Dental Caries The Disease and Its Clinical Management 2025 (Fourth Edition)

In the middle of the previous century, the six heads of the departments of Operative or Restorative Dentistry at all the Scandinavian Dental Schools joined in writing a Nordic Textbook of Cariology (Nordisk Lärobok I Kariologi). The chapters were written in Swedish, Norwegian, or Danish as it was still expected that the dental students would be able to read and understand the different languages of the Nordic countries. Each professor was assigned a part of the subject that they were assumed to be particularly knowledgeable about. In the last 5th edition in 1980, the number of contributors had grown to 15 as the Karolinska Institute in Stockholm included 3 contributors, and 2 came from University of Turku and 2 from Copenhagen. During the entire period the book was edited by Professor Yngve Ericsson from Stockholm. Over the years he gradually took a more firm grip of the editing content and organization of the book, but admitted in the last preface that there were some differences in interpretation of research data and conclusions by the various contributors. So, when Yngve retired it became evident that two different “schools of thinking” concerning etiology and pathogenesis of dental caries had grown to an extent where it was no longer possible to maintain the principles of a united text combining all departments dealing with dental caries in the four Nordic countries. Thus, one Swedish dental school was insisting that dental caries was a result of Streptococcus mutans infection and did not want to join the now 25 other researchers from the different Nordic countries who wrote the first Textbook of Cariology edited by Anders Thylstrup from the dental school in Copenhagen and Ole Fejerskov from the Royal Dental College in Aarhus. Hitherto, cariology was considered a theoretical discipline almost totally separated from the clinical, operative procedures associated with the treatment of the carious cavities and insertion of fillings. This was – and still is – the core of most of the restorative work in the oral cavity – the backbone of dentistry. To bring the message to the dental students that the content of the textbook was indeed highly important for daily clinical decision making we, in the second edition, changed the title to Textbook of Clinical Cariology. Professor Thylstrup died all too young, and I decided to bring the future editions even closer to the clinic by joining forces with Professor Edwina Kidd, a well-known English restorative dentist with some experience in cariology as co-editor from 2003. We changed the title to Dental Caries: The Disease and Its Clinical Management in order to send the message that this book is the backbone of knowledge necessary for every dentist who wish to conduct up-to-date diagnosis, prevention/control, and treatment of the disease Dental Caries. We are most grateful to Professor Kidd (who decided to retire some years ago) for the immense enthusiasm and inspiration she has been for this book. Everyone who has followed how this textbook has developed over the years will appreciate that the underlying message has been to reveal what is meant by the concept of “caries control.” In international lectures, we have claimed, based on the growing evidence, that “caries cannot be prevented; rather its progression can be controlled.” You might say that this is semantics, but we will argue that by making this distinction, dentists can appreciate that no single method or modality can prevent dental caries from occurring. That is true for all populations worldwide. Dental caries is ubiquitous and as old as humankind. The current edition is a thorough update on the basic biological mechanisms behind dental caries and what is presently known about social and commercial determinants of health inequalities as far as dental caries is concerned. Any development and evaluation of community-based interventions to control caries progression – and when necessary perform restorative dental treatment – may have limited success if the interventions are not firmly based on understanding the nature of dental caries. Ole Fejerskov and Bente Nyvad Aarhus January 2024