New strategies and mechanisms for targeting Streptococcus mutans biofilm formation to prevent dental caries: A review

Dental caries, a prevalent oral infectious disease, is intricately linked to the biofilm formation on the tooth surfaces by oral microbes. Among these, Streptococcus mutans plays a central role in the initiation and progression of caries due to its ability to produce glucosyltransferases, synthesize extracellular polysaccharides, and facilitate bacterial adhesion and aggregation. This leads to the formation of biofilms where the bacteria metabolize dietary carbohydrates to produce acids. Therefore, devising effective strategies to inhibit S. mutans biofilm formation is crucial for dental caries prevention and oral health promotion. Though preventive measures like mechanical removal and antibacterial drugs (fluoride, chlorhexidine) exist, they pose challenges such as time consumption, short-term effectiveness, antibiotic resistance, and disruption of oral flora balance. This review provides a comprehensive overview of emerging strategies such as antimicrobial peptides, probiotics, nanoparticles, and non-thermal plasma therapies for targeted inhibition of S. mutans biofilm formation. Moreover, current research insights into the regulatory mechanisms governing S. mutans biofilm formation are also elucidated. The objective is to foster the development of innovative, efficient and safe techniques for caries prevention and treatment, thereby expanding treatment options in clinical dentistry and promoting oral health.