Oral diseases such as dental caries, periodontitis, and oral cancer affect nearly 3.5 billion people worldwide, and the growing problem of antibiotic resistance has reduced the effectiveness of conventional treatments, highlighting the need for safer alternatives. Antimicrobial peptides (AMPs), naturally occurring components of the innate immune system, offer a promising solution as they destroy microbial cell membranes rather than targeting specific metabolic pathways, lowering the risk of resistance. In addition to their antimicrobial action, AMPs also regulate immune responses, reduce inflammation, and promote tissue repair with high biocompatibility. A new study published in Translational Dental Research by researchers from China reviews AMP classifications, mechanisms of action, and their potential applications in treating oral diseases.

According to senior and co-corresponding author Qiang Feng, antimicrobial peptides (AMPs) show broad therapeutic potential across multiple oral diseases. In dental caries, peptides such as Temporin-GHa derivatives, ZXR-2, and GH12 inhibit Streptococcus mutans, disrupt biofilm formation, and support tooth remineralization, while in periodontitis, human-derived and synthetic AMPs effectively eliminate periodontal pathogens, suppress pro-inflammatory cytokines, and promote tissue regeneration. AMPs also demonstrate promise in oral cancer by inducing cancer cell death and modulating anti-tumor immunity, and in conditions like oral candidiasis and mucositis by controlling infection and enhancing wound healing. Several AMPs have already entered clinical trials, and ongoing developments include their use in implant coatings, oral dressings, combination therapies, and even as diagnostic biomarkers, highlighting their expanding clinical potential in oral healthcare.

Despite their promise, the clinical translation of antimicrobial peptides (AMPs) faces several challenges, including reduced stability due to oral enzymes, pH changes, and high salt levels, as well as potential cytotoxicity, immunogenicity, and high production costs. To overcome these barriers, researchers are exploring strategies such as chemical modifications, nanocarrier-based delivery systems, sequence optimization using D-amino acids, and microbial or plant-based expression platforms to enhance stability, safety, and scalability. As noted by Qiang Feng, the multifunctional nature of AMPs and their low potential for resistance position them as a transformative option in oral medicine, with future research focusing on understanding AMP–microbiota interactions, leveraging artificial intelligence for peptide discovery, and designing formulations tailored to the oral environment to support clinical application.

source: https://www.keaipublishing.com/en/news/antimicrobial-peptides-in-oral-medicine-from-mechanisms-to-clinical-translation/