Dental caries is a common and costly multifactorial biofilm disease caused by cariogenic bacteria that ferment carbohydrates to lactic acid, demineralizing the inorganic component of teeth. Therefore, low pH (pH 4.5) is a characteristic signal of the localised carious environment, compared to a healthy oral pH range (6.8 to 7.4). The development of pH-responsive delivery systems that release antibacterial agents in response to low pH has gained attention as a targeted therapy for dental caries. Release is triggered by high levels of acidogenic species and their reduction may select for the establishment of health-associated biofilm communities. Moreover, drug efficacy can be amplified by the modification of the delivery system to target adhesion to the plaque biofilm to extend the retention time of antimicrobial agents in the oral cavity. In this review, recent developments of different pH-responsive nanocarriers and their biofilm targeting mechanisms are discussed. This review critically discusses the current state of the art and innovations in the development and use of smart delivery materials for dental caries treatment. The authors’ views for the future of the field are also presented.

Dental caries is a major disease associated with the proliferation of acidogenic bacterial species such as Streptococcus mutans that are part of the commensal microbiota of the mouth. Silver nanoparticles (AgNPs) are attractive antibacterial agents as they target multiple sites in bacteria which reduces antimicrobial resistance. In this study, we synthesised stable, highly positively charged AgNPs capped with branched PEI (BPEI‐AgNPs) and characterized them using UV–vis absorption, transmission electron microscopy (TEM), the size of which were approximately 7.5 nm. The antibacterial activity and anti‐biofilm capacity of BPEI‐AgNPs was investigated against cariogenic bacteria. Our results demonstrated that BPEI‐AgNPs are potent clinical oral antiseptics. The cytotoxicity of the BPEI‐AgNPs was also studied against two mammalian cell lines. The results indicated that BPEI‐AgNPs were non‐cytotoxic and were safer than commercially used dental antiseptics. We conclude that the BPEI‐AgNPs are safe for oral clinical application and are an effective oral antimicrobial agent.