With age, the gingival tissues recede below the edge of the enamel, exposing the dentin or cementum. These layers are much more soluble than enamel, and, therefore, more susceptible to acid attack.1 This is why root caries are more prevalent in geriatric patients.16 In this population, decreased salivary flow due to age or medications, and a change in diet to softer foods, can make root caries difficult to manage. The following Table summarizes the differences between enamel caries and root caries:
| Enamel Caries | Root Caries | |
| Intact tissue mineral content (by volume): | 85% to 87% | 45% |
| Etiology: | Plaque | Plaque and recession |
| Result of acid attack: | Acid dissolves subsurface; white spot lesion | Acid dissolves surface; subsurface sticky or tacky |
| Physical changes: | Complete dissolution = cavitation | Complete dissolution = contour changes |
| Remineralization potential: | Possible if outer area is intact | Mineral content can be increased if collagen layer still present |
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