Heredity patterns, endocrine coordinations, metabolic conditions, and dietary factors are primary influences in resistance to caries.
In comparisons of 100 well children susceptible to caries, with an equal number relatively immune thereto—in terms of constitutional, endocrine, metabolic, nutritional, and oral factors-7 percent had familial susceptibility to caries; 9 percent had individual immunity. The teeth of the caries-susceptibles had steep cusp- inclines and food-impacting areas paralleling the tooth structures, inherited from one of the parents. Susceptibility or immunity to caries, in some children, may be explained on the basis of Mendelian segregation. Of the children having chronic areas, 10 percent were in hypothyroidism, hyperthyroidism, hypopituitarism, or hyperparathyroidism, in contrast with 8 percent of the caries-immune in adiosogenitopituitarism, or hyperpituitarism. Caries was not arrested until these endocrine disturbances were corrected. Of the caries-susceptibles, 12 percent had metabolic disorders—cyclic vomiting, celiac disease, alimentary allergy, epilepsy, and chronic sinusitis—in contrast with 8 percent of the caries-immunes in diabetes or hemophilia. Caries was not arrested until these metabolic conditions were alleviated. Of the caries-susceptibles, 64 percent were on sub-optimal nutrition, in contrast with 66 percent of the caries-resistant on an adequate nutritional intake. After dietary deviations in carbohydrate, acid/base ash, calcium, and vitamins A, C, and D, were corrected, caries was arrested within three months in 65 percent of the caries-susceptibles. Of the caries-susceptibles, 7 percent showed local factors causing caries, while 9 percent of the caries-resistant practised excellent mouth care, systemic factors being secondary with respect to caries.
Reference: N. Y. State J. Med., 37, 1733, 1937.