Abstract
Carbohydrates, together with fats and proteins, provide the necessary energy needs for humans, and constitute, therefore, an integral part of a normal diet. An etiological model for caries that considers local and host factors is presented, highlighting the interaction of bacteria, saliva, minerals, and trace elements with food residues and with other intrinsic environmental and behavioral characteristics of the host. Consideration of this complex multifactorial etiology precludes the identification of any one factor as the only one to be singled out in prevention and management of oral disease. Sugar is, unquestionably, a risk factor for caries, and, therefore, its total substitution with energetic or nonenergetic sweeteners has been found useful. However, partial substitutions of fermentable sugars may have limited practical value in controlling caries prevalence. Caries preventive programs that take into consideration not one, but several etiologic factors, will be effective and beneficial to the general population.