Streptococcal infections of the oral cavity
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Oral Streptococci: Key Players in Oral Health and Disease
Streptococci are among the first and most common bacteria to colonize the oral cavity. They play a dual role: some species help maintain oral health, while others are linked to various oral and systemic diseases. The balance between beneficial and harmful streptococci is crucial for oral health 16.
Common Streptococcal Species in the Oral Cavity
The oral cavity hosts a variety of streptococcal species, including Streptococcus mutans, Streptococcus sobrinus, Streptococcus oralis, Streptococcus sanguinis, Streptococcus gordonii, Streptococcus mitis, Streptococcus salivarius, and members of the Streptococcus anginosus group 15678. Each species tends to colonize specific sites in the mouth, such as dental plaque, tongue, or mucosal surfaces .
Streptococcal Infections and Oral Diseases
Dental Caries and Periodontal Disease
Streptococcus mutans and Streptococcus sobrinus are well-known for their role in dental caries. They ferment sugars, producing acids that demineralize tooth enamel, leading to cavities. Other species, like S. gordonii and S. salivarius, can help neutralize acids and inhibit the growth of harmful bacteria, thus protecting against caries 169.
In periodontal disease, streptococci act as initial biofilm formers, creating a foundation for more harmful bacteria to colonize and cause gum inflammation and tissue destruction 19.
Systemic Infections Linked to Oral Streptococci
Oral streptococci can enter the bloodstream, especially after dental procedures or in cases of poor oral hygiene. Once in the blood, they can cause serious systemic infections such as infective endocarditis, brain abscesses, and even contribute to autoimmune diseases and intestinal inflammation 134568. Streptococcus oralis and members of the mitis group are particularly associated with infective endocarditis 35.
Virulence Factors and Pathogenic Mechanisms
Oral streptococci possess various virulence factors that help them adhere to surfaces, evade the immune system, and cause disease. These include:
- Adhesive molecules for colonization
- Enzymes like neuraminidase and glucosyltransferases
- Toxins and extracellular polymeric substances
- Hydrogen peroxide production, which can inhibit other bacteria and help evade immune cells
- IgA1 proteases that help them evade local immune defenses 1245678
Horizontal gene transfer and adaptation to the oral environment further enhance their ability to cause disease .
Beneficial Roles and Probiotic Potential
Not all oral streptococci are harmful. Some, like Streptococcus salivarius, produce bacteriocins and other inhibitory substances that suppress pathogenic bacteria and help maintain a healthy oral microbiome. Probiotic strains of S. salivarius are being explored for their potential to prevent oral infections and restore microbial balance 1610.
Conclusion
Streptococcal infections in the oral cavity are complex, involving a balance between beneficial and harmful species. While some streptococci are essential for oral health, others can cause dental and systemic diseases, especially when the oral microbiome is disrupted. Understanding the roles, mechanisms, and interactions of oral streptococci is key to managing and preventing both oral and related systemic infections 12345678+2 MORE.
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