A Microbiological Study of Primary Root-caries Lesions with Different Treatment Needs

Abstract

Samples of altered or carious dentin for microbiological culture were obtained from 301 primary root-caries lesions in 59 patients by means of a standardized sampling procedure. This involved the cleansing of each root surface of extraneous supragingival plaque by means of a hand-held toothbrush and distilled water and the collection of the sample with a sterile dental excavator passed through the entire vertical dimension of each lesion. The total number of colony-forming units (cfu) in each sample and the numbers of mutans streptococci (primarily Streptococcus mutans), lactobacilli, yeasts, and Gram-positive pleomorphic rods (GPPR) were determined. Individual bacterial counts were expressed as log10 (cfu per sample), as a percentage of the total number of bacteria per sample, and as a frequency of isolation from lesions with different clinical diagnostic criteria. Clinical measurements of each lesion were made for color, texture, position relative to the gingival margin, and treatment need. Lesions classified as soft yielded significantly more bacteria, mutans streptococci, lactobacilli, and GPPR than leathery lesions, which yielded more bacteria than hard lesions. Lesions were classified into 5 treatment categories: soft and restore, leathery and restore, leathery and debride of caries; leathery and treat therapeutically; and hard no treatment. The total numbers of bacteria, mutans streptococci, lactobacilli, GPPR, and yeasts decreased significantly with decreasing treatment need. The frequency of isolation of mutans streptococci, lactobacilli, and yeasts was significantly greater from lesions requiring restoration and from lesions situated within 1 mm of the gingival margin. We suggest that the majority of root caries is initiated adjacent to the gingival margin.

The Effect of Antibacterial Monomer MDPB on the Growth of Organisms Associated with Root Caries

“…They were characterized by their proximity to the gingival margin and their soft texture evident upon probing 10) . [7][8][9] .…”

An evaluation of an oral health training programme for carers of the elderly in residential homes

“…The length of exposed root from cemento-enamel junction to the gingival margin and condition of each root surface was recorded 19 as above. Root caries was defined as 'an area of exposed root at or below the cemento-enamel junction, where the texture of the lesion dictated operative treatment' , eg soft or leathery and within 1 mm of the gingival margin.…”

Impact of Low Level Magnification on Incipient Occlusal Caries Diagnosis and Treatment Decision Making

“…While visual examination alone has been advocated for caries detection; visual-tactile assessment is preferred by most clinicians, as tactile assessment is said to be an important criteria in determining lesion activity [5]. The WHO recommended the use of community periodontal index-treatment needs (CPI-TN) probe for caries detection [6].…”