Dental caries is a complex disease process that afflicts a large proportion of the world's population, regardless of gender, age and ethnicity, although it does tend to affect more indivduals with a low socioeconomic status to a greater extent. The process of dental caries is dependent upon biological factors that are present within the saliva and dental plaque. There are many different agents within saliva and plaque that serve to protect the tooth surface against caries development. Salivary flow rate, buffering capacity, antimicrobial activity, microorganism aggregation and clearance from the oral cavity, immune surveillance, and calcium phosphate binding proteins all interact to inhibit or reverse demineralization of exposed tooth surfaces. Cariogenic bacteria levels within the saliva and plaque determine whether caries will occur or not, and the concentration in saliva and plaque are intimately related to the type of carbohydrate ingestion and the frequency of ingestion, as well as the oral hygiene practiced by the individual.

Kidd EAM. Caries management. Dental Clinics North America 43: 743-64, 1999.
Caries management
Dental Clinics North America
, vol. 
43
 (pg. 
743
-
64
)
Anderson MH. Current concepts of dental caries and its prevention. Oper Dent Suppl 6: 11-18, 2001.
Current concepts of dental caries and its prevention
Oper Dent Suppl
, vol. 
6
 (pg. 
11
-
18
)
Clarkson BH. Introduction to cariology. Dental Clinics North America 43: 569-578, 1999.
Introduction to cariology
Dental Clinics North America
, vol. 
43
 (pg. 
569
-
578
)
Featherstone JDB. Prevention and reversal of dental caries: role of low level fluoride. Community Dent Oral Epidemiol 27: 31-40, 1999.
Prevention and reversal of dental caries: role of low level fluoride
Community Dent Oral Epidemiol
, vol. 
27
 (pg. 
31
-
40
)
Featherstone JDB The science and practice of caries prevention. JADA 131: 887-99, 2000.
JADA
, vol. 
131
 (pg. 
887
-
99
)
Hicks MJ, Flaitz CM. Epidemiology of dental caries in the pediatric and adolescent population: a review of past and current trends. J Clin Pediatr Dent 18: 43-49, 1993.
Epidemiology of dental caries in the pediatric and adolescent population: a review of past and current trends
J Clin Pediatr Dent
, vol. 
18
 (pg. 
43
-
49
)
Powell LB. Caries risk assessment: relevance to the practitioner. JADA 129: 349-3, 1998.
Caries risk assessment: relevance to the practitioner
JADA
, vol. 
129
 (pg. 
349
-
3
)
Anusavice KJ. Caries risk assessment. Oper Dent Suppl 6: 19-26, 2001.
Caries risk assessment
Oper Dent Suppl
, vol. 
6
 (pg. 
19
-
26
)
Reich E, Lussi A, Newbrun E. Caries risk assessment. Int Dent J 49: 15-26, 1999.
Caries risk assessment
Int Dent J
, vol. 
49
 (pg. 
15
-
26
)
Ettinger RL. Epidemiology of dental caries: a broad review. Dent Clinics North America 43: 679-94, 1999.
Epidemiology of dental caries: a broad review
Dent Clinics North America
, vol. 
43
 (pg. 
679
-
94
)
Zero DT. Dental caries process. Dental Clinics North America 43: 635-64, 1999.
Dental caries process
Dental Clinics North America
, vol. 
43
 (pg. 
635
-
64
)
Blinkhorn AS, Davies RM. Caries prevention-a continued need worldwide. Int Dent J 46: 119-25, 1996.
Caries prevention-a continued need worldwide
Int Dent J
, vol. 
46
 (pg. 
119
-
25
)
Sreebny LM. Saliva in health and disease: an appraisal and update. Int Dent J 50: 140-61, 2000.
Saliva in health and disease: an appraisal and update
Int Dent J
, vol. 
50
 (pg. 
140
-
61
)
Lendenmann U, Grogan J, Oppenheim FG. Saliva and dental pellicle-a review. Adv Dent Res 14: 22-8, 2000.
Saliva and dental pellicle-a review
Adv Dent Res
, vol. 
14
 (pg. 
22
-
8
)
Dowd FJ. Saliva and dental caries. Dental Clinics North America 43: 579-97, 1999.
Saliva and dental caries
Dental Clinics North America
, vol. 
43
 (pg. 
579
-
97
)
Baum BJ. Prospects for re-engineering salivary glands.Adv Dent Res 14: 84-8, 2000.
Prospects for re-engineering salivary glands
Adv Dent Res
, vol. 
14
 (pg. 
84
-
8
)
Fejerskov O. Concepts of dental caries and their consequences for understanding the disease. Community Dent Oral Epidemiol 25: 5-12, 1997.
Concepts of dental caries and their consequences for understanding the disease
Community Dent Oral Epidemiol
, vol. 
25
 (pg. 
5
-
12
)
Walsh LJ. Preventive dentistry for the general dental practitioner. Aust Dent J 45: 76-82, 2000.
Preventive dentistry for the general dental practitioner
Aust Dent J
, vol. 
45
 (pg. 
76
-
82
)
Balakrishnan M, Simmonds RS, Tagg JR: Dental caries is a preventable infectious disease.Aust Dent J 45: 235-45, 2000.
Aust Dent J
, vol. 
45
 (pg. 
235
-
45
)
Ciancio SG. Medications as a risk factor for caries and periodontal disease. NY State Dent J October; 32-6, 1997.
