Cited by 124Bacterial biofilms and quorum sensingOral microbiology and periodontitis researchPolysaccharides Composition and Applications

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The Role of Exopolysaccharides in Oral Biofilms

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Cugini, C., Shanmugam, M., Landge, N., Ramasubbu, N.·2019·Journal of Dental Research

DOI 10.1177/0022034519845001PMC PMC6589894

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Abstract

The oral cavity contains a rich consortium of exopolysaccharide-producing microbes. These extracellular polysaccharides comprise a major component of the oral biofilm. Together with extracellular proteins, DNA, and lipids, they form the biofilm matrix, which contributes to bacterial colonization, biofilm formation and maintenance, and pathogenesis. While a number of oral microbes have been studied in detail with regard to biofilm formation and pathogenesis, the exopolysaccharides have been well characterized for only select organisms, namely Streptococcus mutans and Aggregatibacter actinomycetemcomitans. Studies on the exopolysaccharides of other oral organisms, however, are in their infancy. In this review, we present the current research on exopolysaccharides of oral microbes regarding their biosynthesis, regulation, contributions to biofilm formation and stability of the matrix, and immune evasion. In addition, insight into the role of exopolysaccharides in biofilms is highlighted through the evaluation of emerging techniques such as pH probing of biofilm colonies, solid-state nuclear magnetic resonance for macromolecular interactions within biofilms, and super-resolution microscopy analysis of biofilm development. Finally, exopolysaccharide as a potential nutrient source for species within a biofilm is discussed.

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The Human Oral Microbiome
Dewhirst, F. E., Chen, T., Izard, J., Paster, B. J., Tanner, A. C. R., Yu, W.-H., Lakshmanan, A., & Wade, W. G. (2010) · Journal of Bacteriology · doi:10.1128/jb.00542-10 · Cited by 3,352
Physiological heterogeneity in biofilms
Stewart, P. S., & Franklin, M. J. (2008) · Nature Reviews Microbiology · doi:10.1038/nrmicro1838 · Cited by 2,327
Bacterial Extracellular Polysaccharides Involved in Biofilm Formation
Vu, B., Chen, M., Crawford, R. J., & Ivanova, E. P. (2009) · Molecules · doi:10.3390/molecules14072535 · Cited by 1,125
Biology of Streptococcus mutans-Derived Glucosyltransferases: Role in Extracellular Matrix Formation of Cariogenic Biofilms
Bowen, W. H., & Koo, H. (2011) · Caries Research · doi:10.1159/000324598 · Cited by 1,085
Oral Biofilms: Pathogens, Matrix, and Polymicrobial Interactions in Microenvironments
Bowen, W. H., Burne, R. A., Wu, H., & Koo, H. (2018) · Trends in Microbiology · doi:10.1016/j.tim.2017.09.008 · Cited by 1,059
Spatial structure, cooperation and competition in biofilms
Nadell, C. D., Drescher, K., & Foster, K. R. (2016) · Nature Reviews Microbiology · doi:10.1038/nrmicro.2016.84 · Cited by 1,012
Cell Death in Pseudomonas aeruginosa Biofilm Development
Webb, J. S., Thompson, L. S., James, S., Charlton, T., Tolker‐Nielsen, T., Koch, B. M., Givskov, M., & Kjelleberg, S. J. (2003) · Journal of Bacteriology · doi:10.1128/jb.185.15.4585-4592.2003 · Cited by 600
Giving structure to the biofilm matrix: an overview of individual strategies and emerging common themes
Hobley, L., Harkins, C., MacPhee, C. E., & Stanley-Wall, N. R. (2015) · FEMS Microbiology Reviews · doi:10.1093/femsre/fuv015 · Cited by 581
The Exopolysaccharide Matrix: A Virulence Determinant of Cariogenic Biofilm
Koo, H., Falsetta, M. L., & Klein, M. I. (2013) · Journal of Dental Research · doi:10.1177/0022034513504218 · Cited by 523
The Exopolysaccharide Matrix Modulates the Interaction between 3D Architecture and Virulence of a Mixed-Species Oral Biofilm
Xiao, J., Klein, M. I., Falsetta, M. L., Lu, B., Delahunty, C. M., Yates, J. R., Heydorn, A., & Koo, H. (2012) · PLoS Pathogens · doi:10.1371/journal.ppat.1002623 · Cited by 523

