Effects of Drugs on Oral Mucosa and Tongue1,2,4
Oral mucosal membranes may be the sole site of involvement, or they may be a part of a more generalized skin reaction to the offending drug. The main type of hypersensitivity reaction that affects oral mucosa is a delayed reaction mediated by sensitized T-lymphocyte. Stomatitis medicamentosa, or fixed drug eruption, occurs with systemic drug usage and stomatitis venenata appears with contact hypersensitivity. Lesions associated with fixed drug eruption are erythematous in mild cases and appear ulcerated in severe cases. The reactions usually appear in 24 hours post-ingestion of the drug. Delayed reaction (up to two weeks) has been noted after use of ampicillin.2 Withdrawal of the causative drug results in resolution of the lesions. Drugs with the potential to cause fixed drug eruptions are shown in Table 1.
| Table 1. Drugs with potential to cause fixed drug eruptions | |
| Barbiturates | Lidocaine |
| Chlorhexidine | Penicillamine |
| Gold | Salicylates |
| Indomethacin | Sulphonamides |
Contact stomatitis is a local reaction of the mucosa after repeated contact with the causative agent. Reactions can be seen as erythematous to ulcerative lesions. The patient may complain of a burning sensation in the mouth together with xerostomia. The reaction may develop from days to years post-exposure to the causative agent. Compounds with potential to cause contact stomatitis are shown in Table 2.
| Table 2. Compounds with potential to cause contact stomatitis include1,2 | |
| Antibiotics | Iodine |
| Antiseptic lozenges | Mouthwashes |
| Chewing gum | Toothpastes (especially those containing cinnamonaldehyde, formalin and herbal components) |
| Cosmetics | Topical anesthetics |
| Dental materials (amalgam, steel wires, beryllium, palladium, platinium, acrylic components) | Topical steroids |
| Food additives | |
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| Page 3 of 22 | |
| Citation Number: Vol. 4, No. 1, Page 012 |
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