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Is there a preferable management for root caries in middle-aged and older adults? A systematic review

British Dental Journal (2021)Cite this article

Abstract

Aim This systematic review aimed to critically summarise the results of clinical studies investigating agents able to: stop the progression of carious lesions; stop the development of new root carious lesions; preserve the vitality of the infected dental tissues; and increase the surface hardness or change of surface texture, in middle-age and older adults.

Methods PubMed, Scopus, and Web of Science were searched systematically, following PRISMA guidelines. Clinical trials published from 2011 to 2020 (March) were included. This systematic review is registered in the PROSPERO database (CRD42018104399). Languages were restricted to English.

Results Thirteen of 312 studies were eligible for this review. Eight agents were identified in the studies and their efficacy was assessed using different methods. The agents that presented valuable results on preventing or arresting root caries were 38% silver diamine fluoride (SDF), arginine-containing toothpaste and high-fluoride toothpastes.

Conclusions Based on the selected studies' findings, annual applications of 38% SDF could be the most effective treatment for root caries in older adults. In addition, the daily use of a 1.5% arginine toothpaste or a high-fluoride toothpaste could also be recommended. More research on root caries-specific diagnostic methods, especially at very early stages, is necessary.

Key points

  • Annual application of 38% silver diamine fluoride was found to be the most effective treatment for root caries in middle-aged and older adults.

  • The daily use of a 1.5% arginine toothpaste or a high-fluoride toothpaste contributed to the root caries arrest in older adults and could also be suggested as a preventive treatment.

  • Fluoride varnish, chlorhexidine varnish and xylitol were found to be the least effective agents identified in this review.

  • The heterogeneity of the study designs and protocols underlines the lack of methodologies used for diagnosis and treatment; this highlights the need for further research on diagnosis methods, especially at very early stages.

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Authors and Affiliations

  1. Departmento de Materiais Dentários e Prótese, Faculdade de Odontologia de Ribeirão Preto, University of São Paulo, Ribeirão Preto, São Paulo, Brazil; Université de Lyon – Université Claude Bernard Lyon 1, UMR CNRS 5615, Laboratoire des Multimatériaux et Interfaces, F-69622, France

    Raísa Castelo

  2. Université de Lyon – Université Claude Bernard Lyon 1, UMR CNRS 5615, Laboratoire des Multimatériaux et Interfaces, F-69622 Villeurbanne, France; Université de Lyon – Université Claude Bernard Lyon 1, Faculté d’Odontologie, 69008 Lyon, France

    Nina Attik

  3. Departmento de Materiais Dentários e Prótese, Faculdade de Odontologia de Ribeirão Preto, University of São Paulo, Ribeirão Preto, São Paulo, Brazil

    Alma Blasida Concepcion Elizaur Benitez Catirse & Camila Tirapelli

  4. Université de Lyon – Université Claude Bernard Lyon 1, UMR CNRS 5615, Laboratoire des Multimatériaux et Interfaces, F-69622 Villeurbanne, France; Département d’Odontologie Conservatrice – Endodontie, Université de Paris, Faculté Dentaire, Hôpital Rothschild, Assistance Publique-Hôpitaux de Paris, France

    Nelly Pradelle-Plasse

  5. Université de Lyon – Université Claude Bernard Lyon 1, UMR CNRS 5615, Laboratoire des Multimatériaux et Interfaces, F-69622 Villeurbanne, France; Université de Lyon – Université Claude Bernard Lyon 1, Faculté d’Odontologie, 69008 Lyon, France; Hospices Civils de Lyon, Centre de Consultations et de Traitements Dentaires, 69007 Lyon, France

    Brigitte Grosgogeat

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  1. Raísa Castelo
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  2. Nina Attik
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  3. Alma Blasida Concepcion Elizaur Benitez Catirse
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Contributions

Camila Tirapelli and Brigitte Grosgogeat have contributed equally to the supervision of this work

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Correspondence to Nina Attik.

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Castelo, R., Attik, N., Catirse, A. et al. Is there a preferable management for root caries in middle-aged and older adults? A systematic review. Br Dent J (2021). https://doi.org/10.1038/s41415-021-3003-2

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