CONCEPTS OF DENTAL-CARIES AND THEIR CONSEQUENCES FOR UNDERSTANDING THE DISEASE

The way in which we conceptually consider dental caries determines our choice of preventive and treatment strategy. In this paper the defini tion of dental caries is discussed and the related problems concerning causality are addressed. Dental caries reflects symptoms of ongoing a nd past disease - not the disease itself. As such, it is important to record early stages of signs of the disease, i.e. non-cavitated stages of lesion development. The dynamic nature of the processes leading to net loss of mineral (hence a lesion) is emphasized, and appreciating that caries is ubiquitous in populations around the world and initiati on and progression of lesions continues lifelong leads to the logical conclusion that we can control dental caries through a variety of meas ures - but not truly prevent the disease. We can prevent cavities by c ontrolling the patho-physiological events which may result in a net lo ss of mineral. The relative role of dental plaque in caries control is discussed in relation to the role of the many determinants which infl uence the likelihood for lesion development. It is concluded that seve ral paradigms about the nature of dental caries should be reconsidered to provide the most cost-effective dental services.