Individual Human Caries Experience

As in rodents and other animals, there is much individual variation in human caries experience. In the Vipeholm study, 25% of subjects taking the sticky candies did not develop any cavities over 6 years, whereas a few cavities appeared in control subjects who received a diet that contained little carbohydrate and no refined carbohydrate. A few cavities also appeared in children of the Hopewood House study who received a similar diet. Within 74 junior and senior dental students attending the College of Dentistry at the University of Oklahoma in 1985 (mean age 26 years), the mean DMFT was 8.4 with a variability of 40% about the mean (Fig. 15.10). Two had only one tooth affected and two others had, respectively 15 and 16 teeth affected. The variation is due to differences in microbiota, dietary carbohydrate intake, sahva flow, fluoride exposure, and acquired immunity (Table 15.1). 

Differences in the gram-positive composition of supragingival microbial biofilms 

Dietary carbohydrate ingestion, especially its sucrose content, and also its physical consistency and frequency of ingestion 

Saliva access to teeth surfaces and its flow rate 

Antibodies to Streptococcus mutans in blood and the oral cavity 

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In 1945, the Vipeholm study was set up to determine whether increasing sucrose intake actually increased human caries experience. The marked variation in caries severity between individuals (Sect. 15.2.1) had led to doubts that increased sucrose consumption was really responsible. The study was conducted at the Vipeholm Hospital for individuals with mental handicaps outside the University City of Lund, Sweden. The study examined the effects of different diets on dental caries in the inmates and it ended in 1951. The results indicated that sticky sugar candies (toffees) between meals and popular with the inmates increased their DMFT by an average of one cavity per year. The use of mentally handicapped subjects was criticized in the Swedish press and all studies on mentally handicapped individuals were stopped in 1954. 

Harris, N. O., Swanson, A., and Segreto, V. The Infrared Spectral Characteristics of Human Whole Stimulated Saliva Collected from Individuals Classified as to Dental Caries Experience (Report 56-90) Brooks Air Force Base, Texas School of Aviation Medicine, Dental Sciences Div., June 1959. 

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