Tooth decay occurs when bacteria in your mouth create acids that damage the enamel on the surface of your teeth. Dentists call the damage “caries,” but most people refer to the holes that result in damaged teeth as “cavities.”

Decay can occur on any surface of the tooth: the biting surface, the smooth flat sides of the tooth, and the root. Root cavities by definition are the cavities that affect the root.

cavity, tooth, decay, root cavity, smooth surface cavity, pit and fissure cavityShare on Pinterest
Three different types of cavities are illustrated here.

Typically, tooth decay causes all cavities, including root cavities, to develop. The process occurs over time, and it starts with a sticky film called plaque that develops on your teeth when bacteria in your mouth feed on sugar and starches that are left behind from the foods that you eat.

The plaque can harden into tartar, and acid within the plaque can begin to eat away at the enamel surface of your teeth.

Tiny holes in the enamel develop, and bacteria can wiggle their way down into the holes and reach the dentin layer of your tooth. If not stopped, that bacteria can even make their way down to the center of your tooth, where the nerve is located.

In general, tooth decay tends to occur more often in your back teeth since it’s harder to keep them clean. Research also shows that root cavities tend to develop twice as fast as cavities on other surfaces of the teeth, which involve damage to the enamel. That makes early intervention imperative to stop the damage.

Since a root cavity, by definition, develops on the root of a tooth, you probably won’t be able to see it by peering into a mirror and looking into your open mouth. But you might notice some warning signs, like some pain in your tooth, or perhaps some sensitivity, particularly to cold or heat.

Also, if you notice that your gums are receding, it’s important to see a dentist, as gum recession is often the first step on the way to root cavities. Without the coverage of the gums, the roots can be more vulnerable to bacteria and decay.

Anyone can develop root cavities, but older people are at much greater risk. In fact, research suggests that age 70 is the peak age for developing root cavities. That’s because older people are more likely to have a condition known as periodontal support loss, which is a degradation of the tissues that support the teeth.

Over time, those tissues can gradually recede from the teeth. Sometimes, part of the root can even be exposed. Bacteria can get down into the tissues, which can lead to inflammation and, yes, cavities. The teeth can become loose, too.

Older people are also more likely to have other chronic health conditions, like diabetes and metabolic syndrome, that can raise their chances of developing inflammation in their gums that leads to periodontal disease.

A 2019 systematic review of research on root caries also found that smoking can also raise your risk of developing periodontitis, as can poor dental hygiene.

Complications can arise from root cavities, so you do need to get treatment for them. In fact, don’t delay seeking treatment, as the tooth decay that caused your cavity can continue to spread and may cause more damage.

The decay can spread to the tissues at the center of your tooth, known as the pulp. If that happens, you may have to get a root canal to remove the damaged or dead pulp, clean out all the little canals in your tooth, and seal up your tooth.

Unless you need a root canal, your treatment for a root cavity shouldn’t be too different from treatments for other types of cavities. A dentist will remove the decayed area and then put in a filling, which can be made from a variety of materials.

However, if the damage is pretty deep, the dentist may recommend a root canal. If you do undergo a root canal, they may also cover the tooth with a crown afterward. Crowns are often used to cover significant damage to teeth and can strengthen the remaining tooth.

The best treatment is prevention. Practicing good dental hygiene can reduce your risk of developing tooth decay, including root cavities.

Fluoride is a very effective weapon in the battle to prevent tooth decay and cavities. A 2020 systematic review of research found that professional fluoride treatments and self-applied fluoride treatments like a daily fluoride mouth rinse can be very effective in reducing root cavities.

You should also brush your teeth with fluoridated toothpaste twice a day after eating or drinking.

Here are some other ways to prevent root cavities:

Root cavities can develop before you realize it. You need to be especially mindful of them if you’re older, since you’re more at risk for developing root cavities, in general.

In fact, if you know you’re at elevated risk for developing root cavities for any reason, talk to a dentist about the best combination of preventive treatments and professional examinations to both reduce your risk and identify any problems early.