Show all 59 references

Research works printed but not linked: 1

Rocco CJ, 2018, J Bacteriol, 200

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Background
Sugar Substitute Stevia Inhibits Biofilm Formation, Exopolysaccharide Production, and Downregulates the Expression of Streptococcal Genes Involved in Exopolysaccharide Synthesis
AlKanderi, S., AlFreeh, M., Bhardwaj, R. G., & Karched, M. (2023) · Dentistry Journal · doi:10.3390/dj11120267 · Cited by 9
“The EPS matrix in bioﬁlms serves as a foundation for bacterial colonization, multi-species bioﬁlm formation, and plays a role in pathogenesis [22,23], hence, playing a signiﬁ-cant part in the development of dental caries and periodontal diseases such as gingivitis and periodontitis [18,24].”
Background
4-hydroxy-3-methoxybenzaldehyde causes attrition of biofilm formation and quorum sensing–associated virulence factors of Streptococcus mutans
Ganesh, P. S. (2024) · Archives of Oral Biology · doi:10.1016/j.archoralbio.2024.105976 · Cited by 8
Exploration of the primary antibiofilm substance and mechanism employed by Lactobacillus salivarius ATCC 11741 to inhibit biofilm of Streptococcus mutans
Ma, N., Wei, Y., Chen, B., Bao, M., Li, Y., Wang, M., Yang, X., Liu, J., Wang, C., & Qiu, L. (2025) · Frontiers in Cellular and Infection Microbiology · doi:10.3389/fcimb.2025.1535539 · Cited by 8
Antimicrobial Peptide P-113-DPS Suppresses the Cariogenic Virulence of Streptococcus mutans
Liu, Q., Zhou, L., Peng, S., Li, Q., & Wong, H. M. (2025) · ACS Applied Bio Materials · doi:10.1021/acsabm.5c00314 · Cited by 8
Saccharibacteria (TM7), but not other bacterial taxa, are associated with childhood caries regardless of age in a South China population
You, Y., Yin, M., Zheng, X., Liang, Q., Zhang, H., Wu, B., & Xu, W. (2023) · PeerJ · doi:10.7717/peerj.15605 · Cited by 8
Regulating Oral Biofilm from Cariogenic State to Non-Cariogenic State via Novel Combination of Bioactive Therapeutic Composite and Gene-Knockout
Chen, H., Yang, Y.-M., Weir, M., Dai, Q., Lei, L., Homayounfar, N., Oates, T., Yang, K., Zhang, K., Hu, T., et al. (2020) · Microorganisms · doi:10.3390/microorganisms8091410 · Cited by 9
“It serves as nutrients and helps form the core of the matrix scaffold [52].”
Background
Anti-biofilm studies of synthetic imidazolium salts on dental biofilm in vitro
Pan, T. S., Liu, F., Lin, H., & Zhou, Y. N. (2022) · Journal of Oral Microbiology · doi:10.1080/20002297.2022.2075309 · Cited by 8
“The extracellular polymer, particularly EPS synthesized by bacteria, contributes to bacterial colonization, biofilm formation and pathogenesis, and protects bacteria from desiccation, predation or antimicrobial agents [45,46].”
Background
Exopolysaccharides metabolism and cariogenesis of Streptococcus mutans biofilm regulated by antisense vicK RNA
Sun, Y., Chen, H., Xu, M., He, L., Mao, H., Yang, S. S., Qiao, X., & Yang, D. (2023) · Journal of Oral Microbiology · doi:10.1080/20002297.2023.2204250 · Cited by 7
“EPS in S. mutans is principally glucan, including water-insoluble glucan (WIG) and water-soluble glucan (WSG), synthesized by Gtfs and decomposed by dextranase (Dex) [7,13].”
Background
How Do Polymer Coatings Affect the Growth and Bacterial Population of a Biofilm Formed by Total Human Salivary Bacteria?—A Study by 16S-RNA Sequencing
Al‐Ahmad, A., Wollensak, K., Rau, S. J., Solarte, D. L. G., Paschke, S., Lienkamp, K., & Staszewski, O. (2021) · Microorganisms · doi:10.3390/microorganisms9071427 · Cited by 8
Effect of exopolysaccharides from cariogenic bacteria on human gingival fibroblasts
Szkaradkiewicz, A. K., & Szkaradkiewicz, A. (2021) · International Journal of Medical Sciences · doi:10.7150/ijms.57221 · Cited by 7
“mutans constitute monosaccharides, mainly α-D-glucans, which play a key role in the formation of dental plaque, mediating in cariogenic effect [34].”
Background
Glycosylation of oral bacteria in modulating adhesion and biofilm formation
Yi, S., Liu, Y., Wu, Q., Zhao, D., Li, Z., Peng, X., Liao, G., & Wang, S. (2025) · Journal of Oral Microbiology · doi:10.1080/20002297.2025.2486650 · Cited by 6
