Caries and Periodontitis: Contesting the Conventional Wisdom on Their Aetiology.

Area of Science:

• Oral microbiology
• Dental pathology
• Stochastic modeling

Background:

• Traditional research on dental caries and periodontitis has focused on specific determinants with limited predictive value.
• Existing models struggle to explain the observed variations in disease distribution in epidemiological and clinical studies.

Purpose of the Study:

• To propose a novel stochastic model for explaining the pathogenesis of dental caries and periodontitis.
• To provide a parsimonious explanation for disease development and progression based on the oral microbiome's inherent variability.

Main Methods:

• Literature review on the oral microbiome and its role in dental diseases.
• Application of a stochastic model based on the Weiner process to explain disease pathogenesis.
• Analysis of model's ability to explain epidemiological and clinical findings.

Main Results:

• The Weiner process model offers simple explanations for caries and periodontitis, integrating random metabolic "noise" from commensal microorganisms.
• Disease progression and regression are viewed as natural processes influenced, but not solely determined, by other factors.
• Model's distributional characteristics align with epidemiological data, showing age-related increases and a decreasing likelihood of affliction over time.

Conclusions:

• The stochastic Weiner process model provides a robust framework for understanding dental caries and periodontitis.
• This approach simplifies complex disease mechanisms and explains previously difficult-to-explain phenomena.
• Findings have significant implications for clinical practice and public health strategies in managing oral diseases.