Topic Overview:
Although it has been more than 100 years since W.D. Miller, DDS, first postulated about the etiopathogenesis of caries, the condition remains the most prevalent noncontagious infectious disease in humans. It is clear that current preventive approaches, including water fluoridation and school-based programs, are not enough to decrease the prevalence of caries in all populations. Further research is needed in the epidemiology of primary and secondary caries, risk assessment, diagnostic methods, and disease etiology.

Vieira will discuss systematic research on caries risk assessment using population-based cohort techniques, as well as his studies to identify genes and genetic markers of diagnostic, prognostic, and therapeutic value. Using results from a genome-wide linkage analysis, Vieira searches for loci that either increase susceptibility to caries or offer protection from the disease. His preliminary results suggest that a gene or genes on chromosome 5 are involved with lower caries experience, and he is currently fine-mapping additional loci on chromosomes 13, 14, and X. Vieira also uses candidate gene analyses to study the genes involved in enamel formation, saliva function, and immune response. This approach has shown promise, and genetic variants of proteins such as amelogenin, beta-defensin 1, and aquaporin 5 have been associated with the presence of caries. As this work progresses, Vieira continues to emphasize the discovery and identification of molecules and mechanisms that can affect caries susceptibility.