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TWENTY-FIVE years ago we first observed that children with diabetes mellitus tended to have less advknce of tooth decay than does the usual child.' Further observations indicated that such freedom from advancing decay was conditioned. by the degree in which the child's food intake approached accepted nutritional standards, and in which his diabetic anomaly was controlled through the use of insulin.2 Within two months after the routine of diet and insulin management had been established, open cavities would become stony hard at their base, and no new cavities would develop. Among diabetic children who failed to observe the prescribed regimen, caries tended to appear and to advance as rapidly or more rapidly than in the average child. The serial dental data for a group of diabetic girls are summarized in the first chart (Figure 1). Each horizontal bar represents the dental course of one child for successive years; the zones shaded black represent periods when no new caries could be detected. It will be noted that most of the periods of observation were characterized by non-advance of caries, and that the total increment of new caries was very low.8

Epidemiologic Studies in Dental Caries, III. The Interpretation of Clinical Data Relating to Caries Advance