Burne RA, Marquis RE: Alkali production by oral bacteria and protection against dental caries. FEMS Microbiology Letters 193: 1-6, 2000.
FEMS Microbiology Letters
, vol. 
193
 (pg. 
1
-
6
)
Burne RA. Oral streptococci… Products of their environment. J Dent Res 77: 445-52, 1998.
Oral streptococci… Products of their environment
J Dent Res
, vol. 
77
 (pg. 
445
-
52
)
Stenudd C, Nordlund A, Ryberg M, Johansson I, Kallestal C, Stromberg N. The association of bacterial adhesion with dental caries. J Dent Res 80: 2005-10, 2001.
The association of bacterial adhesion with dental caries
J Dent Res
, vol. 
80
 (pg. 
2005
-
10
)
Marsh PD. Microbiologic aspects of dental plaque and dental caries. Dental Clinics North America 43: 599-614, 1999.
Microbiologic aspects of dental plaque and dental caries
Dental Clinics North America
, vol. 
43
 (pg. 
599
-
614
)
Rosan B, Lamont RJ. Dental plaque formation. Microbes Infect 2: 1599-607, 2000.
Dental plaque formation
Microbes Infect
, vol. 
2
 (pg. 
1599
-
607
)
Duckworth RM, Jones Y, Nicholson J, Jacobson APM, Chestnutt IG. Studies of plaque fluoride after use of F-containing dentifrices. Adv Dent Res 8: 202-7, 1994.
Studies of plaque fluoride after use of F-containing dentifrices
Adv Dent Res
, vol. 
8
 (pg. 
202
-
7
)
Pearce E. Plaque minerals and dental caries. New Zealand Dent J 94: 12-5, 1998.
Plaque minerals and dental caries
New Zealand Dent J
, vol. 
94
 (pg. 
12
-
5
)
Wong L. Plaque mineralisation in vitro. New Zealand Dent J 94: 15-8, 1998.
Plaque mineralisation in vitro.
New Zealand Dent J
, vol. 
94
 (pg. 
15
-
8
)
Bowden GH. Mutans streptococci, caries and chlorhexidine. J Canadian Dent Assoc 62: 700-7, 1996.
Mutans streptococci, caries and chlorhexidine
J Canadian Dent Assoc
, vol. 
62
 (pg. 
700
-
7
)
Tanzer JM. Salivary and plaque microbiological tests and management of dental caries. J Dent Educ 61: 866-74, 1997.
Salivary and plaque microbiological tests and management of dental caries
J Dent Educ
, vol. 
61
 (pg. 
866
-
74
)
Mandel ID. Caries prevention, current strategies, new directions. JADA 127: 1477-88, 1996.
Caries prevention, current strategies, new directions
JADA
, vol. 
127
 (pg. 
1477
-
88
)
Jensen ME. Diet and dental caries. Dental Clinics North America 43: 615-33, 1999.
Diet and dental caries
Dental Clinics North America
, vol. 
43
 (pg. 
615
-
33
)
De Soet JJ, De Graaff J. Microbiology of carious lesions. Dent Update 25: 319-24, 1998.
Microbiology of carious lesions
Dent Update
, vol. 
25
 (pg. 
319
-
24
)
Liljemark WF, Bloomquist C. Human oral microbial ecology and dental caries and periodontal disease. Crit Rev Oral Biol 7: 180-98, 1996.
Human oral microbial ecology and dental caries and periodontal disease
Crit Rev Oral Biol
, vol. 
7
 (pg. 
180
-
98
)
Wan AK, Seo WK, Purdie DM, Bird PS,Walsh LJ,Tudehope DI: Oral colonization of streptococcus mutans in six-month-old predentate infants. J Dent Res 80: 2060-5, 2001.
J Dent Res
, vol. 
80
 (pg. 
2060
-
5
)
Rudney JD. Saliva and dental plaque.Adv Dent Res 14: 19-39, 2000.
Saliva and dental plaque
Adv Dent Res
, vol. 
14
 (pg. 
19
-
39
)
Schenkels LCPM,Veerman ECI, Amerongen AVN. Biochemical composition of human saliva in relation to other mucosal fluids. Crit Rev Oral Biol 6: 161-75, 1995.
Biochemical composition of human saliva in relation to other mucosal fluids
Crit Rev Oral Biol
, vol. 
6
 (pg. 
161
-
75
)
Tenovuo J. Salivary parameters of relevance for assessing caries activity in individuals and populations. Community Dent Oral Epidemiol 25: 82-6, 1997.
Salivary parameters of relevance for assessing caries activity in individuals and populations
Community Dent Oral Epidemiol
, vol. 
25
 (pg. 
82
-
6
)
Lenander-Lumikari M, Loimaranta V. Saliva and dental caries. Adv Dent Res 14: 40-7, 2000.
Saliva and dental caries
Adv Dent Res
, vol. 
14
 (pg. 
40
-
7
)
Vissink A, Spijkervet FKL, Amerongen AVN. Aging and saliva: a review of the literature. Spec Care Dent 16: 95-103, 1996.
Aging and saliva: a review of the literature
Spec Care Dent
, vol. 
16
 (pg. 
95
-
103
)
Nederfors T. Xerostomia and hyposalivation. Adv Dent Res 14: 48-56, 2000.
Xerostomia and hyposalivation
Adv Dent Res
, vol. 
14
 (pg. 
48
-
56
)
This content is only available as a PDF.