New insights in understanding dental caries and periodontal disease: the avalanche model
Peter Gaengler, Ljubisa Markovic, Dagmar Norden, Rainer A. Jordan
DOI: 10.4236/health.2009.14042   PDF    HTML     6,437 Downloads   11,946 Views   Citations


Biology is based on evolution; therefore, eu-kariotes like plants, animals and human beings are living in harmony with their procariote an-cestors. If this is obviously the normal way of life, then pathobiology follows the same basic principles. The highly complex harmony of the living world may be disrupted, and a punctuated disease starts which is different from the health equilibrium. To reflect this biological archetype on the main diseases in dentistry - caries and periodontitis - the avalanche model is being proposed based on scientific and clinical evi-dence. This way of argumentation does influ-ence the strategic planning of preventive and curative programmes in dental research as well as in daily practise.

Share and Cite:

Gaengler, P. , Markovic, L. , Norden, D. and A. Jordan, R. (2009) New insights in understanding dental caries and periodontal disease: the avalanche model. Health, 1, 263-268. doi: 10.4236/health.2009.14042.

Conflicts of Interest

The authors declare no conflicts of interest.


[1] Diamond, J. C. (2005) How societies choose to fail or succeed. New York: Viking.
[2] Reichholf, J.H. (2008) Warum die Menschen sesshaft wurden. Frankfurt: S. Fischer Verlag GmbH.
[3] Chazel, J.C., Tramini, P., and Pélissier, B. (2005) Obser-vations on the severity of carious lesions throughout five periods of history. Caries Res., 39, 312.
[4] Bagramian, R.A., Garcia-Godoy, F., and Volpe, A.R. (2009) The global increase in dental caries: A pending public health crisis. Am J Dent., 22, 3-8.
[5] Arnold, W.H., Naumova, E.A., Koloda, V.V., and G?ngler, P. (2006) Tooth wear in two ancient populations of the Khazar Kaganat Region in the Ukraine. Int J Osteoar-chaeol., in press.
[6] G?ngler, P. (1986) Klinische und experimentelle Aspekte der vergleichenden Odontologie und Periodontologie. Nova Acta Leopoldina N. F., 58, 525-537.
[7] Ugur, Z.A., G?ngler, P., and Karababa, A.O. (2001) Zusammenhang zwischen Kariespr?valenz und attrition sowie abrasion bei einer türkischen population in Witten. Dtsch Zahn?rztl Z., 56, 172-176.
[8] G?ngler, P., Hoyer, I., Kosa, W., Metzler, E., and Schuder, S. (1988) Degeneration und regeneration des endodonts und periodonts als kopie phylogenetischer zahnentwick-lungsmuster. Zahn Mund Kieferheilkd Zentralbl, 76, 4-13.
[9] Socransky, S., Haffajee, A., Goodson, J., and Lindhe, J. (1984) New concepts of destructive periodontal diseases. J Clin Periodontol.,11, 21-32.
[10] Backer, D. O. (1966) Posteruptive changes in dental enamel. J Dent Res., 45, 503-511.
[11] Koulourides, T., Cueto, H., andPigman, W. (1961) Re-hardering of softened enamel surface of human teeth by solutions of calcium phosphates. Nature, 189, 26-227.
[12] G?ngler, P. (1985) Die pathogenese der zahnkaries und parodontalerkrankungen - das konzept von progression und stagnation. Zahn Mund Kieferheilkd Zentralbl., 73, 77-483.
[13] Eldredge, N. and Gould, S.J. (1972) Punctuated equilib-ria: An alternative to phyletic gradualism. In: Schopf TJ, editor. Models in Paleobiology. San Francisco: Freeman, Cooper & Company.
[14] Gould, S.J., Eldredge, N. (1993) Punctuated equilibrium comes of age. Nature, 366, 223-227.
[15] Metschnikoff II. (1884) Eine neue entzündungstheorie. Allg Wiener Med Ztg, 29, 307-332.
[16] Larmas, M. (2003) Dental caries seen from the pulpal side: A non-traditional approach. J Dent Res, 82, 253-256.
[17] Fejerskov, O. (1997) Concepts of dental caries and their consequences for understanding the disease. Community Dent Oral Epidemiol, 25, 5-12.
[18] Gilthorpe, M.S., Zamzuri, A.T., Griffiths, G.S., Maddick, I.H., Eaton, K.A., and Johnson, N.W. (2003) Unification of the “burst” and “linear” theories of periodontal disease progression: A multilevel manifestation of the same phe-nomen. J Dent Res, 82, 200-205.
[19] Kilian, M. (2005) Facing facts - Making sense of oral infections. Oral Biosciences and Medicine, 2, 163-165.
[20] Kilian, M., Poulsen, K., Blomqvist, T., Havarstein, L.S., Bek-Thomsen, M., Tettelin, H., et al. (2008) Evolution of streptococcus pneumoniae and its close commensal rela-tives. PLoS ONE, 3, e2683.
[21] G?ngler, P., Hoffmann, T., Willershausen, B., Schwenzer, N., and Ehrenfeld, M. (2005) Konservierende zahn- heilkunde und parodontologie. Stuttgart: Thieme.
[22] Ismail, A.I., Sohn, W., Tellez, M., Amaya, A., Sen, A., Hasson, H., et al. (2007) The International Caries Detec-tion and Assessment System (ICDAS): An integrated sys-tem for measuring dental caries. Community Dent Oral Epidemiol, 35, 170-178.
[23] Gaengler, P., Montag, R., and Hoyer, I. (1992) Assess-ment of caries progression by combined index system. J Dent Res, 72, 749.
[24] Bardow, A., Nyvad, B., and Nauntofte, B. (2001) Rela-tionships between medication intake, complaints o dry mouth, salivary low rate and composition, and the rate of tooth demineralization in situ. Arch Oral Biol, 46, 413-423.
[25] Rezwani-Kaminski, T., Kamann, W., and Gaengler, P. (2002) Secondary caries susceptibility of teeth with long-term performing composite restorations. J Oral Rehabil, 29, 1131-1138.
[26] Axelsson, P., Nystr?m, B., and Lindhe, J. (2004) The long-term effect of a plaque control program on tooth mortality, caries and periodontal disease in adults. Re-sults after 30 years of maintenance. J Clin Periodontol, 31, 749-757.
[27] Rodrigues, R.M., Gon?alves, C., Souto, R., Feres-Filho, E.J., Uzeda, M., and Colombo, A.P. (2004) Antibiotic re-sistance profile of the subgingival microbiota following systemic or local tetracycline therapy. J Clin Periodontol, 31, 420-427.
[28] Jordan, R.A., Raetzke, P., and G?ngler, P. (2007) Preva-lence of oral manifestations in HIV-seropositive patients undergoing highly-active antiretroviral therapy. Dtsch Zahn?rztl Z, 62, 376-385.

Copyright © 2024 by authors and Scientific Research Publishing Inc.

Creative Commons License

This work and the related PDF file are licensed under a Creative Commons Attribution 4.0 International License.