Streptococcus sanguis colonizes several human oral surfaces, including both hard and soft tissues. Large salivary mucin like glycoproteins bearing sialic acid residues are known to bind various S.sanguis strains. However, the molecular basis for the adhesion of S.sanguis to human buccal epithelial cells (HBEC) has not been established. The present study shows that S.sanguis OMZ 9 binds to exfoliated HBEC in a sialic acid-sensitive manner. The desialylation of such cells invariably abolhhes adhesion of S.sanguis OMZ 9 to the cell surface. A soluble glycopeptide bearing short sialylated O-linked carbohydrate chains behaves as a potent inhibitor of the attachment of S.sanguis OMZ 9 to exfoliated HBEC. The resialylation of desialylated HBEC with CMP-sialic acid and Galβ1,3GalNAc α2,3-sialyltransferase specific for O-glycans restores the receptor function for S.sanguis OMZ 9, whereas a similar cell resialylation with the Galβ1,4GlcNAc α2,6-sialyltmnsferase specific for N-glycans is without effect. Finally, ceinyl-sialic acid as a substrate yeilds exfoliated HBFC bearing flurescence as the catalyst. The latter finding demonstrates that this 23kDa cell surface glycoprotein bears NeuNAcα2-3Galβ1-3GalNAc O-linked sugar chains, a carbohydrate sequence which is recongnized by S.sanguis OMZ 9 on exfoliated HBEC. In similar experiments carried out with a buccal carcinoma cell line termed SqCC/Y1 S.sanguis OMZ 9 did not attach in great numbers to such cultured cells, and these cells were shown to not express membrane glycoprotien bearing α2,3-sialylated O-linked carbohydrate chains.