Diet and the microbial aetiology of dental caries: new paradigms.
Level 5 - mechanism / opinion, no new human data
Narrative review of microbial and dietary mechanisms without systematic review methodology
PubMed 24283286 · doi:10.1111/idj.12082
What was done
This narrative review synthesized historical and molecular microbiological concepts regarding dietary and bacterial drivers of dental caries, examining the paradigm shift away from *Streptococcus mutans* and sucrose as the exclusive primary causes.
What was found
The abstract reports no numerical data. It describes conceptual findings: *Streptococcus mutans* does not fulfill Koch's postulates, molecular microbiological methods demonstrate a diverse community of acidogenic microbes in plaque, and cooked starches contribute substantially to prolonged acid production due to high intraoral retention.
Why it matters
Understanding that dental caries involves a polymicrobial acidogenic community and non-sucrose fermentable carbohydrates indicates that interventions focused strictly on *S. mutans* eradication or sucrose restriction are insufficient for caries management.
Limits
The abstract contains no quantitative metrics, confidence intervals, or defined systematic search protocol. It provides mechanistic reasoning and expert consensus rather than primary empirical or controlled trial data.
Cited by
- supports Sugar itself does not damage teeth; rather, bacteria metabolize sugar and carbohydrates into acids that cause enamel damage.