Challenges in the Eradication of Enterococcus faecalis and its Implications on Health

ᅟ: Enterococcus faecalis is frequently found in infected root canals of teeth with persistent apical periodontitis. Purpose: To review the challenges involved in the eradication of persistent Enterococcus faecalis infections and their impact on human health. Recent Findings: In the root canal system, Enterococcus faecalis resides in biofilm communities that are able to resist a wide range of harsh conditions and treatments and persist for years. Various virulence and resistance factors provide Enterococcus faecalis capabilities in adherence, colonization, and biofilm formation, which is much more resistant to antibacterial agents than planktonic bacteria. These capabilities explain its persistence in root canal infections. To date, the available therapeutic tools to efficiently eradicate Enterococcus faecalis infections remain limited. Recently, in a model mimicking Enterococcus faecalis root canal infection, novel biofilm inhibitors and dispersing agents, such as D-Leucine, presented superior capability over sodium hypochlorite, the frequently used root-canal antibacterial irrigation solution, in the eradication of Enterococcus faecalis. Summary: These recent studies present promising treatment regimens for Enterococcus faecalis persistent infections.