Dental caries is a transmissible infectious disease, in which mutans streptococci (MS) play the role of main pathogens. This oral disease represents a public health problem worldwide, and despite the advances in dental health with the use of fluoride abroad, treatment of caries manifestations and their outcomes are still highly costly to public and private healthcare systems. Lack of treatment of dental caries ultimately may have serious systemic consequences. Mutans streptococci have a panel of virulence factors important for their establishment in the complex microbial community of the dental biofilm and in the induction of caries. In this review we discuss the advances in our understanding of the molecular mechanisms which underlie MS transmission, tooth colonization and virulence. Infection and disease take place in a milieu exposed to components of the mucosal and systemic immune systems of the host. Thus, inducing host responses which target aspects of mutans streptococcal colonization and disease may provide additional measures to modify dental caries. This review also describes current strategies for anti-caries vaccination efforts with regard to important bacterial targets, routes, adjuvants and delivery systems for active and passive immunization.
[Show abstract][Hide abstract] ABSTRACT: Dental caries is an infectious and transmissible disease, in which many genetic, environmental and behavioral risk factors interact. The mutans streptococci (MS), mainly Streptococcus mutans and Streptococcus sobrinus are the microorganisms most strongly associated with this disease. The main virulence factors associated with MS cariogenicity include adhesion, acidogenicity and acid tolerance. These properties work together to modify the physico-chemical properties of the biofilm, resulting in ecological changes in the form of increased proportions of S. mutans and other acidogenic and aciduric species. In addition, reports of higher numbers of S. mutans genotypes with increased virulence in caries-active subjects suggest the importance of microenvironmental factors in increasing the risk of caries. This review focuses on the transmission and establishment of different genotypes of S. mutans and the role they play in the development of dental caries.
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