Therapeutic gases as emerging treatments for oral diseases.

Oral delivery of gas-based therapies provides a targeted, minimally invasive approach to treating oral diseases. Conventional strategies, such as mechanical debridement, antibiotics, and surgical intervention, are limited by the inaccessibility of oral biofilms, the development of antimicrobial resistance, and challenges in promoting tissue regeneration. Therapeutic gases, including oxygen (O2), ozone (O3), nitrous oxide (N2O), nitric oxide (NO), carbon monoxide (CO), carbon dioxide (CO2), hydrogen (H2), hydrogen sulfide (H2S), and argon-based plasma, have emerged as promising options to address these challenges. Each gas exhibits distinct biological effects relevant to dental care, including antimicrobial properties, promotion of tissue healing and regeneration via angiogenesis and collagen synthesis, and anti-inflammatory benefits through modulation of oxidative stress and immune responses. Despite these advantages, significant barriers hinder clinical translation, such as dose control, toxicity at high concentrations, delivery limitations, and the high cost of specialized equipment. To address these challenges, research is advancing innovative delivery systems, such as gas-generating nanoplatforms, hydrogels, capsules, and nano-bubble water, that enable responsive release of the therapeutic gases within the oral environment. Future directions include developing safe, patient-friendly delivery technologies, expanding clinical trials, and establishing a transparent regulatory framework to fully realize the potential of gas-based therapies as effective adjuncts or alternatives to conventional dental treatments.