“The EPS consists mainly of polysaccharides, proteins, lipids, and nucleic acids (eDNA), which help to form the overall scaffolding of the biofilm [26,27].”
One‐Step Doping of P and S Elements to Fe‐ZIF‐8 Derivatives for Enhanced ROS Generation and Antibacterial Application
Cheng, J., Xin, Q., Zhang, Y., Ma, Z., Sun, S., Gao, W., Zhu, Z., Chen, H., Qin, M., & Li, J. (2025) · Small · doi:10.1002/smll.202508557 · Cited by 6
ZccE, a P‐type ATPase contributing to biofilm formation and competitiveness in Streptococcus mutans
Pan, Y., Zou, J., Zhang, K., Wang, X., Ma, Q., Mei, L., Li, Y., & Pan, Y. (2023) · Molecular Oral Microbiology · doi:10.1111/omi.12405 · Cited by 6
Bacterial colonisation during regular daily use of a power-driven water flosser and risk for cross-contamination. Can it be prevented?
Bertl, K., Geissberger, C., Zinndorf, D., Johansson, P. E., Alshammari, H. D., Eick, S., & Stavropoulos, A. (2021) · Clinical Oral Investigations · doi:10.1007/s00784-021-04167-1 · Cited by 6
Microbiological Impact of Antimicrobial Photodynamic Therapy in Non-Surgical Periodontal Treatment
Sousa, F. P., Assunção, M. A., Bessa, L. J., & Alves, R. C. (2025) · Pharmaceutics · doi:10.3390/pharmaceutics17081070 · Cited by 5
“Oral microorganisms are organized in biofilms, surface-associated communities embedded in a self-produced extracellular polymeric substance (EPS) matrix that are highly structured physically and functionally [4,5].”
Recent perspectives on precision-targeting therapy against oral biofilm
Wu, L., Tu, Y., Xiao, S., Zeng, J., Sun, G., & Li, Y. (2026) · Journal of Oral Microbiology · doi:10.1080/20002297.2026.2662093 · Cited by 5
“Finally, the mature biofilm is characterized by a resilient three-dimensional architecture embedded within a protective EPS matrix, which confers its enhanced resistance to both antimicrobials and host defences [3,4].”
Nuclear magnetic resonance to study bacterial biofilms structure, formation, and resilience
Abreu, A. C., & Fernández, I. (2020) · Elsevier eBooks · doi:10.1016/b978-0-12-819497-3.00002-7 · Cited by 5
Microscale analyses of the effect of arginine on oral biofilms
Assar, S., Kristensen, M. F., Rey, Y. C. D., Lund, M., Raittio, E. J., Schramm, A., Meyer, R. L., & Schlafer, S. (2025) · Journal of Dentistry · doi:10.1016/j.jdent.2025.105863 · Cited by 4
Deficiency of dltD contributes to increased autolysis in Streptococcus mutans
Du, J., Huang, S. H., Li, Y., Wu, M., Chen, S., Zhan, L., & Huang, X. (2023) · Journal of Oral Microbiology · doi:10.1080/20002297.2023.2290221 · Cited by 4
“Bacterial autolysis can release substantial amounts of eDNA, which is a crucial component of the extracellular matrix of bacterial biofilms [22].”
smu_1558c-mediated regulation of growth and biofilm formation in Streptococcus mutans
Zhou, J., Ma, Q., Liang, J., Pan, Y., Chen, Y., Yu, S., Liu, Y., Zhang, Q., Li, Y., & Zou, J. (2025) · Frontiers in Microbiology · doi:10.3389/fmicb.2024.1507928 · Cited by 4
The FtcR-Like Protein ActR in Azorhizobium caulinodans ORS571 Is Involved in Bacterial Motility and Symbiosis With the Host Plant
Sun, L., Wang, D., Yin, Z., Zhang, C., Bible, A. N., & Xie, Z. (2021) · Frontiers in Microbiology · doi:10.3389/fmicb.2021.744268 · Cited by 4
Antimicrobial Peptide in Oral Health: A Therapeutic Approach
Kumari, A., & Kumari, S. (2024) · Springer eBooks · doi:10.1007/978-3-031-67515-7_3 · Cited by 3
Fastidious or rarely isolated gram-negative rods with a particular focus on Kingella kingae
Zbinden, R., & Yagupsky, P. (2025) · Clinical Microbiology Reviews · doi:10.1128/cmr.00048-25 · Cited by 3
Dental plaque biofilm-targeting composite nanomaterials: advances and outlook
Zhao, J., Huang, S., Yang, Y., Wang, J., Guo, Q., Xu, Y., Jiang, B., & Lin, J. (2025) · Biomaterials Science · doi:10.1039/d5bm01747e · Cited by 5
Biofilm formation: A well-played game in bacterial pathogenesis
Thite, V. S., Bharathi, R. K., & Srinandan, C. S. (2023) · Elsevier eBooks · doi:10.1016/b978-0-323-99977-9.00009-0 · Cited by 3
Pudilan Keyanning mouthwash inhibits dextran-dependent aggregation and biofilm organization ofStreptococcus mutans
