Caries organic factors

The importance of nutrition in the dental caries problem is reviewed in 90 pages by Shaw.22 Although we have indicated that metabolic peculiarities in the area of mineral metabolism seem "most likely to be pertinent" to the dental caries problem (p. 218), it does not follow that interest should be restricted to this field. Because teeth are organic structures produced as the result of metabolic processes, there is not a single vitamin, amino acid, or other nutrient factor which may not be implicated in the disease. Probably many different deficiencies are involved in the production of the sum total of all caries existing in all individuals. Much evidence, of course, has been found to indicate the importance of calcium, phosphorus, and vitamin D, but other items may also be very important. 

This chapter describes dental caries (tooth decay) and its causes. Sucrose and other mono- and disaccharides are metabolized to acid (lactate) by bacteria that remain in stagnation areas of the teeth. Rats and hamsters fed a 50% sucrose diet developed a caries-sensitive, predominantly gram-positive microbiota that became caries resistant when the rodents were fed penicillin (Sect. 1). Further studies identified Streptococcus mutans (S. mutans) as the etiological agent. This organism synthesizes an insoluble polysaccharide capsule that is stable and retains lactate at the enamel surface (Sect. 2). The key enzyme, glucosyl transferase, is related to salivary amylase which adheres to oral bacteria and enhances bacterial acid production. The chapter concludes with a discussion of salivary and other factors responsible for the marked variation observed in individual caries experience (Sect. 3). 

Tooth decay (dental caries) is one of the most common diseases in humans [8]. It has been defined as a chronic, dietomiaobial, site-specific disease caused by a shift from protective factors favouring tooth remineralization to destructive factors leading to demineralization [9]. The specific factors leading to destruction of the mineral phase of the tooth are the presence of oral bacteria, mainly Streptococcus mutans [10], and the availability of fermentable carbohydrates from the diet. This combination leads to the production of organic acids as a result of the metabolic process of the bacteria, of which the main one is lactic acid, though other weak acids, such as ethanoic and propanoic can also occur [11]. These acids dissolve the mineral component of the tooth, leading to loss of structure. 

---