Root Caries Prevention: Integrating Microbiome Modulation, Diagnostics, and Personalized Interventions

Root caries prevention is a rapidly evolving field at the intersection of clinical dentistry, public health, and oral microbiology. Root caries has become an increasingly significant challenge due to demographic shifts, with more adults experiencing gingival recession, exposed root surfaces, and the impacts of systemic disease and polypharmacy, particularly xerostomia. Unlike coronal caries, lesions on root surfaces progress on more susceptible tissues and arise in populations with complex risk profiles, creating persistent gaps in prevention and management. Ongoing debates concern the effectiveness of current protocols, the limitations of conventional risk assessment, and the barriers to implementation, especially among vulnerable and older populations.Recent research has yielded promising results in several domains, including microbiome-focused interventions, advanced remineralization technologies, and innovative diagnostic modalities. Studies are increasingly exploring the integration of probiotics and biofilm modulation, the use of high-fluoride and novel remineralizing agents, and the adoption of digital and AI-assisted diagnostics for early detection. Clinical trials and translational studies underscore the need for tailored, longitudinal preventive regimens, yet they also highlight variability in real-world settings and implementation, especially for patients with limited manual dexterity or access to care. Despite methodological advances, there remains a critical need to clarify optimal strategies, suitable delivery pathways, and to understand how multidisciplinary evidence can drive better root caries outcomes across different care contexts.This Research Topic aims to advance evidence-based, personalized, and scalable prevention of root caries by integrating clinical, microbiological, behavioral, and digital innovations. The objectives are to clarify which strategies are most effective for various at-risk populations, explore the potential of microbiome-targeted and diagnostic-driven interventions, and identify facilitators and barriers to real-world implementation. The ultimate goal is to bridge scientific breakthroughs with practical solutions that improve oral health and quality of life, with special attention to medically complex, aging, or underserved populations.The focus of this Research Topic is on prevention, early detection, and risk-tailored management of root caries, explicitly excluding restorative and surgical interventions as primary outcomes. We encourage contributions that span laboratory, translational, and real-world clinical research, including pragmatic studies that evaluate practical, scalable protocols.To gather further insights in this field, we welcome articles addressing, but not limited to, the following themes: • Microbiome-focused prevention strategies, including probiotics, prebiotics, and modulation of biofilm ecology • Innovations in oral hygiene and behavioral interventions tailored for exposed root surfaces and high-risk groups • Advanced fluoride and remineralization systems, with comparative effectiveness and new delivery approaches • Personalized caries risk assessment, including salivary function, diet, systemic disease, and digital decision-support • Diagnostic advances for early lesion detection and longitudinal monitoring, including biomarker, imaging, and AI-assisted tools • Implementation research focusing on prevention across the lifecourse, health systems integration, cost-effectiveness, and care equityArticle types welcomed include original research, systematic reviews, meta-analyses, clinical trials, pragmatic and implementation studies, methodological manuscripts, and high-quality narrative reviews, with an emphasis on clinically meaningful and practice-changing outcomes. Topic editors: Katherine CM Leung, LINLU DAI Source: https://www.frontiersin.org/research-topics/77757/root-caries-prevention-integrating-microbiome-modulation-diagnostics-and-personalized-interventions