An Update on Drug-induced Oral Reactions

Abstract

-Adverse drug reactions (ADRs) are one of the major culprits in the development of oral lesions, which can be misdiagnosed with underlying diseases. The goal of this study is to summarize and update the current knowledge about drug-induced oral reactions. Electronic searches were performed in Scopus, Google Scholar, Cochrane and PubMed databases, for articles published between January 2008 and August 2017. Two authors screened the titles and abstracts for eligibility. Finally, 56 studies included in this review. There was no systematic homogeneity in the included studies; thereby no meta-analysis was performed. The most frequent oral ADR was xerostomia, and the most reported cause was antihypertensive medications. Cardiovascular drugs were the most reported culprit agents for induction of oral ulcerative and vesiculo-bullous lesions, followed by methotrexate. Nonsteroidal anti-inflammatory drugs (NSAIDs) and β-blockers were found the most common responsible drugs for induction of oral lichen planus.

Combined treatment of dexamethasone mouthwash and low‐level laser therapy in the management of aphthous‐like ulcers caused by nonsteroidal anti‐inflammatory drugs: A case report

“…Keeping the pill in the mouth for a while without swallowing it directly is the first culprit of oral ulcers. Ulceration can appear on every site of the oral mucosa, be painful, and with time become filled with granulation tissue 1 . Although the exact molecular processes underlying these kinds of oral ulcerations are yet unknown, immune responses might be partially responsible 3 .…”

“…ADRs may affect every part of the oral cavity and are the result of drugs taken either locally or systematically. They may have a variety of clinical manifestations; the most frequent are hyposalivation/xerostomia, burning mouth symptoms, ulcerative lesions, vesiculobullous lesions, red and white lesions, pigmented lesions, and dental anomalies 1 . Adverse effects may be single or multiple lesions.…”

Oral Ulcers as an Unpredictable Adverse Reaction to Quetiapine Use in a Patient With Schizophrenia

“…After complete cessation of quetiapine, the patient's oral ulcers almost immediately began to resolve. There are various medication-related effects that impact the oral cavity, including dry mouth, dental anomalies, and ulcerative lesions 7 . There are 2 clinical classifications of oral ulcers.…”

Generalized hypertrophic lichen planus: an atypical presentation of a characteristic disease

“…The clinical features have been described as the 4 P's: pruritic, purple, polygonal, plaques. Individual papules are generally only a few millimeters but may fuse leading to larger plaques [7]. Faint white lines can be seen of these papules/plaques and eponymously named "Wickham's Striae".…”