摘要:
Dental caries is the most prevalent infectious disease affecting man. Considerable evidence implicates Streptococcus mutans as a major causal microorganism although other bacteria are clearly involved in at least some circumstances. Dietary factors, especially the pattern of sucrose intake, and host factors are important. Normal salivation is essential to the host defences against caries and immunological factors are important. Immunisation of rodents and primates has been successful in protecting against caries and the search for antigens of Str. mutans that are protective and free of possible toxic effects is showing promise. Preventive dentistry already has a large armamentarium capable of preventing and controlling caries. Dietary restriction of sucrose and the use of fluorides, especially systemic fluoridation, are capable of producing a major reduction in caries. However, in spite of the success and safety of fluoridation this major advance, introduced first over 35 years ago, still reaches only a minority of the population. In view of the negative public reaction to fluoridation and the current concern involving vaccination against more life-threatening disease, the future of immunisation against caries would appear to depend on many factors other than scientific feasibility.