Immutable string classes in C# are essential for efficiency, particularly because they can share storage for identical objects, reducing overhead associated with creating and destroying temporary objects. In object-oriented programming, seemingly harmless operations can lead to unnecessary object creation, but immutable strings mitigate this issue. Mutable strings, such as those managed by the StringBuilder class, should only be used when the string's contents are expected to change after creation. StringBuilder pre-allocates a large array for characters, minimizing the need for repeated memory allocation during extensive string concatenation, making it significantly more efficient in scenarios involving heavy string manipulation.