Management of root caries: a guide for the Brazilian dentist based on the translation and cultural adaptation of the international consensus/ORCA and EFCD
DOI:
https://doi.org/10.22456/2177-0018.116951Keywords:
Root caries, Conservative treatment, Dental care, Dental atraumatic restorative treatment, Frail elderly, AgedAbstract
Aim: Root caries are a problem in modern dentistry, but the lack of guidelines regarding their management is notable. We aim to develop and adapt a guide based on the translation of the recommendations of the international consensus as outlined by the European Organization for Caries Research (ORCA) and the European Federation of Conservative Dentistry (EFCD) for clinical decision-making in the intervention of the caries process in the elderly, with a focus on root caries. Materials and methods: The protocol for translating the recommendations of the international consensus consisted of the following steps: (1) initial translation, (2) synthesis of the translation, (3) back-translation, (4) review by an expert committee with cultural adaptation. Based on the translation, a guide was developed with guidelines for the treatment of root caries in Brazil. Results: To prevent new lesions, daily brushing with toothpaste >1,500ppm/F is recommended. Toothpaste with 5,000ppm/F or varnishes (>20,000ppm/F) may be recommended to paralyze active root lesions and for prevention in elderly people with high susceptibility to root caries, and Silver Diamine Fluoride (>30%) to paralyze active lesions. Direct invasive interventions are indicated depending on the clinical situation. Discussion: There is a lack of interest in primary studies on treatments for root caries, thus creating a gap in relation to its management, which is reflected by the level of evidence detected in the consensus. Conclusion: Clinical guidelines are important to reduce the gap between research and clinical practice. This translation into Portuguese will facilitate access by Brazilian dentists to the consolidated evidence gathered to date for the management of root caries.
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Marques RA, Antunes JL, Sousa Mda L, Peres MA, Frazão P. Prevalência e extensão da cárie dentária radicular em adultos e idosos brasileiros [Root caries prevalence and severity in Brazilian adults and older people]. Rev Saude Publica. 2013 Dec;47 Suppl 3:59-68. Portuguese. doi: 10.1590/S0034-8910.2013047004365.
Arthur RA, Martins VB, de Oliveira CL, Leitune VC, Collares FM, Magalhães AC, et al. Effect of over-the-counter fluoridated products regimens on root caries inhibition. Arch Oral Biol. 2015 Oct;60(10):1588-94. doi: 10.1016/j.archoralbio.2015.07.018.
Schwendicke F, Göstemeyer G. Cost-effectiveness of root caries preventive treatments. J Dent. Jan 2017;56:58-64. doi:10.1016/j.jdent.2016.10.016.
Cussi F. Estudo do prognóstico e custo-efetividade de tratamentos não invasivos para lesões de cárie radicular [dissertação]. Universidade de Brasília, Faculdade de Odontologia; 2020.
Heasman PA, Ritchie M, Asuni A, Gavillet E, Simonsen JL, Nyvad B. Gingival recession and root caries in the ageing population: a critical evaluation of treatments. J Clin Periodontol. Mar 2017;44 Suppl 18:S178-93. doi:10.1111/jcpe.12676.
Paris S, Banerjee A, Bottenberg P, Breschi L, Campus G, Doméjean S, et al. How to intervene in the caries process in older adults: a joint ORCA and EFCD expert delphi consensus statement. Caries Res. 2020 Dec 8;54(5-6):1-7. doi: 10.1159/000510843.
Fejerskov O, Nyvad B. Root surface caries - rationale behind good diagnostic practice. Monogr Oral Sci. 2017;26:43-54. doi: 10.1159/000479306.
Cai J, Palamara J, Manton DJ, Burrow MF. Status and progress of treatment methods for root caries in the last decade: a literature review. Aust Dent J. Mar 2018;63(1):34-54. doi:10.1111/adj.12550.
Thomson WM, Spencer AJ, Slade GD, Chalmers JM. Is medication a risk factor for dental caries among older people? Community Dent Oral Epidemiol. Jun 2002;30(3):224-32. doi:10.1034/j.1600-0528.2002.300309.x.
