I’ve been in practice for over 9 years and I’m seeing more and more of the root caries.

Root Cavities Are A Bigger Problems Nowadays

Why is this happening?  In my opinion (and that of a lot of supporting studies), it is because of these 3 main reasons:

1. The diet is becoming more acidic.  This leads to more demineralization in the mouth as a result of the foods and liquids we eat and also the more acidic saliva.
2. Unbalanced bites.  When bites aren’t even, then certain teeth start to form abfractions (flaking off of enamel).
3. Gum recession that is exposing the softer, more cavity-prone dentin/cementum.

Dentists are not emphasizing the more obvious cause which is the diet.  Probably because we weren’t trained in school or because it is easier to just drill, fill and bill.  But when most of the diseases in the mouth are preventable, then it is our duty to emphasize the cause.

Treatment wise I recommend filling them if there’s decay present, severely stained/discolored, or if there is sensitivity.  However, if none of those are present, then we need to consider desensitizing the teeth, taking care of the root cause of the problem (the bite for instance), or just educating the patient.