Dental Therapeutics, Pharmacology and Toxicology

Dental therapeutics integrates pharmaceutical strategies to manage pain, infection, tissue regeneration and inflammatory disorders in oral healthcare. Analgesia is anchored on local anaesthetics—amino-amide and amino-ester agents—whose formulations have evolved with pH buffering, computer-controlled delivery and microneedle platforms to enhance onset, depth and patient comfort while minimising neurotoxicity. Antimicrobial regimens range from antiseptic rinses (chlorhexidine, povidone-iodine) to systemic antibiotics targeting the polymicrobial flora of caries, periodontitis and endodontic infections, balanced against antimicrobial-resistance surveillance. Innovative biomaterials—fluoride-doped nanoparticles, bioactive glasses and self-assembling peptides—drive minimally invasive remineralisation of enamel and dentin. Host-modulation approaches employing curcumin derivatives and resolvins aim to resolve periodontal inflammation without broad-spectrum antibiotics. Toxicological considerations include biofilm reservoirs of multidrug-resistant staphylococci, cellular pathways of anaesthetic-induced neurotoxicity and adverse effects of long-term bisphosphonates. Evidence-based dosing, therapeutic-drug monitoring and interdisciplinary collaboration underpin personalised, safe and effective dental pharmacotherapy on a global scale.

Research from Nature Portfolio

A paediatric randomised trial compared EMLA cream alone, EMLA with microneedle enhancement and conventional palatal block in children undergoing palatal anaesthesia. Both topical regimens halved procedural pain scores versus injection, and the microneedle group reported further reductions in discomfort without loss of anaesthetic efficacy, illustrating a needle-free alternative for aversive procedures. In subgingival microbiology, large-scale profiling of biofilm samples from healthy, gingivitis and periodontitis sites identified staphylococci in nearly half of periodontitis cases. mecA-positive strains frequently co-harboured fibronectin-binding and Panton-Valentine leucocidin genes, with over 10% showing multidrug resistance. These findings establish the periodontal pocket as a non-nasal reservoir for antibiotic-resistant staphylococci and highlight the need for targeted infection-control protocols.

Dental Therapeutics, Pharmacology and Toxicology publication trend

The graph below shows the total number of articles in dental therapeutics, pharmacology and toxicology across all publications each year (not limited to Nature Index journals).

Technical terms

Amino-amide agent: A class of local anaesthetic (e.g. lidocaine, articaine) metabolised by hepatic enzymes, chosen for rapid onset and lower allergenicity.

mecA gene: A chromosomal determinant in Staphylococcus conferring methicillin resistance by encoding an altered penicillin-binding protein.

Buffered formulation: Adjustment of anaesthetic solution pH toward physiologic levels to reduce injection pain and accelerate nerve blockade.

Microneedle patch: A topical delivery system featuring arrays of microscopic projections that transiently disrupt mucosa to enhance drug permeation.

Paresthesia: Prolonged altered sensation (numbness or tingling) sometimes following local anaesthetic nerve exposure or neurotoxicity.

References

1. Evaluation of EMLA cream with microneedle patches in palatal anesthesia in children: a randomized controlled clinical trial. Scientific Reports (2024).
2. Antimicrobial resistance and virulence of subgingival staphylococci isolated from periodontal health and diseases. Scientific Reports (2023).
3. Schwann cells exposed to articaine display distinct toxic pathways compared to lidocaine. Chemico-Biological Interactions (2024).
4. Fluoride-doped amorphous calcium phosphate nanoparticles as a promising biomimetic material for dental remineralization. Scientific Reports (2018).
5. Investigating Bioactive-Glass-Infused Gels for Enamel Remineralization: An In Vitro Study. Journal of Functional Biomaterials (2024).
6. In vitro re-hardening of artificial enamel caries lesions using enamel matrix proteins or self-assembling peptides. Journal of Applied Oral Science (2016).
7. A novel modified-curcumin 2.24 resolves inflammation by promoting M2 macrophage polarization. Scientific Reports (2023).