The observations in the Vipeholm Study regarding sugar consumption and oral lactobacillus counts were reviewed in relation to recent data on the epidemiology of mutans streptococci. The mutans streptococci were not present in higher counts in a population with high level of sugar consumption compared to two populations with a low level. As expected, differences were found in the caries prevalence between the different populations. An association between bacterial count and dental caries status could be demonstrated at the low level of sugar consumption and caries prevalence. Strains of mutans streptococci isolated in a population with extremely low caries prevalence were shown to be cariogenic in the hamster model. It is apparent that the observations made in the Vipeholm Study and the present finding have similarities, although different bacteria are studied. It was concluded that the difference in diet between the populations or groups were not sufficient to affect the counts of lactobacilli or mutans streptococci, but may have been sufficient to create the differences in caries prevalence.