The Centers for Disease Control and Prevention reports that caries is the most prevalent infectious disease in our nation’s children. Early childhood caries (ECC) can be a particularly virulent form of caries, beginning soon after primary tooth eruption, usually developing first on smooth surfaces, progressing rapidly, having a lasting detrimental impact on the dentition.
Newer theories on the etiology of tooth decay and transmission of causative organisms highlight the fact that dental caries is an infectious and communicable disease. This review of the caries process covers:
Etiology and Transmission
In the simplest terms, the process of dental caries can be illustrated by this Venn diagram:
Bacteria use dietary fermentable carbohydrates (principally sugars and cooked starches) as a substrate for acid production, resulting in a lowering of the pH of the area. Species of Streptococcus and Lactobacillus are most often implicated in the caries process.
However, we now know that caries is a multifactorial, chronic disease with many outside influences.
Streptococcus mutans acquisition is usually associated with the eruption of the first primary teeth. However, S. mutans may appear as an oral microbe in the infant prior to the eruption of primary teeth primarily through direct transmission between caregiver and child. Transmission from caregivers with high levels of S. mutans can be delayed or prevented by the caregiver initiating a prevention program for that includes meticulous oral hygiene.