Background: Streptococcus mutans, a bacterium commonly found in the oral cavity, displays remarkable adaptive capabilities that enable its survival in this unique environment. Maintaining good oral hygiene practices, adhering to hygienic behaviors, and adopting healthy dietary habits have been identified as potential factors for restraining the growth of cariogenic bacteria. While numerous strategies have been developed for managing dental caries, the ultimate goal is to identify preventive agents that can effectively halt the progression of caries and impede the development of new lesions. This review aims to explore the competent behavior of Streptococcus mutans, specifically its role in causing oral infections that can have prolonged effects on systemic health. The establishment, persistence, and strengthening of the interaction between species response and the human system contribute to this phenomenon. The implications of Streptococcus mutans in human health are significant, and as such, this review focuses extensively on its putative virulence factors, the mechanisms by which it exerts its virulence, and the clinical complications associated with its presence. By providing a comprehensive understanding of the molecular mechanisms employed by Streptococcus mutans and the consequences of its colonization in the oral cavity, this review expands our knowledge of the potential systemic implications associated with this bacterium. Ultimately, it calls for the development of targeted preventive strategies to mitigate the negative impact of Streptococcus mutans on both oral and systemic health. © 2025 Elsevier B.V., All rights reserved.