Ren, S., Cheng, Y., Deng, Y., Xia, M., Yang, Y., Lei, L., & Hu, T. (2023) · Journal of Applied Microbiology · doi:10.1093/jambio/lxad298 · Cited by 3
Harnessing the Regulatory Effects of Streptococcus mutans Two‐Component Signal Transduction Systems for Therapeutic Interventions Against Dental Caries
Qiu, B., Deng, Y., Yi, Z., Yang, Y., Lei, L., & Hu, T. (2025) · Molecular Oral Microbiology · doi:10.1111/omi.70006 · Cited by 2
“The exopolysaccharide (EPS) matrix synthesized by S. mutans is a critical virulence factor of cariogenic biofilms (Cugini et al. 2019; Klein et al. 2015).”
Asiatic Acid Disrupts the Biofilm Virulence of Streptococcus mutans by Transcriptional Reprogramming of Quorum Sensing System
Shi, Q., Li, F., Peng, Y., Sun, Q., Zhao, H., Lu, F., & Zhao, H. (2025) · International Journal of Molecular Sciences · doi:10.3390/ijms26199510 · Cited by 4
“Collectively, these protective functions contribute to the persistence of a localized low-pH microenvironment [16,17].”
Streptococcus mutans Extracellular Vesicles Regulate Early Streptococcus sanguinis Nanoadhesion
Leiva‐Sabadini, C., Levesque, C. M., Bozec, L., Schuh, C. M. A. P., & Aguayo, S. D. (2026) · Journal of Dental Research · doi:10.1177/00220345261417246 · Cited by 2
“However, the potential influence of S. mutans bEVs on other key virulence factors such as EPS production, biofilm nanomechanical stability, and bacterial viability remains to be elucidated (Cugini et al 2019; Gloag et al 2020).”
Development and evaluation of a piceatannol-L-arginine nanogel for sustained salivary pH and exopolysaccharide reduction in caries prevention
Kaur, P., Vyas, M., Verma, S., Sharma, S., Rathore, K., Kamboj, S., & Satija, S. (2025) · Letters in Drug Design & Discovery · doi:10.1016/j.lddd.2026.100327 · Cited by 2
Surface-related factors affecting bacterial adhesion on dental implants: a short literature review
Choi, S. (2026) · The Journal of Advanced Prosthodontics · doi:10.4047/jap.2026.18.3.261 · Cited by 3
“47,48 This increased resilience is a key factor in the persistence of biofilms on dental implant surfaces and contributes to the pathogenesis of peri-implant mucositis and peri-implantitis.”
Multispecies metabolomics interactions resulting in the development of resistance
Anavadiya, B., Acharya, D., Saraf, M. S., & Goswami, D. (2023) · Elsevier eBooks · doi:10.1016/b978-0-323-95715-1.00016-9 · Cited by 2
Effect of 6-Shogaol Derived from Ginger (Zingiber officinale) on Dual-Species Biofilm Formation by Streptococcus mutans and Candida albicans
Jung, E., Hwang, G., & Kim, K. (2025) · Nutrients · doi:10.3390/nu17182999 · Cited by 1
“This finding suggests that 6-shogaol can weaken the mechanical stability and reduce the pathogenicity of biofilms [22].”
Deletion of dltD gene modulates biofilm matrix and acid metabolism to attenuate Streptococcus mutans cariogenicity
Du, J., Huang, S., Li, Y., Qiu, Z., Hao, Y., Huang, J., Zhan, L., Chen, S., & Huang, X. (2026) · Frontiers in Cellular and Infection Microbiology · doi:10.3389/fcimb.2025.1741359 · Cited by 1
Impact of extraction methods on quality of oils and extracts from Zanthoxylum armatum DC. seeds, a natural therapeutics against oral pathogens
Balkrishna, A., Varshney, Y., Verma, S., Nain, P., Srivastava, J., & Varshney, A. (2026) · Results in Chemistry · doi:10.1016/j.rechem.2026.103226 · Cited by 1
Streptococcus mutans CcpA Promotes Biofilm Exopolysaccharide Production and Virulence Gene Expression
Zhang, Y., Chen, Z., Jing, M., Huang, Z., & Mao, M. (2026) · Molecular Oral Microbiology · doi:10.1111/omi.70027 · Cited by 1
“EPS also contributes to limiting the diffusion of lactic acid, resulting in tooth demineralization and thus promoting the occurrence and development of dental caries (Cugini et al. 2019 ).”
Buprenorphine enhances Streptococcus mutans virulence and biofilm formation
Pedrosa, M. D. S., Iannaccone, L. L., Schuls, C. S., & Ribeiro, A. A. (2026) · Journal of Oral Microbiology · doi:10.1080/20002297.2026.2652173 · Cited by 1
“These genes are a key virulence trait of S. mutans because they enable persistence on tooth surfaces and resistance to environmental stress [45,49,58].”
Influential

