Streptococcus mutans, an assessment of its physiological potential in relation to dental caries.

Streptococcus mutans converts low levels of sucrose to lactic acid, but at high levels favours synthesis of glucans for plaque accumulation. Thus, the continued exposure to sucrose fluxes would select microorganisms in the oral cavity (S. mutans being a prototype) with highly specialized adaptation and potential dental caries activity. The bacteria that have evolved physiological systems to function efficiently under these conditions are the lactic acid bacteria. These organisms survive in environments where carbohydrate availability is constantly changing. High tolerances to acidic environments may be an important determinant in establishing the ecology of the carious lesion. Also, the intercellular polysaccharide storgae (glycogenamylopectin) and extracellular polymer reserves (levan and soluble glucan) are important during carbohydrate depletion. Further, the formation of insoluble glucans is a prerequisite for the caries process on smooth surfaces of teeth through plaque development. These conditions could result in an increase in S. mutans and cariogenic microorganisms. As a result, this process may be best understood as a manifestation of an amphibiotic shift.