Etiology: The Triad

What Causes Dental Caries?

  • Caries is a multifactorial process affected by environmental, behavioral and host risk factors.
  • Oral bacteria (Polymicrobial including mutans streptococci and lactobacilli) metabolize dietary carbohydrates into acids.
  • Acid demineralizes the tooth enamel.
  • If the cycle of acid production and demineralization continues, the enamel will become weakened and break down into a cavity.


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.