Pharmacological Approaches To Oral-Systemic Diseases: A Clinical Review Integrating Dentistry And Pharmacy

Abstract

Background: Oral diseases are biofilm-mediated, immuno-inflammatory conditions that persist into later life and serve as reservoirs for systemic infection and inflammation. Their microbiology—ranging from β-lactamase–producing anaerobes (e.g., Prevotella, Fusobacterium) to intracellular periodontal pathogens (Aggregatibacter actinomycetemcomitans, Porphyromonas gingivalis) and opportunistic yeasts (Candida spp.)—creates therapeutic challenges that demand antimicrobial stewardship and interprofessional coordination.

Aim: To synthesize pharmacological approaches for preventing and treating oral–systemic diseases, integrating dental procedures with pharmacist-guided antimicrobial, antifungal, antiviral, and host-modulatory strategies, with particular emphasis on medically compromised patients and cardiovascular risk mitigation.

Methods: Narrative clinical review of pathogen ecology, disease mechanisms, and treatment paradigms across odontogenic infections, periodontal and peri-implant diseases, cancer therapy–related toxicities, and preventive pharmacology, highlighting collaborative models between dentistry and pharmacy.

Results: Effective management hinges on procedural source control supplemented by targeted pharmacotherapy (e.g., penicillin plus metronidazole for β-lactamase–associated anaerobes), locally delivered antimicrobials for periodontal pockets, azole or polyene therapy for candidosis with interaction surveillance, and antivirals for herpetic disease in high-risk hosts. Host modulation (e.g., Subantimicrobial-dose doxycycline) tempers matrix degradation. Pre-treatment dental clearance reduces sepsis and osteonecrosis risks in immunosuppressed or antiresorptive-treated patients. Preventive regimens combine mechanical biofilm control with adjunct antiseptics; chlorhexidine is effective short-term but limited by adverse effects, whereas triclosan-containing dentifrices demonstrate durable reductions in plaque/gingivitis and slower periodontal progression. Periodontal therapy aligns with reductions in systemic inflammatory markers and improved endothelial function.

Conclusion: Pharmacological strategies, embedded within structured dentist–pharmacist collaboration, reduce oral infectious burden, attenuate systemic inflammation, and safeguard complex medical therapies. Standardized protocols and outcome monitoring are essential to optimize whole-person health.