Publication Date

Winter 4-2026

Keywords

Streptococcus, Plaque, microbiome, dental caries, targeted therapy, bacteriophage therapy

Abstract

Abstract:

Dental caries is a highly prevalent, biofilm-mediated disease driven by dysbiosis within the supragingival plaque microbiome. Although Streptococcus mutans has traditionally been regarded as a primary cariogenic pathogen, advances in microbiome research underscore the importance of community-level interactions and collective metabolic activity in disease progression. This literature review synthesizes current evidence on the ecological role of S. mutans, the functional dynamics of plaque biofilms, and emerging therapeutic strategies targeting cariogenic microbiomes. Metagenomic and metatranscriptomic analyses indicate that caries is characterized by reduced microbial diversity and a shift toward acidogenic and aciduric metabolic pathways across the microbial community. Furthermore, mobile genetic elements, including integrative and conjugative elements, enhance the adaptability and persistence of S. mutans within biofilms. Novel therapeutic approaches—particularly bacteriophage-based strategies—demonstrate promising specificity in targeting S. mutans while preserving commensal oral microbiota, with supportive evidence from both in vitro and in vivo studies. Collectively, these findings support a paradigm shift from broad-spectrum antimicrobial treatments toward precision-based interventions that modulate microbial composition and function. Advancing our understanding of plaque microbiome ecology and targeted therapies may enable more effective and sustainable strategies for the prevention and management of dental caries.

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