PATHOGENESIS OF DENTAL-CARIES

Caries have three main interrelated etiological factors: 1) a bacterio logical factor represented by cariogen oral bacteria, mainly Streptoco ccus mutans, which adhere to the dental surface and initiate the decal cification of the enamel by producing an acid environment through carb ohydrate degradation; 2) the quality of the oral biofilm which is colo nized more or less rapidly by bacteria after brushing, leading to an a dhesive and aggressive dental plaque; 3) the quality of enamel which i s reinforced by fluor ion, and of saliva. The early superficial phase of carie constitution is reversible through remineralisation from calc ium, phosphate and fluor ions present in the oral cavity. In the absen ce of remineralisation the destructive and infectious process extends to the inner part of the tooth leading, to ifs progressive destruction . Prevention is based upon the following pathophysiological data, main ly: 1) family education on oral hygiene by regular brushing, and avoid ance of foods or fluids containing sugars between meals; 2) fluoride i ntake starting at birth and being adapted to age, the prescription of fluoride supplementation, taking into account possible other sources o f fluor (salt, water). (C) 1998 Elsevier, Paris.