Authors: Cugini, C., Shanmugam, M., Landge, N., & Ramasubbu, N.
Affiliations: Rutgers, The State University of New Jersey (US)
Corresponding author: Ramasubbu, N.
ORCID: Cugini, C.
Ramasubbu, N.
Venue: Journal of Dental Research
Publisher: SAGE Publications
Published: 2019-04-22
Volume: 98
Issue: 7
Pages: 739-745
ISSN: 0022-0345 (ISSN-L)
1544-0591
DOI: 10.1177/0022034519845001
PMC: PMC6589894
OpenAlex: W2941974751
Cited by: 124
References: 59
Citations by year: 2026: 14 · 2025: 25 · 2024: 15 · 2023: 26 · 2022: 17 · 2021: 19 · 2020: 6 · 2019: 2
FWCI: 0.97
Type: journal article
Language: en
Open access: green
www.ncbi.nlm.nih.gov
Licence: journals.sagepub.com/page/policies/text-and-data-mining-license (tdm)
Locations: Journal of Dental Research (publishedVersion)
PubMed Central (publishedVersion)
PubMed (publishedVersion)
Funders: National Institute of Dental and Craniofacial Research (R21DE027125, DE022544)
Topics: Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Bacterial biofilms and quorum sensing
Health Sciences › Dentistry › Periodontics › Oral microbiology and periodontitis research
Life Sciences › Agricultural and Biological Sciences › Food Science › Polysaccharides Composition and Applications
Keywords: exopolysaccharides, dental plaque, biofilm matrix, Streptococcus mutans, Aggregatibacter actinomycetemcomitans, exopolysaccharide biosynthesis, gene expression regulation, bacterial colonization, pathogenesis, immune evasion, solid-state NMR, super-resolution microscopy
MeSH terms: Humans, Mouth, Polysaccharides, Bacterial, Streptococcus mutans, Aggregatibacter actinomycetemcomitans, Biofilms

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The Role of Exopolysaccharides in Oral Biofilms

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