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There have been many studies reporting on the prevalence of root surface caries in elderly populations, but there is little consistency in these reports concerning the associated risk factors. In the present study, intraoral examinations were carried out on adult patients (age range 22 to 91 years, mean age 57.9) on the acute care wards of a teaching hospital. Of the 103 patients examined, 23.3% exhibited carious lesions on root surfaces, these lesions occurring more frequently in males than in females, and more frequently in the 60 years and older age groups. Forty-five per cent of all root lesions recorded were found on the buccal or facial root surfaces of teeth exhibiting root surface caries. Individuals exhibiting root surface caries had more surfaces with gingival recession and loss of attachment greater than or equal to 3mm, more retained roots, higher DMFT values, and less teeth. However, statistically significant relationships were not obtained between root surface caries and a) coronal caries, b) dental plaque, c) calculus, d) bleeding on probing, and e) probing depth greater than or equal to 4mm. Thirty-three strains of Actinomyces viscosus were isolated from plaque samples taken from root surface lesions compared to 21 strains isolated from intact root surfaces.