DENTAL CARIES AND PERIODONTAL DISEASES: A NARRATIVE REVIEW OF SHARED RISK FACTORS, PATHOGENESIS, INTERRELATIONSHIPS AND PREVENTIVE STRATEGIES

Background: Dental caries and periodontal diseases are the two most prevalent oral diseases worldwide and remain leading causes of pain, tooth loss, reduced quality of life and avoidable health expenditure. Although traditionally studied as separate entities, they share an ecological, behavioural and socio-economic foundation that has important implications for prevention and clinical care.
Objective: To provide an integrated narrative review of the epidemiology, pathogenesis, shared risk factors, classification, prevention and management of dental caries and periodontal diseases, and to consider the implications for routine clinical practice and public oral health.
Methods: A narrative review was conducted using PubMed/MEDLINE and Google Scholar, supplemented by hand-searching of consensus reports, Cochrane reviews and World Health Organization publications. English-language systematic reviews, consensus statements, guidelines and key primary studies were prioritised. Reporting was guided by the SANRA quality criteria for narrative reviews.
Results and Discussion: Both conditions are biofilm-mediated, non-communicable diseases driven by dysbiosis of the oral microbiome in response to environmental pressures, principally frequent free-sugar intake in caries and host inflammatory dysregulation in periodontitis. Tobacco use, poor plaque control, socio-economic disadvantage and systemic conditions such as diabetes act as common risk factors. Evidence supports fluoride delivery, sugar reduction, sealants and minimally invasive caries management for caries, and mechanical biofilm control, risk-factor modification and staged periodontal therapy for periodontal diseases. A common risk factor approach, delivered through patient-centred behaviour change and integrated care pathways, offers the most efficient route to reducing the combined burden.
Conclusion: Caries and periodontal diseases should be managed within a single preventive framework that targets the shared determinants of oral health. Strengthening prevention in primary dental care, particularly in resource-limited settings such as South Africa, is essential for reducing the burden of these largely preventable diseases.