Etiology (Theories) of Dental Caries

Humoral Theory

Hippocrates and Galen were of the view that caries was due to humoral pathology and opined that a state of health or a specific disease was determined by the relative amount of humor, blood, phlegm, yellow bile and black bile

Hippocrates and Galen

They further suggested that dental decay was due to accumulation of certain juices in the tooth

Galen

• He once stated that “when the head becomes diordered in nature, it produces many excrements from which lesions of lower organs occurs.”

• According to him, dental caries is produced by internal action of acid and corroding humors.

Worm Theory

The early history of India, Egypt, and Homer writings have also referred ‘worm’ as the cause of toothache. Therefore, it was hypothesized that caries could be recognized as a worm over tooth surface

Guy de Chauliac

• 1300 to 1368

• Was the first to report worms causing dental diseases

Van Leeuwenhoek

The father of microscopy, observed three different worms from the extracted teeth that act as demons and substituted foods as likely source

Hole

Early researchers were of the view that the tooth cavity, which was the result of worm boring into a tooth is referred to as?

Oil of Vitriol

The common treatment for worms at that time

Vital Theory

Earlier authors postulated that tooth decay originated from within the tooth itself like ‘gangrene"‘. They observed wider area beneath and smaller pin-point area on the top of the tooth histologically

Chemical Theory

A few authors in early 19th century suggested that the teeth were destroyed by unidentified chemical agent formed in the oral cavity

Robertson

Proposed that the acid was formed by fermentation of food particles around teeth

Ficnus

Attributed dental caries to ‘denticolae’, the generic term for decay related microorganisms

Leber and Rotenstein

Reported presence of microorganisms in caries affected teeth.

Clark, Tomes and Magitot

Opined that bacteria were essential for initiation of caries, although they suggested an exogenous source of acids

Fungi and Long Leptirichia

Type organisms on the tooth surface and within the carious lesion

Parasitic Theory

The filamentous parasites in the membrane of tooth surfaces were considered as the causative agent for dental caries

Filamentous Parasite

Considered as the causative agent for dental caries

Erdl

Described filamentous parasites in the membrane of tooth surfaces. He suggested that it was not the tooth worm but filamentous organisms on the tooth surface, which might have infiltrated into the tooth and produced dental caries

Miller’s Chemicao Parasitic Theory

It is a blend of chemical and septic theories which was hypothesid by WD Miller

Proteolytic Theory

According to this theory, the proteolytic enzymes librated by oral bacteria destroy the organic matrix of enamel, resulting in loosening of apatite crystals with eventual loss of minerals

Gram-negative Bacilli

Produce sulphuric acid during their invasion of organic pathway, subsequently destroying the inorganic minerals

Putrefaction Theory

Few authors suggested putrefaction as the cause of dental decay, but the availability of skeletal remains and the evidence that putrefaction did no advance the dental lesion quickly dispelled the idea

Septic Theory

Hypothesized that acid capable of causing decalsification was actually produced by bacteria.

Underwood and Milles

They hypothesized that acid capable of causing decalsification was actually produced by bacteria.

Diet Detergent Theory

Hypotheiszed that the fibrous part of diet acts as detergent, which leads to physical removal of substrate required for initiation of caries

Wallace

He hypotheiszed that the fibrous part of diet acts as detergent, which leads to physical removal of substrate required for initiation of caries