RESPONSE TO SEOW - BIOLOGICAL MECHANISMS OF EARLY-CHILDHOOD CARIES

For more than three decades, it has been recognized that dental caries is an infectious and transmissible disease in which diet plays a key role. Nevertheless, in treating patients with early childhood caries, scant attention is placed on exploring the source of infection and the prevalence of caries in other family members. Results from studies co nducted in animals clearly show that the virulence of mutans streptoco cci can be enhanced by a highly cariogenic environment. For example, o ffspring from a highly caries-active dam develop significantly more ca ries than pups from a low caries-active dam. Considerable attention ha s been placed on the role of the nursing bottle in early childhood car ies. Milk and some infant formulas do not promote caries and the role of the remainder of the diet has been largely ignored. The nursing bot tle can effectively block salivary access to tooth surfaces, thereby i ncreasing the cariogenicity of any food remaining in the mouth. Recent evidence shows that salivary gland function is impaired by iron defic iency and by prenatal exposure to lead. Clearly, early childhood carie s is a complex disease that requires careful and extensive investigati on.