What are the main factors associated with root caries?

Data sources Medline, EMBASE, PubMed and Scopus databases were used as the data sources for the systematic review. Articles published between 1 January 1990 to 31 October 2018 were included with no language restrictions. A manual search of the references lists of the selected studies and review articles was conducted.Study selection Two independent researchers identified observational studies that investigated at least one risk factor of root caries in the study population. Studies were only included if they demonstrated statistical analysis of data on root caries, had a sample size of >100 and were in vivo. A third researcher was consulted to achieve consensus if there was disagreement. Methodological quality was evaluated via the modified Newcastle-Ottawa Scale for cross-sectional studies.Data extraction and synthesis Data was extracted and pooled into descriptive summary tables with study characteristics and results. Data on the presence and extent of root caries was recorded in addition to information on the relationship between the studied factors and root caries found in the unadjusted and adjusted data. Due to heterogeneity of key aspects among the included studies, meta-analysis was not conducted. Data were grouped under six categories - sociodemographic, general health behaviour, general health condition, fluoride exposure, oral health behaviour and oral health condition - and qualitatively analysed.Results Following screening of 984 articles, 62 were included in methodological quality assessment. Twenty-five were classified as moderate quality, 37 as low quality and 18 excluded. Of the 44 included articles which were qualitatively analysed, a higher association of dental caries was found in tobacco users and those with low socioeconomic status, gingival recession, poor oral hygiene and in older age groups.Conclusions Based on the present evidence, there are a number of factors associated with root caries. More high-quality observational analytical studies are needed in this field in future studies.