Streptococcus mutans and Cariogenic Biofilms: Mechanisms, Disruption Strategies, and Future Therapeutic Directions

Dental caries, a significant global health concern, is intricately linked to the development and persistence of cariogenic biofilms on tooth surfaces. These complex microbial ecosystems orchestrate a multifactorial process of decay, adhering to teeth, producing acids that erode enamel, and exhibiting resistance to traditional therapies. This review delves into the intricate mechanisms of cariogenic biofilm formation and pathogenesis, exploring adhesion, acid production, extracellular polymeric substance (EPS) mediated acid tolerance, and nutrient acquisition within the biofilm. We then explore novel strategies for disrupting these biofilms, including next-generation antimicrobials, anti-adhesion molecules, biofilm-dispersing enzymes, and the potential of probiotics and prebiotics. Finally, the review examines promising future directions in oral disease treatment, highlighting the potential of personalized medicine, biofilm-modifying enzymes and peptides, host modulation strategies, and the development of combination therapies and advanced delivery systems for enhanced biofilm control. Understanding the mechanisms of cariogenic biofilms and exploring innovative treatment strategies could pave the way for more effective prevention and management of dental caries.