Organ transplantation is currently one of the most effective methods of treating end-stage chronic diseases, significantly improving patient survival and quality of life. In particular, kidney transplantation is considered the “gold standard” for treating end-stage renal disease. However, its success depends largely on lifelong immunosuppressive therapy to prevent graft rejection, which is accompanied by both systemic and local complications. Among these, oral lesions are particularly important. They result from both the direct effects of immunosuppressive drugs on oral tissues and microbiome and from reduced immune defenses, which promote infectious processes. The most common are viral, bacterial, and fungal infections, including herpes simplex virus, cytomegalovirus, and Candida spp. Drug-induced complications include gingival hyperplasia, stomatitis, mucositis, and xerostomia. Of particular note is hypertrophic gingivitis associated with cyclosporine and other immunosuppressants, which can significantly impair quality of life and complicate oral hygiene. Reduced salivation also promotes pathogenic microbial growth and increases the risk of inflammatory disease. This review is
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