We present a case ofStreptococcus sanguinisendocarditis in a 26-year-old female following orthodontic bracing. The rarity and debilitating consequences of endocarditis caused byStreptococcus sanguinisare elaborated. The patient exhibited severe regurgitation with the eccentric posteriorly directed flow, leading to significant cardiac strain, further accentuated by systolic flow reversal in the right superior pulmonary vein. Surgical intervention, including mitral valve replacement, was crucial in addressing the underlying infection, restoring valve function, and preventing further complications. However, a second mitral valve replacement was performed due to recurrent bioprosthesis endocarditis. This case underscores the unique challenges ofStreptococcus sanguinisendocarditis, emphasizing the need for a multidisciplinary approach and individualized decision-making to optimize patient care.