Dental caries, a highly prevalent oral disease, impacts a significant portion of the global population. Conventional approaches that indiscriminately eradicate microbes disrupt the natural equilibrium of the oral microbiota. In contrast, biointervention strategies aim to restore this balance by introducing beneficial microorganisms or inhibiting cariogenic ones. Over the past three decades, microbial preparations have garnered considerable attention in dental research for the prevention and treatment of dental caries. However, unlike related pathologies in the gastrointestinal, vaginal, and respiratory tracts, dental caries occurs on hard tissues such as tooth enamel and is closely associated with localized acid overproduction facilitated by cariogenic biofilms. Therefore, it is insufficient to rely solely on previous mechanisms to delineate the role of microbial preparations in the oral cavity. A more comprehensive perspective should involve considering the concepts of cariogenic biofilms. This review elucidates the latest research progress, mechanisms of action, challenges, and future research directions regarding probiotics, prebiotics, synbiotics, and postbiotics for the prevention and treatment of dental caries, taking into account the unique pathogenic mechanisms of dental caries. With an enhanced understanding of oral microbiota, personalized microbial therapy will emerge as a critical future research trend.

龋齿是一种非常流行的口腔疾病，影响着全球很大一部分人口。不加区别地消灭微生物的传统方法破坏了口腔微生物群的自然平衡。相反，生物干预策略旨在通过引入有益微生物或抑制致龋微生物来恢复这种平衡。在过去的三十年中，微生物制剂在预防和治疗龋齿的牙科研究中引起了相当大的关注。然而，与胃肠道、阴道和呼吸道的相关病理不同，龋齿发生在牙釉质等硬组织上，并且与致龋生物膜促进的局部酸过度产生密切相关。因此，仅仅依靠先前的机制来描述微生物制剂在口腔中的作用是不够的。更全面的视角应该考虑致龋生物膜的概念。本文结合龋齿独特的致病机制，阐述了益生菌、益生元、合生元和后生元预防和治疗龋齿的最新研究进展、作用机制、挑战和未来研究方向。随着对口腔微生物群了解的加深，个性化微生物治疗将成为未来的一个重要研究趋势。