The Future of Caries Research

Dental caries is the most common health condition worldwide. It is also preventable, with known etiologic factors and widely available methods to control the disease. This apparent paradox can be explained in several ways, for example, (1) caries lesions can easily develop due to our society’s high exposure to fermentable carbohydrates and the fact that our oral microbiome is well-suited to process them into acids that dissolve the tooth minerals; (2) caries is a multifactorial disease, meaning there is not a single etiological factor that can be targeted independently, making it challenging to implement comprehensive eradication efforts; (3) tooth decay is often considered “normal,” with many believing that developing caries lesions is an unavoidable part of childhood, adulthood, and/or elderhood.

Tooth decay is not normal at any age, and access to preventive measures should be available and utilized by everyone. However, as countries worldwide, from lower income to higher income, continue to suffer the health and economic consequences of this disease, it is clear that controlling it is no easy task. We need more research to better understand and creatively propose approaches that either increase access, make it more feasible, or make it more likely for individuals, communities, and nations to use resources to effectively control or manage the disease. Research should address the various factors involved in the disease process across different individuals, communities, and nations. We need both basic and applied research to translate innovative discoveries into better oral health for everyone.

Research in dental caries has experienced an ebb and flow of various trending topics, featured in Caries Research throughout its 57 years. The initial focus was on the crucial understanding of the basic physicochemical aspects of how caries lesions initiate and evolve into cavities, and how fluoride reduces mineral loss. This was followed by a better understanding of the role of highly complex microbial communities associated with caries, aided by evolving technologies to study biofilm structure and microbial diversity. Caries can be modeled and its associated factors studied using unique in vitro, in situ, and in vivo models that researchers have developed and refined over decades. Numerous essential clinical trials continue to explore different aspects of the disease and therapies used to control it. Recently, there has been increased focus on the behavioral, social, and economic factors associated with caries development and the challenges to control it, acknowledging that being preventable does not necessarily translate into being prevented. Reflecting the multifactorial nature of the disease itself, research into caries encompasses many different forms, involving researchers from diverse backgrounds.

What does the future hold? The ultimate goal of caries research is to reduce the burden of dental caries. The scientific community has made incremental progress toward this objective and should continue on this path. Addressing this complex problem requires teams with diverse knowledge and skills. Questions need to be asked in different and creative ways so that each study contributes valuable insights to help solve the problem, moving us toward a future where dental caries is in the past.

As the 8th Editor-in-Chief of Caries Research, I am committed to advancing caries research by upholding the highest scientific standards and rigor. The journal will continue to welcome studies at the forefront of science, covering all matters related to caries and associated diseases, with the vision that only research can lead to the discovery of more solutions to this problem. I hope you will join me and our Editorial Board in this collective effort. I look forward to the many exciting studies that will be published in Caries Research in the coming years, advancing the control of dental caries into a reality for all.