Caries disease/disorder coordination with IDO

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Here's a recent thread:

Caries as infection (not)
Alan Ruttenberg <alanruttenberg@gmail.com>
Dec 20 (2 days ago)

to Lindsay, Albert, Alexander, Bill 

Infection:

A part of an extended organism that itself has as part a
population of one or more infectious agents and that (1) exists
as a result of processes initiated by members of the infectious
agent population and is (2) clinically abnormal in virtue of the
presence of this infectious agent population, or (3) has a
disposition to bring clinical abnormality to immunocompetent
organisms of the same Species as the host (the organism
corresponding to the extended organism) through transmission of a
member or offspring of a member of the infectious agent
population.

Caries satisfies (1) and (2) but not (3).

The conclusion would be that caries is not an infection. That
seems not quite right.

Suggestions?

Alan Ruttenberg <alanruttenberg@gmail.com>
Dec 20 (2 days ago)
to Lindsay, Albert, Alexander, Bill 

Wouldn't the same logic apply to e.g. bacteremia in the case that
it is native commensal bacteria that are the circulating
bacteria.

Lindsay Cowell
Dec 20 (2 days ago)
to me, Albert, Alexander, Bill 

Isn't caries tooth decay?  In which case not an infection but
realization of an infectious disease.  Or secondary disorder

Alan Ruttenberg <alanruttenberg@gmail.com>
Dec 20 (2 days ago)

to Lindsay, Albert, Alexander, Bill 

On Sat, Dec 20, 2014 at 7:31 PM, Lindsay Cowell 
<Lindsay.Cowell@utsouthwestern.edu> wrote:

Isn't caries tooth decay?  In which case not an infection but
realization of an infectious disease.  Or secondary disorder

"tooth decay" interpreted as a disease course imply the existence
of some material basis for the disease. Asserting it would be an
infectious disease has the same issue I raised. There is a
disease course particular, so there is a disease particular that
has material basis an X. The question is, is X an infection then
it has to have the possibility of being transmitted.

Here's our definition:

A disorder that affects a tooth that includes both the infectious
organisms, the material they generate from the tooth, any immune
effectors that are a response to the presence of the disorder and
the physical changes to the tooth (i.e., demineralization or a
cavity) resulting from the disorder. It is the physical basis for
the disease "dental caries."

There are some papers that say it is transmissible - look like
only in certain circumstances - mother to child, among pre-tooth
children is what I found[1]. Maybe that's enough? I suppose it
might be true that scraping some from an adult cavity and
introducing it to a baby's mouth would, in some number of babies,
be enough to give them caries when their teeth erupt.

On the other hand, there's a NHS page [2] that argues that you
can't "catch" caries - that the relevant bacteria are generally
present in the mouth to start with, and provides a couple of
experiments as evidence.

I guess it would be interesting to know the answer in both
cases. In the case that it is transmissible it seems
unproblematically an infection. In the case not I'm guessing it
would be a colony and surrounding material as described in our
definition.

[1] http://medind.nic.in/icb/t09/i2/icbt09i2p191.pdf
[2] http://www.ncl.ac.uk/dental/oralbiol/oralenv/comment/caries_infection.htm

Original issue reported on code.google.com by alanruttenberg@gmail.com on 22 Dec 2014 at 5:07

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Dan says:

- Caries is definitely considered an infectious disease process by the dental 
community, no ifs ands or buts about it.
- I don't understand what #3 is saying.
- "Isn't caries tooth decay?" -- No.  Caries is the disease.  Tooth decay (a 
carious lesion) is the result of the disease (caries).

Original comment by alanruttenberg@gmail.com on 22 Dec 2014 at 5:17

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Regarding caries being an infectious disease, I'm curious what definition of 
infectious disease is in that community.  On what basis is it considered an 
infectious disease. Is it not the case that the bacteria responsible for caries 
are present in everyone's mouth? 

The issue being discussed is that IDO has a specific definition of infection 
and infectious disease and the question is whether caries satisfies that 
definition or not. 

Depending on the evidence regarding transmissibility there are several options.

1) We determine for sure that caries is in all cases transmissible. If that's 
the case then IDO's definition works.

2) The scientific answer is not clearcut, or we determine that only a subset of 
caries instances are actually transmissible. In that case we either use other 
terms from IDO to describe caries or we argue with Lindsay about the definition 
of infection. (did you check out my second citation?)

Original comment by alanruttenberg@gmail.com on 22 Dec 2014 at 5:24

• Added labels: Type-Enhancement
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Original comment by alanruttenberg@gmail.com on 22 Dec 2014 at 6:11

• Added labels: Domain-Clinical, Type-Clinical
• Removed labels: Type-Enhancement

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In response to the last comment: IMHO, cCaries is always transmitted before it 
occurs. The first instance of that is during the birth of babies. You can also 
get caries by  kissing, using someone else's toothbrush or eating food that has 
been contaminated by caries-causing bacteria.

Original comment by titus.sc...@gmail.com on 7 Jan 2015 at 2:22