Background: Drug-induced oral adverse reactions (ADRs) are frequently encountered in dental practice but are often underrecognized or misdiagnosed due to their clinical resemblance to primary oral diseases. As systemic drug use increases, particularly in aging and polymerizate populations, awareness of these reactions becomes essential for timely diagnosis and effective management.

Objective: This review aims to synthesize current evidence on the range, frequency, causative agents, and clinical implications of drug-induced oral ADRs, with an emphasis on diagnostic relevance for dental professionals.

Methods: A structured literature search was conducted across PubMed, Scopus, Cochrane Library, and Google Scholar for articles published between January 2000 and March 2023. From an initial pool of 20 studies, 8 met the inclusion criteria and were analysed. Data were extracted on the type of oral ADRs, implicated drug classes, clinical presentation, and management strategies. A narrative synthesis was used due to heterogeneity in study design and outcome reporting.

Results: The most frequently reported ADR was xerostomia, commonly induced by antihypertensives, antidepressants, and diuretics. Lichenoid reactions, oral ulcers, and mucositis were frequently associated with NSAIDs, β-blockers, and methotrexate. Gingival enlargement was commonly observed in patients taking calcium channel blockers, phenytoin, or cyclosporine. Medication-related osteonecrosis of the jaw (MRONJ) was reported with bisphosphonates and antiangiogenic agents. Tongue disorders, including glossitis and burning tongue, were reported with nervous system and anti-infective medications. Several studies highlighted underreporting and diagnostic challenges due to lack of pharmacovigilance in dentistry.

Conclusion: A wide range of systemic medications can induce clinically significant oral ADRs. Dental professionals must be vigilant in recognizing these reactions, taking thorough drug histories, and collaborating with medical teams for appropriate interventions. Increased education, reporting practices, and awareness of pharmacogenomic variability are essential for improving oral healthcare outcomes related to medication use.

Oral adverse drug reactions, xerostomia, gingival hyperplasia, lichenoid reaction, osteonecrosis of jaw, drug-induced oral lesions, pharmacovigilance, dental pharmacology.

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