Cavities are caused by bacteria that stick together on your teeth and create a protective layer called a biofilm. This review article explains how these bacteria work together to damage your teeth and explores exciting new ways to fight them. Scientists are looking at everything from special molecules that stop bacteria from sticking, to probiotics (good bacteria), to personalized treatments based on your unique mouth bacteria. Understanding how cavity-causing biofilms work could help dentists prevent and treat cavities better in the future.

The Quick Take

  • What they studied: How bacteria called Streptococcus mutans form sticky communities on teeth that cause cavities, and what new treatments might work better than current methods
  • Who participated: This is a review article that summarizes research from many other studies rather than testing people directly
  • Key finding: Cavity-causing bacteria are much harder to kill when they’re in their protective biofilm communities compared to when they’re alone, and new approaches like enzymes, probiotics, and combination treatments show promise for breaking down these communities
  • What it means for you: Future cavity prevention and treatment may be more effective by targeting how bacteria stick together rather than just trying to kill them. However, these new treatments are still being researched and aren’t widely available yet.

The Research Details

This is a review article, which means scientists read and summarized findings from many other research studies instead of doing their own experiment. The authors looked at what we know about how cavity-causing bacteria form protective communities on teeth, how these communities survive and cause damage, and what new treatment ideas scientists are testing. They organized this information to show how bacteria stick to teeth, make acids that eat away enamel, protect themselves from medicines, and get nutrients from their environment. Then they explored different strategies being researched to fight these bacteria, from new antibiotics to probiotics to personalized medicine approaches.

Understanding how cavity-causing bacteria work together as a team helps scientists develop smarter ways to stop them. Instead of just trying to kill all the bacteria (which doesn’t always work), researchers can now target the glue that holds them together, the acids they produce, or the protective shield around them. This approach is more likely to succeed because it attacks the bacteria’s weaknesses.

This is a review article published in a scientific journal, which means it summarizes current knowledge rather than presenting new experimental data. The strength of the conclusions depends on the quality of the studies being reviewed. Since this is a recent review (2025) in a peer-reviewed journal, it represents current scientific thinking, but individual recommendations still need testing in real patients before becoming standard treatment.

What the Results Show

Cavity-causing bacteria don’t work alone—they form communities called biofilms that stick to your teeth like a protective fortress. These bacteria produce acids that slowly eat away at tooth enamel, and they create a slimy shield made of sticky substances that protects them from toothpaste, mouthwash, and antibiotics. The bacteria inside the biofilm are much harder to kill than bacteria floating freely, which is why cavities are so hard to prevent and treat.

Scientists have discovered several new ways to fight these bacterial communities. Some approaches try to stop bacteria from sticking to teeth in the first place using special anti-adhesion molecules. Others use enzymes (natural proteins) that can break down the protective shield around the bacteria. Probiotics—beneficial bacteria that compete with cavity-causing bacteria—and prebiotics (foods that help good bacteria grow) also show promise in laboratory and animal studies.

The most exciting approaches combine multiple strategies at once. For example, using an enzyme to break down the protective shield while also delivering an antibiotic directly to the weakened biofilm could be much more effective than either treatment alone. Scientists are also working on personalized treatments based on analyzing which specific bacteria live in each person’s mouth.

The review highlights that cavity-causing bacteria survive by producing acids that they protect themselves from using special chemical processes. They also work together to gather nutrients and share resources within their community. Some bacteria in the biofilm act as leaders that coordinate the group’s activities. Understanding these roles opens new treatment possibilities—for example, targeting the leader bacteria might cause the whole community to fall apart.

This review builds on decades of research showing that cavities are caused by bacterial biofilms rather than individual bacteria. Previous research focused mainly on killing bacteria with antibiotics and fluoride, which works somewhat but doesn’t completely solve the problem because biofilms are so protective. This review emphasizes that newer approaches targeting how bacteria stick together, communicate, and protect themselves may be more effective than traditional methods.

This is a review article that summarizes other studies, so it doesn’t present new experimental evidence. Many of the promising treatments discussed are still in early research stages and haven’t been tested in large numbers of people yet. The review focuses on laboratory and animal studies, so it’s unclear which treatments will actually work in human mouths. Additionally, individual responses to treatments may vary based on genetics, diet, and oral hygiene habits.

The Bottom Line

Current evidence supports continuing standard cavity prevention: brush twice daily with fluoride toothpaste, floss daily, limit sugary foods and drinks, and visit your dentist regularly (moderate to high confidence). Emerging treatments like probiotics and enzyme-based therapies show promise in research but aren’t yet standard recommendations—ask your dentist about new options as they become available (low to moderate confidence for new approaches).

Everyone should care about cavity prevention, but this research is especially relevant for people who get cavities frequently despite good oral hygiene, people with dry mouth, and those interested in new preventive approaches. The new treatments discussed may eventually help people who don’t respond well to traditional cavity prevention.

Standard prevention methods (brushing, flossing, fluoride) show results within weeks to months of consistent use. New treatments being researched may take 5-10 years to be tested in people and approved for regular use. If you try new approaches, give them at least 3-6 months to show effects.

Want to Apply This Research?

  • Track daily oral hygiene habits (brushing twice daily, flossing, sugar intake) and note any new cavities or tooth sensitivity at dental visits. Record the date of dental checkups and any new treatments tried.
  • Set daily reminders for brushing and flossing, log sugary food and drink consumption to identify patterns, and schedule regular dental appointments. If your dentist recommends new treatments like probiotics or special rinses, use the app to track consistency and any changes in cavity formation.
  • Monitor cavity development over 6-12 months while maintaining or improving oral hygiene habits. Track which prevention methods you use consistently and correlate with dental visit findings. If trying new treatments, compare cavity rates before and after implementation with your dentist’s help.

This article summarizes scientific research about cavity-causing bacteria and experimental treatments. It is not medical advice. Current cavity prevention methods (brushing, flossing, fluoride, regular dental visits) remain the most proven approaches. Many treatments discussed are still in research stages and not yet available or recommended for regular use. Always consult your dentist before starting new oral health treatments, especially if you have existing dental conditions, take medications, or have a weakened immune system. This information is for educational purposes and should not replace professional dental care.