Cavities and tooth decay are kids’ stuff, right? The Centers for Disease Control and Prevention reports that 18.6% of American children aged 5 to 19 have untreated cavities. But your risk for developing cavities doesn’t end once you become an adult. In fact, 31.6% of American adults aged 20 to 44 have untreated cavities — indicating more adults than children have tooth decay in need of treatment. Adults — particularly older adults — may develop a root cavity, which is a type of tooth decay that forms on the roots of the teeth.

How Do Root Cavities Develop?

Whether a cavity forms on the root of the tooth or on a part of the tooth that is exposed, the way the cavity develops is the same. Cavities form as a result of acids produced by bacteria that naturally live in the mouth and feed on sugar. In the “normal” formation of cavities, those acids eat away at the tooth enamel, as the American Dental Association (ADA) explains.

However, in the case of root cavities, the acids eat away at cementum, which is the material that covers tooth roots. The ADA notes that cementum is softer than tooth enamel and is also susceptible to decay. The development of root cavities is actually twice as fast as other types of cavities, according to a review in the Cochrane Database of Systematic Reviews (CDSR).

One factor that can contribute to the development of root cavities is the recession of the gums. When gums pull away or recede from the teeth, they leave the roots exposed. Although the CDSR review calls receding gums a “prerequisite” for root cavities in nearly all cases, it also notes that 10% to 20% of cavities in the roots of teeth develop beneath the existing gumline.

Who Is at Risk for Root Cavities?

The ADA notes that it is common for adults over the age of 50 to have cavities in the roots of their teeth, and the CDSR review states that 70 is the “peak age” for root decay. One reason for the higher rates of root cavities in older adults is that older people are more likely to have gum recession than younger people are. It’s also more common today for older individuals to retain their teeth throughout their life.

But, much like other types of cavities, how well a person cares for their teeth directly influences their risk of decay. If older people lose their dexterity, brushing and flossing can become increasingly difficult, so it’s important for them to find ways to maintain proper oral hygiene on their natural teeth. If they smoke, drink alcohol frequently or consume high amounts of sugar, they may be even more susceptible to root cavities, explains the CDSR review.

How to Treat a Root Cavity

Treatment for root cavities is similar to that of other cavities. If a dentist detects the cavity early on, they might be able to stop the decay process and protect the tooth from further damage. Ways to reverse the process of decay include fluoride treatments, cleaning your teeth often to remove plaque and reducing the amount of sugar and other carbohydrates in your diet, reports the CDSR review.

When a root cavity is severe enough to cause a person pain or to interfere with the functioning of the tooth, it’s usually necessary to fix the cavity by restoring the tooth. Restoration involves a dentist removing the decayed area of the tooth, then filling it with a restorative material, such as a composite resin or amalgam filling.

What You Can Do to Prevent Root Cavities

It is possible to prevent the formation of root cavities and other types of cavities. These steps can help you avoid tooth decay anywhere on your teeth, as the ADA outlines:

  • Brush your teeth at least twice a day, using fluoride toothpaste. (If you have difficulty brushing, the ADA recommends using an electric toothbrush.)
  • Clean between your teeth with either floss or interdental cleaners.
  • Limit the amount of sugar in your diet.
  • See your dentist for regular dental exams and cleanings.
  • Ask your dentist about in-office fluoride treatments.

Additionally, if you have receding gums, ask your dental professional if there is anything more you can do to restore your gum health and reduce your risk of developing root cavities. By working as a team, you and your dentist can take steps to treat and prevent these cavities.