Early Childhood Caries (ECC), defined as 1 or more decayed, missing, or filled teeth in a child less than 6 years of age, is the most prevalent chronic disease in children, occurring 5 times as frequently as asthma. When left untreated, dental caries is chronic and extremely painful, resulting in costly restorative services and persisting into adulthood. Arizona has one of the worst ECC incidence rates in the nation, with significant ethnic health disparities that both conform (Hispanic and non-Hispanic white populations) and run counter (Native American populations) to the national trends, which cannot be explained by the socio-economic factors traditionally associated with caries. The biological component of caries, specifically the sub-strain type, virulence, and bacterial load of ECC-causing S. mutans and S. sobrinus infections are likely playing a significant, but not well-defined role in observed incidences and health disparities. Thus, our goal is to quantify the impact of bacterial genetics on caries outcomes in preschool children, thereby improving caries prediction capability and enhancing statewide prevention efforts. Would you like to know more?