Caries Prevention by Arginine Metabolism in Oral Biofilms: Translating Science into Clinical Success

Knowledge acquired from microbiological studies of oral arginine metabolism over the past 40 years has recently found its way to clinical application in dentistry. Novel arginine formulations incorporated into dentifrices have proven to be effective as an approach to prevent dental caries. In oral biofilms, arginine metabolism via the arginine deiminase system (ADS) produces ammonia, which inhibits tooth demineralization by neutralizing glycolytic acids and by suppressing the emergence of a cariogenic microflora. Evidence from translational science studies suggests that arginine metabolism in oral biofilms decreases the risk for caries development. These studies have expanded the focus of caries research beyond cariogenic bacteria to health-related, ADS-positive bacteria. The focus of this article is on the contribution of arginine metabolism to pH homeostasis in oral biofilms and its impact on the etiology of dental caries.