Antimicrobial Peptides as Novel Ecological Approaches to Caries Prevention

Wentao Jiang,1,2 Jintao Liu,1 Aijia Chen,2 Tongxin Zhao,2 Zhenkun Xu,3 Laijun Xu,4 Yijie Du,3 Xin Guan,3 Jingzhe Ding,3 Yuming Liu,3 Dongyuan Sun1 1School of Stomatology, Shandong Second Medical University, Affiliated Hospital of Shandong Second Medical University, Weifang, People’s Republic of China; 2Guanghua School of Stomatology, Sun Yat-Sen University, Guangzhou, People’s Republic of China; 3School of Stomatology, the National University of Malaysia, Kuala Lumpur, Malaysia; 4School of Stomatology, Changsha Medical University, Changsha, People’s Republic of ChinaCorrespondence: Dongyuan Sun, School of Stomatology, Shandong Second Medical University, Affiliated Hospital of Shandong Second Medical University, Weifang, People’s Republic of China, Tel +0086-18328581142, Email [email protected]: Antimicrobial strategies have consistently been a central theme in caries prevention research. Due to their potent antibacterial properties and the potential for multifunctionality through sequence modification, antimicrobial peptides (AMPs) are emerging as promising candidates for anticaries therapeutics. Traditional investigations primarily focused on the broad-spectrum bactericidal efficacy of AMPs to eradicate cariogenic bacteria; however, this approach may inadvertently harm the beneficial oral microbiome. With advancing knowledge of oral microecology, the focus has progressively shifted towards ecological approaches. These strategies aim to selectively modulate cariogenic populations or the disease-associated microbiota while preserving microbial diversity and maintaining ecological balance, as demonstrated in multispecies biofilm models and sequencing-based microbiome analyses. Current innovations include targeting specific pathogens, regulating virulence factors, utilizing bio-responsive mechanisms within the cariogenic microenvironment, and disrupting dental plaque biofilms. This article reviews the current progress and limitations of antimicrobial peptide-based ecological approaches to caries control and offers valuable insights for the future design and optimization of antimicrobial peptides with microecology regulating effects or other promising functions aiding caries prevention.Keywords: antimicrobial peptides, dental caries, anticaries agents, ecological prevention of dental caries, multifunctional peptides