Abstract

The World Health Organization (WHO) determines dental caries in two different ways (1). The official determination has been specified by the International Statistical Classification of Diseases and Other Health Related Problems (ICD) (2) and the other one is an epidemiological determination presented by Oral Health Surveys (3). Another problem arises from the fact that dental caries affects both permanent and primary teeth and occurs simultaneously during the period of mixed dentition before and during elementary school years. Indeed dental caries is the same disease in both primary and permanent teeth. Nonetheless, the scientific attitude that caries is primarily an infectious disease and that the host has only a minor role prevails in analyzing the carious process. The terms involved in dental caries include caries activity when referring to the presence and virulence of cariogenic infection and caries susceptibility when speaking about the host resistance covering primary and permanent teeth as well as saliva. Caries occurs in subjects who have an imbalance between favorable caries-causing activity and unfavorable susceptibility resulting in a diseased subject. This means that caries normally affect younger patients and in the elderly they occur in the form of root caries on the tooth’s cementum. A similar imbalance also exists in osteoporotic-penic subjects where the diagnostic outcome and disease consists of bone fractures. Thus, carious lesions in the dentition of carious subjects can be treated as either a diagnostic outcome or a symptom.

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