Which MID approaches are favored for root caries in older adults?

• A. Non-invasive fluoride therapy, sealing with GIC or resin, and resin infiltration when feasible, with careful monitoring.
• B. Extraction of the root
• C. Immediate drilling and filling with amalgam
• D. Root planing only

Answer: (A)

In managing root caries in older adults, the aim is to arrest decay and preserve tooth structure using minimally invasive methods. Non-invasive fluoride therapy helps remineralize exposed root surfaces and can slow or stop lesion progression. Sealing the lesion with glass ionomer cement or resin creates a protective barrier that limits biofilm contact and provides fluoride release, further stabilizing the lesion. Resin infiltration, when feasible, penetrates porous carious tissue to block pathways for acids and bacteria, effectively arresting early lesions without removing much tooth structure. Ongoing monitoring is essential to detect any changes and guide further treatment if needed. These approaches reflect a conservative strategy that prioritizes preservation and control over more invasive options. Extraction removes the tooth and is not a minimally invasive approach for a root caries lesion unless the tooth is non-restorable. Immediate drilling and filling with amalgam is more invasive and may not address the underlying risk factors or progression on root surfaces. Root planing alone targets periodontal issues and does not arrest caries progression.