dental caries

Dental caries is a bacterial infection that causes progressive demineralisation and destruction of the calcified structures of the teeth leading to cavitations. It is a multifactorial disease. Dental caries involves the formation of a biofilm around the tooth structure. Biofilm consists of cariogenic bacteria and the substrate upon which it acts. Cariogenic bacteria release acids during the process of fermentation of the substrate and these in turn cause demineralisation There are numerous intraoral microbes that play a key role in the development of dental caries or tooth decay. Streptococcus mutans are the most important group of cariogenic bacteria. The other bacteria playing key roles in caries development are Streptococcus sobrinus and Lactobacillus .The worldwide prevalence of dental caries is very high. The incidence of dental caries can be prevented to a certain extend by good oral hygiene habits, dietary modifications and fluoride application. Recent advances in immunology have raised a possibility for an effective vaccine against dental caries. Active immunisation, Passive immunisation and DNA vaccines for the prophylaxis of dental caries are under research. Active immunisation for dental caries utilizes the protective effect of salivary IgA antibodies to S.mutans or S.sobrinus.  The S.mutans components that are involved in adhesion, glucan formation or binding, or in cell wall synthesis are targeted by the vaccine. Passive immunisation may be achieved by administration of pre-formed immune-reactive serum or antibodies. Murine monoclonal antibodies, egg-yolk and bovine milk immunoglobulins generated against S.mutans has been used to control the dental caries in humans. Research studies have shown that DNA vaccines are capable of inducing the synthesis of IgA antibodies against S.mutans which would further prevent the adhesion of the bacteria to the tooth surface .This article reviews the current status of dental caries vaccination.

The use of fluorides for oral health has always involved a balance between the protective benefit against dental caries and the risk of developing fluorosis. The link between fluoride and dental health was established to determining the causes of dental fluorosis or enamel mottling. Fluorosis in Indian children was highly prevalent in the early 1990s. Policy were introduced to control fluoride exposure and to reduce the prevalence of fluorosis. The study aimed of describing the prevalence, severity and risk factors for fluorosis, and to describe the trend of fluorosis among Indian children. The study also aimed of exploring the effect of the change in fluoride exposure on dental fluorosis and caries. Establishing an appropriate use of fluoride toothpaste could be successful in reducing fluorosis without a significant increase in caries experience.