eng Oriental Scientific Publishing Company Biomedical and Pharmacology Journal 0974-6242 2025-09-30 18 3 1835 1848 10.13005/bpj/3218 67620 article Ahmed Shaher Alqahtani 1 Department of Oral and Maxillofacial Surgery and Diagnostic Sciences, College of Dentistry, Jazan University – Saudi Arabia. Oral mucosal diseases such as lichen planus, aphthous ulcers, and mucositis are chronic conditions that markedly impair quality of life and often require long-term treatment. Conventional systemic therapies frequently lead to poor targeting and adverse effects, while standard topical formulations face rapid clearance, poor retention, and low patient adherence. To overcome these limitations, research has focused on key strategies such as site-specific mucoadhesion, stimuli-responsive (‘intelligent’) release, and advanced carrier engineering. Mucoadhesive patches, films, and nanoparticles improve drug residence time and precision targeting. Thermo-responsive hydrogels and stimuli-sensitive systems enable sustained release in response to temperature, pH, or enzymatic changes, aligning with real-time disease activity. Advanced carriers like liposomes and lipid-based nanoparticles protect labile drugs and improve mucosal penetration. Innovations such as 3D printing and biosensor-integrated smart patches further personalize oral drug delivery, enhancing both efficacy and patient compliance. This review highlights the current advances in topical drug-delivery systems for oral mucosal diseases and illustrates how biological barriers, materials science, and digital-health technologies intersect. The aim of this comprehensive review is also to discuss emerging platforms and to identify translational gaps that will guide future precision-based mucosal therapeutics. https://biomedpharmajournal.org/vol18no3/topical-drug-delivery-in-oral-mucosal-diseases-challenges-carriers-and-innovations-a-comprehensive-review/ Bioadhesives Drug Carriers Gels Hydrogels (MDDS) Mucoadhesive Drug Delivery Systems Nanoparticles Patches Thermosensitive Hydrogels