Many individuals are caries-free or nearly so, and this is great progress. Many others though have a big issue with it still. The preventive strategy you link to looks quite interesting.
This is even more promising as a caries preventive, as it uses a protein from a natural enemy of Strep mutans to knock it off the teeth:
http://rickwilsondmd.typepad.com/rick_wilson_dmds_blog/2010/06/new-decay-preventing-strategy.html
However, it doesn't really matter what we do, there will (regrettably) be lots of caries for a long time to come. This is because there is an astonishing amount of sugar in our society, especially in liquid form. Between sucrose and other simple sugars, and high fructose corn syrup (which is in everything from sports drinks to breakfast cereals to, probably, the gasoline you put in your car and the mousse you groom your poodle with, due to the politicos and big agribusiness), people can easily overload their system with frequent carb challenges throughout all their days.
And many do.
Whatever preventive strategies we devise, for caries to form we still need: a host, the Strep, and substrate. Poor oral hygiene and simple sugar frequency add up to caries, every time. And it has been my observation that groups of people who started at lower socioeconomic status, but who have now experienced gains in that regard, often consume horrific amounts of sugar; they reach for the cookie jar first, so to speak. Economists say, "A rising tide lifts all boats." It's more like, "A rising tide buys root beer floats". And cavities.
Dental caries remains most upsetting for many of us in children, especially since it is such a preventable disease. And yet I also have more than once been almost reduced to tears of frustration by my older patients. Here's the scenario: We know them for years, maintaining 1960's-era crown and bridge, replacing or doing new crowns on occasion, but generally maintaining excellent oral health for these folks who had a hard start in their dental condition. And then-
Then they develop dry mouth, from age and/or drug side effects. And they develop a medical condition of some sort or other that renders them even more dry. So they take to cough lozenges- sugared ones!- or something equally vicious and, I swear this happens this fast, in less than six months they wreck their dentition. And then we have to clean up the mess...
So, no, I don't believe that dental caries is going to go away no matter what we do in the near future, in every age range, because any system can be overloaded by enough Strep mutans and enough sugar. Recall that the Strep grows to greater numbers as we feed it more...
We have a lot of other things to do anyway, like perio, endo, dealing with fractured cusps and such, and of course esthetics.
But, dang it, if tooth decay was reduced to a tiny fraction of its current levels
next week- I wouldn't miss it one bit. It's bloody awful, the level of dental caries in modern American life.
