Antimicrobial peptides in oral medicine: From mechanisms to clinical translation

Oral diseases pose significant threats to global public health, while conventional antibiotic therapies face increasing challenges from bacterial resistance. Antimicrobial peptides (AMPs) have emerged as promising therapeutic agents in oral medicine due to their broad-spectrum antimicrobial activity, low propensity to induce resistance, and multifunctional properties, including immunomodulation, anti-inflammatory effects, and tissue regeneration promotion. This review examines the classification of AMPs, their antimicrobial mechanisms, and therapeutic applications in treating major oral diseases such as dental caries, periodontitis, oral cancer, oral candidiasis, and oral mucositis. Then, we analyze current challenges in clinical implementation, including stability issues, cytotoxicity, immunogenicity, and production costs, while proposing potential solutions. Finally, we provide perspectives on future research directions to facilitate clinical translation of AMPs in oral medicine and improve prevention and treatment strategies for oral diseases. • Reviews AMP classification, antimicrobial mechanisms, and roles in treating oral diseases. • Summarizes AMP applications in oral medicine. • Analyzes key challenges of AMP clinical translation and corresponding solutions. • Provides research directions to promote AMP clinical use.