As the population of the UK is living longer, the absolute and relative numbers of older people retaining their natural teeth is on the rise. This means that conditions such as root caries, which are cavities located in the root surface of a tooth, and dry mouth will be more prevalent. The provision of patient-centered, minimally invasive treatment plans using only the most suitable materials is therefore essential for restoring and maintaining dentition.
There are many physical changes that can come with ageing that make older people at greater risk of demineralisation and root caries. These include reduced saliva flow, reduction in fine motor skills, cognitive decline, less mobility, changes in diet and general oral heath pathologies that come with a risk of comorbidities.
Root caries in older patients should be approached holistically with a treatment plan that identifies the risk factors, prevents and protects, treats and controls, and recalls if necessary. GC has an all-encompassing range of restorative and preventative materials with proven results to help you ensure that the population is not just living longer, but living longer with greater oral health.
Strengthen and Desensitise
The presence of fluoride and amorphous calcium phosphate in the saliva creates a favourable environment for tissue remineralisation.
Topical fluoride should be used at home and be supplemented with regular professional application of fluoride varnish. Adjunctive use of bio-available calcium phosphates favours tooth repair and has shown impressive results in reducing hypersensitivity.
MI Paste Plus contains Recaldent (bio-available amorphous calcium phosphate) as well as fluoride (900 ppm). It can be used overnight to enhance tooth repair and reduce hypersensitivity, and is available in five flavours that increase patient acceptance.
MI Varnish contains 22600 ppm fluoride as well as Recaldent and is intended for in-office application. It adheres quickly to the teeth, without clumping and serves as a depot for minerals and fluoride, necessary to maintain or remedy the tooth integrity.
When Recaldent comes in contact with fluoride, it stabilises the fluoride ions to create the ideal source for building the more acid-resistant fluorapatite.
Manage erosion, oral hygiene challenges and exposed roots
Fuji TRIAGE, a fluid glass ionomer, will help to protect the surface against caries formation and hypersensitivity
As well as elderly patients developing caries, it is ideal for children with fragile, erupting teeth and any adults seeking immediate relief from sensitive teeth
When the lesion is non-carious or arrested and there is a possibility to isolate well with rubber dam, G-ænial Universal Injectable is an excellent restorative option for root caries lesions. It can easily be polished to high gloss, which reduces plaque retention, and it is wear resistant, which is important in these areas that are subjected to abrasion.
Apart from that, its bendable tip and thixotropic behaviour makes it easy to access even posterior cavities and to control the placement in difficult areas. It comes in many shades, making it possible to make a highly aesthetic restoration - which is being requested increasingly often by patients of all ages.
It is important to adapt the treatment of older patients to their individual needs and conditions. A follow-up plan that adjusts to response to treatment and caries risk is essential. Periodic risk assessment should be routine for all patients. Preventive measures for root caries might be considered to have a better long-term prognosis than restorative treatments.
However, cavitated root caries are less likely to reverse from active to inactive status compared to non-cavitated lesions, so restoration is required in this case. To make it easier to select the necessary interventions and the best products for each stage of the treatment plan, the framework below can be used for guidance.