THE ROLE OF STREPTOCOCCUS MUTANS IN THE DEVELOPMENT OF EARLY CARIES IN CHILDREN: MECHANISMS OF PATHOGENESIS, MICROBIAL INTERACTIONS AND CLINICAL SIGNIFICANCE

Early childhood caries (ECC) is an aggressive form of carious lesion in primary teeth, the etiology of which is traditionally viewed through the prism of an infectious nature. Streptococcus mutans is recognized as the key etiologic agent of this disease. This review summarizes current data on the role of S. mutans in the pathogenesis of ECC, focusing on the mechanisms of primary colonization, the enzymatic activity of glucosyltransferases, the formation of the exopolysaccharide matrix of the biofilm, and synergistic interspecies interactions with Candida albicans, which significantly enhance the cariogenic potential of the consortium. The clinical significance of the timing of infection and threshold concentrations of the pathogen for risk prediction is separately considered. Understanding the molecular basis of S. mutans pathogenicity opens up prospects for the development of targeted preventive strategies that go beyond traditional dietary interventions.