The cariostatic mechanisms of fluoride

Research into oral mucosa-targeted drug delivery systems (DDS) is rapidly evolving, with growing emphasis on enhancing bioavailability and precision targeting while overcoming the unique anatomical and physiological barriers of the oral environment. Despite considerable progress, challenges such as enzymatic degradation, limited mucosal penetration, and solubility issues continue to hinder therapeutic success. Recent advancements have focused on innovative formulation strategies—including nanoparticulate and biomimetic systems—to improve delivery efficiency and systemic absorption. Simultaneously, smart and stimuli-responsive materials are emerging, offering dynamic, environment-sensitive drug release profiles. One particularly promising area involves the application of glycosaminoglycans, a class of naturally derived polysaccharides with excellent biocompatibility, mucoadhesive properties, and hydrogel-forming capacity. These materials not only enhance drug residence time at the mucosal site but also enable controlled release kinetics, thereby improving therapeutic outcomes. However, critical research gaps remain: standardized, clinically meaningful mucoadhesion/permeation assays and robust in vitro–in vivo correlations are still lacking; long-term stability, batch consistency of GAGs, and clear regulatory classification (drug, device, or combination) continue to impede scale-up and translation. Patient-centric performance—palatability, mouthfeel, discreet wearability—and head-to-head trials versus standard care also require systematic evaluation to guide adoption. Overall, converging advances in GAG-based films, hydrogels, and nanoengineered carriers position oral mucosal delivery as a realistic near-term option for precision local and selected systemic therapies—provided the field resolves standardization, stability, regulatory, and usability hurdles.

The objective of this study was to analyse the pattern of medication prescribing among dental practitioners in the Republic of Croatia and to compare it with general medical practice patterns at the national level. Data on drug prescriptions were obtained from the Croatian Health Insurance Fund. The number of dentist prescriptions, the cost of medicine denominated in the national currency (Croatian Kuna [HRK]), and the number of packages and days prescribed have been included in the analysis. Results indicate that there was an increase in medication prescribing(+5.7%) by dentists, with antimicrobials comprising the majority, whereas national medical antimicrobial prescribing had slightly decreased. Antibiotics accounted for 80% of all dentists' prescriptions, with penicillins being the most commonly prescribed. In particular, amoxicillin with clavulanic acid accounted for 56.4% of all antibiotics prescribed. Such broad-spectrum antibiotics were prescribed more frequently than those of narrow-spectrum. Antibiotics were followed by nonsteroidal anti-inflammatory drugs, with prescribing frequency for ibuprofen increasing by 75%. Current trends show an increase in the overall prescription rate for all medications prescribed by dentists. The largest increase was observed for the broad-spectrum amoxicillin with clavulanic acid, and ibuprofen. As the apparent widespread use of broad-spectrum antibiotics by dentists in Croatia is in contrast to national and international recommendations for antibiotic stewardship, there is a need for further prospective investigation and possible provider education and guidelines.

Antibiotic prophylaxis in dentistry has been recommended for different groups of patients, such as patients with impaired immunologic function, patients at risk of developing infective endocarditis or prosthetic joint infection, patients previously exposed to high-dose irradiation of the head and neck regions, and patients receiving intravenous bisphosphonate and antiangiogenic treatment. The guidelines have been changed over the years, and the list of medical conditions requiring antibiotic prophylaxis has been shortened considerably in the context of antibiotic resistance and unnecessary antibiotic prescription.

The study aimed to investigate the rechargeability of ion-releasing dental material specimens immersed in distilled water for 25 months, which depleted their ion-releasing ability. Four restorative dental materials (alkasite composite, giomer, glass-ionomer, and composite material) presented with 24 specimens were studied after topical treatment with a concentrated fluoride gel. The effect of resin coating on the ion uptake and release was investigated on additional 42 specimens of restorative dental materials with coatings. The composite materials were coated with two adhesive systems, whereas the glass-ionomer was coated with the special coating resin. After topical fluoride exposure, ion release and specimen mass were measured at 1, 2, 3, 4, 5, 6, 7, and 14-day intervals using an ion-selective electrode and an analytical balance, respectively. The cumulative fluoride levels for the uncoated specimens of alkasite composite were significantly higher than those of giomer and glass-ionomer cement, with no statistically significant difference between the latter two materials. The conventional composite had the lowest cumulative concentration of fluoride ions (p < 0.05). The adhesive systems affected the fluoride recharge and reduced the ion concentrations absorbed by the specimens. Specimens coated with universal adhesive showed significantly higher ion release compared to universal fluoride-releasing adhesive or special coating resin for glass-ionomers (p < 0.05). No statistically significant change in specimen mass was observed during the 14-day period. Surface coating with adhesive systems as well as special coating resin for glass-ionomers affects the fluoride recharge process.