Pathophysiology of Dental Caries

Area of Science:

• Dental caries research
• Microbiology
• Host-pathogen interactions

Background:

• Carious lesion dynamics are influenced by sugars, environment, bacteria, and host factors.
• Key bacteria include Streptococcus mutans (initiators) and bifidobacteria/lactobacilli (progressors).
• Incomplete understanding of microbial roles in caries initiation and progression.

Purpose of the Study:

• To elucidate the complex interplay of factors driving carious lesion dynamics.
• To highlight the host's defense and repair mechanisms against dental caries.
• To emphasize the importance of selective removal of infected dentine.

Main Methods:

• Review of current understanding of carious lesion dynamics.
• Analysis of bacterial roles in caries initiation and progression.
• Examination of host responses, including dentine-pulp tissue reactions and cellular signaling.

Main Results:

• Specific environmental conditions and bacterial consortia promote caries progression.
• Selective removal of contaminated dentine minimizes microbial regrowth risk.
• Dentine-pulp complex actively defends against caries via odontoblasts and stem cells.
• Pulp fibroblasts regulate local inflammation, regeneration, and vascularization.

Conclusions:

• Understanding microbial and host factors is crucial for managing dental caries.
• Host dentine-pulp tissues possess significant innate repair and defense capabilities.
• Targeting these mechanisms offers potential therapeutic strategies for caries management.