Thomson WM. Epidemiology of oral health conditions in older people. Gerodontology. Feb 2014;31 Suppl 1:9-16. doi:10.1111/ger.12085.
Batista MJ, Rando-Meirelles MP, Sousa Mda L. Prevalência da cárie radicular na população adulta e idosa da região Sudeste do Brasil [Prevalence of root caries among adults and the elderly in southeast Brazil]. Rev Panam Salud Publica. 2014 Jan;35(1):23-9. Portuguese.
Do T, Damé-Teixeira N, Naginyte M, Marsh PD. Root surface biofilms and caries. Monogr Oral Sci. 2017;26:26-34. doi:10.1159/000479304.
Takahashi N, Nyvad B. Ecological hypothesis of dentin and root caries. Caries Res. 2016;50(4):422-31. doi: 10.1159/000447309.
Damé-Teixeira N, Parolo CCF, Maltz M. Specificities of caries on root surface. Monogr Oral Sci. 2017;26:15-25. doi:10.1159/000479303.
Burgess JO, Gallo JR. Treating root-surface caries. Dent Clin North Am. Apr 2002;46(2):385-404, vii-viii. doi:10.1016/s0011-8532(01)00003-9.
Burrows S. Root caries part 2: the restorative challenge. Dental Update. Feb 2020;47:199-212. doi:10.12968/denu.2020.47.3.199.
Wierichs RJ, Meyer-Lueckel H. Systematic review on noninvasive treatment of root caries lesions. J Dent Res. Feb 2015;94(2):261-71. doi:10.1177/0022034514557330.
Oliveira BH, Hyppolito IMD, Malheiros Z, Stewart B, Pannuti CM. Information-seeking behaviors and barriers to the incorporation of scientific evidence into clinical practice: A survey with Brazilian dentists. PLoS One. 2021 Mar 25;16(3):e0249260. doi: 10.1371/journal.pone.0249260.
Beaton DE, Bombardier C, Guillemin F, Ferraz MB. Guidelines for the process of cross-cultural adaptation of self-report measures. Spine (Phila Pa 1976). Dec 15 2000;25(24):3186-91. doi:10.1097/00007632-200012150-00014.
Meyer-Lueckel H, Machiulskiene V, Giacaman RA. How to intervene in the root caries process? Systematic review and meta-analyses. Caries Res. 2019;53(6):599-608. doi:10.1159/000501588.
Meyer-Lueckel H, Paris S. When and how to intervene in the caries process. Oper Dent. Sep 2016;41(S7):S35-s47. doi:10.2341/15-022-o.
Närhi T, Syrjälä A-M. Dental diseases and their treatment in the older population. Nor Tannlegeforen Tid. 2017;127:42-8.
Hakeem FF, Bernabé E, Sabbah W. Association between oral health and frailty: a systematic review of longitudinal studies. Gerodontology. Sep 2019;36(3):205-15. doi:10.1111/ger.12406.
Zhu Y, Hollis JH. Tooth loss and its association with dietary intake and diet quality in American adults. J Dent. Nov 2014;42(11):1428-35. doi:10.1016/j.jdent.2014.08.012.
Markose DA. Root caries, diagnosis, prevention and their treatment. IOSR Journal of Dental and Medical Sciences (IOSR-JDMS). Nov 2016;15:27-30. doi:10.9790/0853-1511102730.
Schwendicke F, Splieth C, Breschi L, Banerjee A, Fontana M, Paris S, et al. When to intervene in the caries process? An expert Delphi consensus statement. Clin Oral Investig. 2019 Oct;23(10):3691-3703. doi: 10.1007/s00784-019-03058-w.
Yoshihara A, Suwama K, Miyamoto A, Watanabe R, Ogawa H. The relationship between sucrose intake in coffee or tea, and root or coronal caries in an elderly Japanese population. Community Dent Health. Aug 31 2020;37(3):185-9. doi:10.1922/CDH_00011Yoshihara05.
