The etiology of dental caries: A correlation of reports

Abstract

It is difficult to say with finality what is the most important factor in the mechanism of caries. 1. 1. The central event is due to enamel decalcification. 2. 2. Mechanical factors seem to account for lowering the carious resistance, such as enamel cracks, thickness, organic tracks, and position of the eruptive teeth. 3. 3. Protective mechanism of dentine may act through saliva or pulp. 4. 4. An environment conducive to acid-forming bacteria is offered to certain areas of the teeth. 5. 5. The carbohydrate diet plays a role in all probability altering the saliva and therefore the oral environment. 6. 6. Physiologic systemic influences may operate by way of the saliva or through pulp and dentine. 7. 7. Several people have pointed out the possibility of an unknown factor in saliva that has inhibitory effects toward Lactobacillus acidophilus in the mouth. 8. 8. Acid pH may fall low enough to cause an extremely favorable environment for the lactobacillus growth. Acid alone cannot cause caries, however. 9. 9. Fluorine content of enamel seems to be related to caries incidence. 10. 10. In general, anything tending to prevent free flow of saliva over all the oral surface or to cause uncleanliness in areas of the teeth also must increase the likelihood of caries. Ammonia nitrogen presence in saliva has a related effect toward dental caries incidence. The essential part of prevention is to raise the resistance, but it seems necessary to establish the mechanism clearly first in order to know what the enemy is, how he operates, what his life lines are, and then proceed to exterminate him by the most expedient method.