Pharmacogenomics in Dentistry: From CYP-Mediated Drug Response to Precision Prescribing in Oral Healthcare.

Cytochrome P450 variants, CYP2D6 foremost among them, alter the bioactivation or elimination of drugs commonly prescribed in dentistry, changing both their efficacy and their toxicity.

This narrative review takes stock of pharmacogenomics in oral healthcare, separating clinically actionable applications from emerging or investigational findings. The literature search covered PubMed/MEDLINE, Scopus and Embase for publications from January 2000 to March 2026, focusing on gene-drug interactions for drug classes commonly prescribed or clinically relevant in dental care: analgesics, NSAIDs, antiplatelet agents, anticoagulants, antibiotics and local anaesthetics. The authors hold that most genomic findings on oral diseases give biological insight with limited routine clinical utility, whereas selected pharmacogenomic determinants are more directly applicable. CYP2D6 is the most robust example, influencing codeine and tramadol efficacy and toxicity; CYP2C9 variants may affect NSAID safety, and CYP2C19, VKORC1 and CYP2C9 are relevant in patients on antiplatelet or anticoagulant therapy. SCN9A, CYP3A4/5 and ABCB1 remain investigational, and the authors argue for selective, scenario-based integration, particularly in pain management, adverse drug reactions, polypharmacy and medically complex patients, taking drug-drug interactions and phenoconversion into account.

Synthesis written by Geno'X. For the full original abstract, please refer to the source publication.

There are no new data here: the review is narrative, with no count of included studies and no reproducible selection method, and its value lies mainly in framing a scattered field for a dental readership. The sorting of determinants into actionable and investigational is reasonable, but the real-world usefulness of genotyping before prescribing in dental practice remains unproven for lack of an impact study. For the practitioner, the immediately usable point concerns codeine and tramadol in a patient whose CYP2D6 status is already known.

Analysis by Dr Thibaut Benquey