Although caries is largely preventable, it remains the most common chronic disease of children age 5 to 17 years in the US, as well as in the rest of the world. In the US, caries is five times more common than asthma (59% versus 11%). Caries is an infectious localized disease that results in loss of minerals from the affected teeth, caused by organic acids that are originated from the microbial fermentation of carbohydrates. It is a multifactorial disease and is usually chronic.
Caries is related to three essential interactive factors: the host (represented by teeth and saliva); the oral microbial flora; and the type of diet. The factors related to the host are under strong genetic control, but they are easily modified by the other factors (i.e., microbiota and diet). Twin studies have provided strong evidence for the role of inheritance in caries. There is complex etiologic heterogeneity with environmental factors, which appear to play a commanding role in susceptibility. By studying caries in populations that have a similar socio-economic level, cultural pressures, and access to dental care, we were able to identify genetic variants associated to caries susceptibility and we are now making progress toward identifying which variants have functional consequence.