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lüll Role of micro-organisms in caries etiology van Houte JJ Dent Res 1994[Mar]; 73 (3): 672-81The microbial etiology of dental caries is discussed in terms of the dynamic relationship among the dental plaque microbiota, dietary carbohydrate, saliva, and the pH-lowering and cariogenic potential of dental plaque. The evidence supports a concept of caries as a dietary carbohydrate-modified bacterial infectious disease. Its key feature is a dietary carbohydrate-induced enrichment of the plaque microbiota with organisms such as the mutans streptococci and lactobacilli which causes an increase of plaque's pH-lowering and cariogenic potential. The shift in the plaque proportions of these organisms appears to be related to their relatively high acid tolerance. A large body of evidence also supports a major effect of saliva on caries development. Integration of salivary effects with the concept of caries as a dietary carbohydrate-modified bacterial infectious disease suggests a broader concept which includes a major role of saliva in the regulation of the exposure of tooth surfaces to carbohydrate and of plaque acidity and, hence, the microbial composition and the pH-lowering and cariogenic potential of dental plaque. It is proposed that caries occurs preferentially in dentition sites characterized by a relatively high exposure to carbohydrate and diminished salivary effects. Some implications of this concept are discussed.|Dental Caries/*microbiology[MESH]|Dental Plaque/chemistry/metabolism/microbiology[MESH]|Diet, Cariogenic[MESH]|Dietary Carbohydrates/*adverse effects/metabolism[MESH]|Humans[MESH]|Hydrogen-Ion Concentration[MESH]|Lactobacillus/metabolism/*pathogenicity[MESH]|Saliva/physiology[MESH]|Streptococcus mutans/metabolism/*pathogenicity[MESH] |