Microbial Physiology 6 2013
MICR540 !Microbial Physiology 6 ! Johnson 2013
Microbial Physiology 6 Engineering Microbes for the Future
Introduction
Dental caries is a slow demineralization of the tooth caused by a loss of hydroxypatite crystals. It has been around since the beginning of recorded history. Before the Iron Age, between 2-4% of teeth showed decay. During the Iron Age and through the Roman period, caries increased to about 10%. Some children from the middle-ages had extensive caries, likely caused by pacifiers made of honeycomb wrapped in linen. Caries increased dramatically toward the end of the seventeenth century and, except for a reprieve during world war II, have continued to rise in the Western world until a decade ago. Underdeveloped countries from the 50's and 60's showed a marked change from low to high caries after exposure to a Western diet.
Historically, there have been some hot-spots for caries, particularly in the United States. In the Northeast, molasses was a major export and swallowed copiously during the 1700's. A visitor to this region wrote:
The inhabitants of this province (Massachusetts) are formed by symmetry, handsome and have delicate complexions . . . but, both sexes have universally and even proverbially bad teeth, which must probably be occasioned by their eating so much molasses.
By the Revolutionary War most 18 year olds from this region failed the physical exam for military duty. It required that the person had two matching front teeth for biting open a container of powder! Military records highlight dental deterioration during the 20th century. During World War II, 8.8% of recruits did not meet the requirement of 6 opposing teeth. A recent by the World Health Organization estimates that 5 billion people world-wide (>70% of the world's population) presently suffer from tooth decay.
Why are bacteria implicated? Several lines of evidence point to bacteria as the major cause of caries: i) germ-free animals do not develop caries; ii) bacteria can demineralize the enamel in vitro or in vivo and iii) bacteria are found within the enamel and dentin of carious lesions.