It is not merely semantics, but rather a paradigm shift in thinking to consider dental caries (cavities) as a ‘complex disease caused by an imbalance in physiologic equilibrium between tooth mineral and biofilm fluid’. A consequence of dental caries being a complex disease is that on a population basis we may have success with a particular preventive oral program in one select segment of population in our country, but not necessarily in another segment with different cultural and behavioral habits. Moreover, society and the dental community may need to organize our dental health care very differently in neighboring counties, and apply fluorides, tooth brushing protocols and flossing in very different ways (mouth rinsing, toothpaste, water fluoridation and supervised brushing etc.) to obtain rather similar caries reductions from one locale to another.
Contrary to urban lore, the mouth is connected to the body. So, whatever directions caries research should take from here it will require a multidisciplinary approach to solving complex problems and should be included in a well-planned healthcare approach. More than ever, well-educated clinical dentists set the stage and should be included in collaboration with colleagues trained in the multitude of new fields in the basic sciences (biophysics, functional genomics, proteomics, chemical biology, nano-technology, etc.) to address clinically relevant questions.
Novy Scheinfeld, DDS, PC
290 Carpenter Drive, 200A
Atlanta, GA 30328
 Fejerskov O, Nyvad B: Is dental caries an infectious disease? Diagnostic and treatment consequences for the practitioner; in Schou L (ed): Nordic Dentistry 2003 Yearbook. Copenhagen, Quintessence Publishing, 2003, pp 141– 151.