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In the most simple terms, the process of dental caries can be illustrated by this Venn diagram:

Susceptible tooth
Presence of bacteria
Access to fermentable carbohydrates and cooked starches
Time

Bacteria use dietary fermentable carbohydrates (principally sugars and cooked starches) as a substrate for acid production, resulting in a lowering of the pH of the area. Species of Streptococcus and Lactobacillus are most often implicated in the caries process.



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Streptococcus mutans do not appear as an oral microbe in the infant until primary teeth erupt. Acquisition of S. mutans appears to take place through mouth-to-mouth transmission between caretaker and child. Transmission can be delayed/prevented by the initiation of a prevention program including meticulous oral hygiene, especially in caretakers who demonstrate a high-risk level of S. mutans.

(Photo: mother to child transmission)
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The Caries Process

Enamel is composed of mineralized crystals in an organic matrix. This unique structure provides channels through which minerals, such as calcium and fluoride, and acids can flow.

We no longer think of dental caries as a simple, uncontrollable, linear progression from acid demineralization to a frank clinical lesion. We now believe the caries process is dynamic and involves demineralization and remineralization.

(Photo: enamel crystals in an organic matrix)

Download the Smiles for Tomorrow Dental Caries and Prevention PowerPoint Presentation.
(72 Slides)