The caries environment: saliva, pellicle, diet, and hard tissue ultrastructure.

The pathogenicity of the dental biofilm is modified by salivary and dietary factors, as well as by the characteristics of the tooth structure. The composition of the acquired pellicle can modify the mineral homeostasis of the tooth surfaces and the attachment of bacteria for the development of the biofilm. The substitution of sucrose from the diet by other less cariogenic sugars and/or sugar substitutes can contribute to reducing the pathogenicity of the biofilm. Saliva clears, dilutes, neutralizes, and buffers acids produced by the biofilm. In addition, saliva provides the biofilm/tooth structure with Ca(2+) PO(4)(3-) and F(-) ions, which can positively affect the equilibrium between demineralization-remineralization toward the remineralization and modify the susceptibility of the tooth structure to caries progression. Copyright 2010 Elsevier Inc. All rights reserved.