[Frontiers in Bioscience 9, 1267-1277, May 1, 2004]


Jeffrey A. Banas

Center for Immunology and Microbial Disease,Albany Medical College,MC-151,47 New Scotland Avenue,Albany, NY 12208


1. Abstract
2. Introduction
3. Adhesion
3.1. Sucrose-Independent Adhesion
3.2. Sucrose-Dependent Adhesion
3.3. Non-enzymatic Glucan-Binding Proteins
3.4. Biofilm Formation
3.5. Carbohydrate Metabolism
4. Acidogenicity
5. Acid-Tolerance
5.1. Maintaining Intracellular pH
5.2. Induction of DNA Repair
5.3. Other Facets of Acid Adaptation
6. Endocarditis
7. Summary
8. References


Streptococcus mutans is considered one of the primary causative agents of dental caries and can also be a source of infective endocarditis. The main virulence factors associated with cariogenicity include adhesion, acidogenicity, and acid tolerance. Each of these properties works coordinately to alter dental plaque ecology. The ecological changes are characterized by increased proportions of S. mutans and other species that are similarly acidogenic and aciduric. The selection for a cariogenic flora increases the magnitude of the drop in pH following the fermentation of available carbohydrate and increases the probability of enamel demineralization. This review focuses on the bacterial components that contribute to each of the major virulence properties. Further understanding of how these components work together in the development of dental caries will be aided by the recent completion of the sequence of the S. mutans genome and experimental designs that model the dental plaque biofilm.