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The prevention of dental caries: ten years later.

By any standards, progress toward caries prevention has been impressive during the past decade. It is arguable that more information on the precise etiology of caries and on potential new preventive methods has been acquired during the 1970s than in any comparable period previously. Substantial advances have been made toward the understanding of the complex interaction among oral microorganisms, host resistance, and dietary substrate in the initiation and progression of a caries lesion. The various mechanisms of action of the fluoride ion have been further elucidated; vaccination against caries and a reduction in the cariogenic potential of sweet foods have both become realistic possibilities. Conspicuous successes have also been achieved in the application of existing knowledge. At least 12 million more children than in 1971 are receiving partial protection against caries through self-applied fluoride programs. Other effective preventive methods, including adhesive sealants and, possibly, antimicrobial agents, could be widely and advantageously utilized if manpower and regulatory constraints were overcome, as their scientific feasibility has, for the most part, already been demonstrated. Of course, it would be naive to predict the early disappearance of dental caries as a major health problem. This will occur only gradually, and will require a much more extensive use of preventive methods--those already available as well as those still being developed by research. Nevertheless, a major step toward the goal of caries prevention has already been taken, and there is good reason to expect even more rapid progress during the 1980s.