ECC Etiology: Triad

What Causes Dental Caries?

  • Multifactorial process affected by environmental, behavioral and host risk factors
  • Oral bacteria (Polymicrobial including Mutans Streptococci and Lactobacilli) metabolize dietary sugars into acids
  • Acids demineralize the tooth enamel
  • If the cycle of acid production and demineralization continues, the enamel weakens and breaks down into a cavity

This process is reviewed in greater depth in the Smiles for Life "Child Oral Health" Course.


Pitts NB, Zero DT, Marsh PD, et al. Dental caries. Nat Rev Dis Primers. 2017; 3:17030.

Fisher-Owens SA, Gansky SA , Platt LJ et al. Influences on Children's Oral Health: A Conceptual Model. Pediatrics. 2007. Vol. 120(3): pp. e510 -e520.

Colak H, Dülgergil CT, Dalli M, Hamidi MM. Early childhood caries update: A review of causes, diagnoses, and treatments. J Nat Sci Biol Med. 2013; 4(1):29-38.