7885 Am J Clin Nutr!994;59(suppl):788S. Printed in USA. © 1994 American Society for Clinical Nutrition Diet and dental caries”2

Dental caries has for a long time been explained by the simple relationship of the combined effect of fermentable carbohydrates and bacteria. This model is too simple to illustrate a multifactonial disease like dental caries. In the clinic we often find patients with low caries activities in spite of poor oral hygiene and high con-sumption of sugar, or patients who in spite of a controlled sugar intake and successful attempts to maintain good oral hygiene have high caries activity. This phenomenon was described in the Vipehohm study 50 y ago, when remarks were made about the great difference in caries activity within the group with the high-est challenge from sugar (1). This situation was called paradox-ical caries at a time when few explanatory variables were known. The individuality in caries activity is easy to understand if we also consider prophylaxis and the effect of defense factors in saliva, such as some electrolytes, enzymes, antibodies and othe