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Nat Rev Dis Primers. 2017 May 25;3:17030. doi: 10.1038/nrdp.2017.30.

Dental caries.

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Dental Innovation and Translation Centre, King's College London Dental Institute, Floor 17 Tower Wing, Guy's Hospital, Great Maze Pond Road, London SE1 9RT, UK.
Department of Cariology Operative Dentistry and Dental Public Health, Oral Health Research Institute, Indiana University School of Dentistry, Indianapolis, Indiana, USA.
Department of Oral Biology, School of Dentistry, University of Leeds, Leeds, UK.
Department of Odontology, University of Copenhagen, Copenhagen, Denmark.
Department of Dental Ecology, University of North Carolina School of Dentistry, Chapel Hill, North Carolina, USA.
UCLA Center Children's Oral Health - UCCOH and Section of Pediatric Dentistry, UCLA School of Dentistry, University of California Los Angeles, Los Angeles, California, USA.
Cariology and Operative Dentistry, Tokyo Medical and Dental University, Tokyo, Japan.
Department of Epidemiology and Public Health, UCL, London, UK.
Restorative Dentistry, Maurice H. Kornberg School of Dentistry, Temple University, Philadelphia, Pennsylvania, USA.


Dental caries is a biofilm-mediated, sugar-driven, multifactorial, dynamic disease that results in the phasic demineralization and remineralization of dental hard tissues. Caries can occur throughout life, both in primary and permanent dentitions, and can damage the tooth crown and, in later life, exposed root surfaces. The balance between pathological and protective factors influences the initiation and progression of caries. This interplay between factors underpins the classification of individuals and groups into caries risk categories, allowing an increasingly tailored approach to care. Dental caries is an unevenly distributed, preventable disease with considerable economic and quality-of-life burdens. The daily use of fluoride toothpaste is seen as the main reason for the overall decline of caries worldwide over recent decades. This Primer aims to provide a global overview of caries, acknowledging the historical era dominated by restoration of tooth decay by surgical means, but focuses on current, progressive and more holistic long-term, patient-centred, tooth-preserving preventive care.

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