León S, González K, Hugo FN, Gambetta-Tessini K, Giacaman RA. High fluoride dentifrice for preventing and arresting root caries in community-dwelling older adults: a randomized controlled clinical trial. J Dent. Jul 2019;86:110-7. doi:10.1016/j.jdent.2019.06.002.
Askar H, Krois J, Göstemeyer G, Bottenberg P, Zero D, Banerjee A, et al. Secondary caries: what is it, and how it can be controlled, detected, and managed? Clin Oral Investig. 2020 May;24(5):1869-1876. doi: 10.1007/s00784-020-03268-7.
Göstemeyer G, da Mata C, McKenna G, Schwendicke F. Atraumatic vs conventional restorative treatment for root caries lesions in older patients: meta- and trial sequential analysis. Gerodontology. Sep 2019;36(3):285-93. doi:10.1111/ger.12409.
Cruz Gonzalez AC, Marín Zuluaga DJ. Clinical outcome of root caries restorations using ART and rotary techniques in institutionalized elders. Braz Oral Res. May 31 2016;30(1). doi:10.1590/1807-3107BOR-2016.vol30.0063.
Nyvad B, Machiulskiene V, Baelum V. Reliability of a new caries diagnostic system differentiating between active and inactive caries lesions. Caries Res. 1999 Jul-Aug;33(4):252-60. doi: 10.1159/000016526.
Schwendicke F, Gostemeyer G. Cost-effectiveness of root caries preventive treatments. J Dent. Jan 2017;56:58-64. doi:10.1016/j.jdent.2016.10.016.
Walsh T, Worthington HV, Glenny AM, Marinho VC, Jeroncic A. Fluoride toothpastes of different concentrations for preventing dental caries. Cochrane Database Syst Rev. Mar 4 2019;3(3):Cd007868. doi:10.1002/14651858.CD007868.pub3.
Takahashi N, Nyvad B. Caries ecology revisited: microbial dynamics and the caries process. Caries Res. 2008;42(6):409-18. doi:10.1159/000159604.
Li R, Lo EC, Liu BY, Wong MC, Chu CH. Randomized clinical trial on arresting dental root caries through silver diammine fluoride applications in community-dwelling elders. J Dent. Aug 2016;51:15-20. doi:10.1016/j.jdent.2016.05.005.
Navarro MFL, Pascotto RC, Borges AFS, Soares CJ, Raggio DP, Rios D, et al. Consensus on glass-ionomer cement thresholds for restorative indications. J Dent. 2021 Apr;107:103609. doi: 10.1016/j.jdent.2021.103609.
Hayes M, Da Mata C, Cole M, McKenna G, Burke F, Allen PF. Risk indicators associated with root caries in independently living older adults. J Dent. Aug 2016;51:8-14. doi:10.1016/j.jdent.2016.05.006.
Tan HP, Lo EC. Risk indicators for root caries in institutionalized elders. Community Dent Oral Epidemiol. Oct 2014;42(5):435-40. doi:10.1111/cdoe.12104.
Bignozzi I, Crea A, Capri D, Littarru C, Lajolo C, Tatakis DN. Root caries: a periodontal perspective. J Periodontal Res. Apr 2014;49(2):143-63. doi:10.1111/jre.12094.
Ingber JS, Rose LF, Coslet JG. The "biologic width"--a concept in periodontics and restorative dentistry. Alpha Omegan. Dec 1977;70(3):62-5.
Pontoriero R, Carnevale G. Surgical crown lengthening: a 12-month clinical wound healing study. J Periodontol. Jul 2001;72(7):841-8. doi:10.1902/jop.2001.72.7.841.
Jardim J. Remoção parcial de tecido cariado em lesões de cárie profundas em dentes permanentes [dissertação]. Universidade Federal do Rio Grande do Sul, Faculdade de Odontologia; 2010.
Angeletaki F, Gkogkos A, Papazoglou E, Kloukos D. Direct versus indirect inlay/onlay composite restorations in posterior teeth. A systematic review and meta-analysis. J Dent. Oct 2016;53:12-21. doi:10.1016/j.jdent.2016.07.011.
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