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Etiology and Transmission

Course Author(s): American Academy of Pediatric Dentistry

Etiology and Transmission

In the most simple terms, the process of dental caries can be illustrated by this Venn diagram:

  • Susceptible tooth
  • Presence of bacteria
  • Access to fermentable carbohydrates and cooked starches
  • Time

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.

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 caretaker and child.  Transmission from caregivers with high levels of S. mutans can be delayed/prevented by their initiating a prevention program for that includes meticulous oral hygiene.

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