Individual Susceptibility to Dental Caries: The Vipeholm Study

The evidence for a genetic component to dental caries is in comparison much less explored in the literature than the other classically described components of the disease: microbiota and diet. Diet can be said to have been conclusively linked to the etiology of dental caries by the results of the Vipeholm study, which did not deal with any microbial aspect of the disease. What is much less emphasized is that these same results provided one of the most robust lines of evidence that exist in support of a genetic component to dental caries. The results of the study showed great variability, with some study participants showing a dramatic increase in the establishment of new carious lesions under conditions that did not affect the majority of the other subjects. Similarly, highly cariogenic conditions due to a diet rich in sugars did not cause an increase in new carious lesions in other participants. The best explanation for these variable results is the existence of individual biological factors (genetic variation) modulating the disease. This chapter also comments on the ethical controversy surrounding the study and the need for finally intervening on the effects of sugars in oral health.