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Scientific Advances in the United States

Background. Scientific advances in cariology in the past 150 years have led to the understanding that dental caries is a chronic, dietomicrobial, site-specific disease caused by a shift from protective factors favoring tooth remineralization to destructive factors leading to demineralization. Epidemiologic data indicate that caries has changed in the last century; it now is distributed unequally in the U.S. population. People who are minorities, homeless, migrants, children with disabilities and of lower socioeconomic status suffer from the highest prevalence and severity of dental caries.

Results. Scientific advances have led to improvements in the prevention, diagnosis and treatment of dental caries, but there is a need for new diagnostic tools and treatment methods.

Conclusions and Clinical Implications. Future management of dental caries requires early detection and risk assessment if the profession is to achieve timely and cost-effective prevention and treatment for those who need it most. Dental professionals look forward to the day when people of all ages and backgrounds view dental caries as a disease of the past.

Key Words: Caries; remineralization; saliva

Abbreviations: ACP: Amorphous calcium phosphate • bis-GMA: Bisphenol-A glycidyl methacrylate • CAD-CAM: Computer-aided design/computer-aided manufacturing • CO₂: Carbon dioxide • Er,Cr:YSGG: Erbium-chromium–doped yttrium scandium aluminum garnet • Er:YAG: Erbium-doped yttrium aluminum garnet • FOTI: Fiber-optic transillumination • ICDAS: International Caries Detection and Assessment Criteria • LED: Light-emitting diode • MS: Mutans streptococci • Nd:YAG: Neodymium-doped yttrium aluminum garnet • OCT: Optical coherence tomography • QLF: Quantitative light-induced fluorescence

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