay and the various gum diseases, can ultimately result in tooth loss.

Seniors and Root Cavities

The older a person gets, the more likely he or she is to develop root cavities, with seniors naturally being the most likely. That’s largely because the older you get, the more likely you are to have receding gums and consequently exposed roots.

By the same token, seniors here in Chicago are more likely to experience dry mouth, sometimes as a side effect of medication. Since saliva protects against tooth decay, people who don’t have enough of it are at greater risk of cavities including root cavities.

Some seniors also suffer from arthritis and/or poor eyesight. These problems can make maintaining effective dental hygiene more difficult.

Preventing Root Cavities

The best way to deal with root cavities is to never get them in the first place. A proper oral hygiene regimen will make your chances as good as they can be.

A proper dental hygiene regimen consists of brushing and flossing twice daily. It’s best to do this about an hour after eating because eating increases the acidity in your mouth, acidity weakens tooth enamel, and attending to your oral care while the enamel’s weak can damage it. Happily, after half an hour to an hour, your saliva reduces the acidity back to its normal level.

A multi-tufted toothbrush with soft bristles works best for the average person. Even with a soft-bristled brush, you still shouldn’t brush too hard, or you could damage your gums and cause them to recede, thus exposing the roots, which would then become more susceptible to disease. A gentle, scrubbing motion is best, and a person should be sure to brush the entire tooth surface from the gum line to the top. Use a fluoride toothpaste because fluoride strengthens tooth enamel, making it more resistant to decay and even reversing early tooth decay in some instances.

When you brush, floss, and if you find flossing difficult for any reason, discuss the problem with a member of your dental treatment team. The dental pro may have tips that will help, and if not, special tools may do the trick. Floss threaders make it easier to work floss between teeth, and handheld water flossers eliminate the need for thread-like floss altogether by substituting a jet of pressurized water.

People who suffer from dry mouth can try drinking more water. They can also suck on sugar-free hard candies. Candies containing sugar are best avoided, though, since sugar is likely to lead to cavities and make existing cavities bigger.

Be sure to visit your dentist’s office regularly, twice a year or more if indicated. A professional cleaning will get rid of any bacteria-breeding plaque and tartar your brushing and flossing didn’t, and the dental health team can catch any problems including the risk of root cavities. If some teeth are at risk, the dentist may use topical fluoride or other preventative measures to strengthen them.

Treatment of Root Cavities

If you do get root cavities, your dentist will treat them in a way that is, on the most basic level, the same as the procedure he or she uses to treat a tooth cavity in the crown. The dentist removes the decayed, damaged part of the structure and then replaces it with filling.

Still, treating root cavities can differ significantly from treating other forms of tooth decay. That’s because it’s more difficult to reach tooth decay when it’s hidden below the gum line. The dentist may need to perform surgery on the gum to get at the problem. This of course can make the procedure more involved and expensive.

Patients concerned about the possibility of root cavities should seek treatment as soon as possible for any signs of gum disease. Periodontal disease often leads to gum recession, exposing the roots of teeth and putting them at risk for root cavities. Even if gum recession has already happened, treatment can sometimes lead to gum reattachment. It may also be possible to perform grafting surgery to facilitate tissue regeneration.