Streptococcus mutans biofilms in the establishment of dental caries: a review

Dental caries is considered as the most common and multifactorial disease worldwide, caused by a variety of oral microorganisms like Streptococcus spp., Veillonella spp., Actinomyces spp., Bifidobacterium spp., and Lactobacillus fermentum, which colonize food debris in oral cavities. Of them, Streptococcus mutans is the predominant bacterium and can induce progressive tooth destruction, especially during dentition. The superior characteristics of S. mutans, such as the presence of the cell surface protein P1 and exopolysaccharide-synthesizing enzymes, acid tolerance, biofilm-forming ability mediated by brpA gene, and multidrug resistance, render it a highly virulent pathogen in the etiology of dental caries. Given its significant role in dental caries, extensive research has been conducted over the past few decades, focusing on the development of specific antimicrobial treatments, and other innovative therapeutic approaches. To gain deeper insights into the genetic diversity and epidemiological patterns of S. mutans, various genotypic methods have been developed and successfully employed. By combining the insights gained from genetic studies of S. mutans with the suitable control measures against the biofilm, we can develop innovative and effective strategies for preventing and treating dental caries.