Doctors of various medical specialties often encounter adverse drug reactions in their clinical practice. Methotrexate (MTX) can cause adverse reactions in the oral cavity, primarily erosions and ulcerations. The aim of the study was to analyse scientific literature on the prevalence, pathophysiological mechanisms, risk factors for oral lesions associated with low doses of MTX, their prevention and treatment. It was demonstrated that the most frequent oral adverse reactions associated with low doses of MTX are hard-to-heal painful necrotic and often irregularly shaped lesions of the oral mucosa (including aphthae and ulcers). The spectrum of histopathological changes ranges from nonspecific ulcerations to lichenoid reactions. Treatment of oral lesions induced by low doses of MTX consists in drug withdrawal or dose tapering. Folic acid and local symptomatic therapy can also be used, if necessary. Practitioners should be aware of the potential development of MTX-induced oral lesions, and specific aspects of the drug pharmacokinetics and pharmacodynamics in order to be able to ensure timely detection of adverse reactions and their effective treatment.

Vitamin D has a variety of effects on oral tissues and organs. Cholecalciferol is involved in the processes of formation of enamel and dentin, metabolism of jaw bone tissue, local immunity and antitumor reactions. The functional features of the vitamin D effects reveal the possibility of dental pathology prevention. Objective. To study the literature data on the effect of vitamin D on oral tissues and organs and the possibility of using vitamin D as a drug in the prevention of dental diseases. Materials and methods. The review and analysis of literary sources was carried out by keywords on the electronic resources of the Scopus, Web of Science, MedLine, The Cochrane Library, RSCI databases. Russian and foreign sources were used. The literature review was conducted between August 2021 and March 2022. Results. Randomized studies prove that receptors for vitamin D (colecalciferol) are found on the surface of almost all cells, which explains the pleiotropic effect of vitamin D on the human body. Colecalciferol is involved in the formation of substitutive dentin in the foci of demineralization. The active metabolite of vitamin D has an antitumor effect on the oral tissues, anti-inflammatory and antimicrobial action in periodontal disease. Colecalciferol influences osseointegration during implantation, the processes of osteogenesis and osteolysis during orthodontic treatment. Conclusion. Vitamin D has effects on various tissues and organs of the oral cavity, which gives the possibility to include cholecalciferol in clinical guidelines for dental diseases prophylaxis.

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