A review of chitosan's effect on oral biofilms: perspectives from the tube to the mouth

Background: The oral cavity is a propitious environment for bacteria with different tissue tropisms to colonize and grow due to its diverse surfaces. For bacterial survival in the oral cavity, where tissues are continuously bathed in fluids, biofilm formation is necessary. Dental biofilm, i.e. dental plaque, is notoriously hard to inhibit and traditional oral care solutions are either ineffective at managing oral bio-films or cause secondary effects, such as teeth staining, that make them unattractive. Highlight: Chitosan has high biocompatibility and antimicrobial activity that is heralded by the pharmaceutical industry for its applicability in biofabrication. Therefore, this material is a potential substitute for the antimicrobials traditionally used in oral care. Conclusion: Currently, the body of work on chitosan and the oral cavity ranges from planktonic studies in vitro to biofilm control/removal studies in vivo. With a wide range of topics available for analysis, this review provides a working understanding of chitosan's role in the control and management of oral biofilms.