Adverse Oral Mucosal Reaction to Sublingual Captopril: A Case Report With Exploratory Insights Into AI-Assisted Clinical Reasoning.
ARG, J., CM, V., CAM, M., PS, P., C, D., & CV, E. (2026). Adverse Oral Mucosal Reaction to Sublingual Captopril: A Case Report With Exploratory Insights Into AI-Assisted Clinical Reasoning.. Special care in dentistry : official publication of the American Association of Hospital Dentists, t. https://doi.org/10.1111/scd.70228
ARG J, CM V, CAM M, PS P, C D, CV E. Adverse Oral Mucosal Reaction to Sublingual Captopril: A Case Report With Exploratory Insights Into AI-Assisted Clinical Reasoning.. Special care in dentistry : official publication of the American Association of Hospital Dentists, t. 2026; doi: 10.1111/scd.70228
ARG J, CM V, CAM M, et al. Adverse Oral Mucosal Reaction to Sublingual Captopril: A Case Report With Exploratory Insights Into AI-Assisted Clinical Reasoning.[J]. Special care in dentistry : official publication of the American Association of Hospital Dentists, t. 2026. DOI: 10.1111/scd.70228.
@article{arg2026,
author = {Júnior ARG and Velane CM and Magario CAM and Pina PS and Domaneschi C and Esteves CV},
title = {Adverse Oral Mucosal Reaction to Sublingual Captopril: A Case Report With Exploratory Insights Into AI-Assisted Clinical Reasoning.},
journal = {Special care in dentistry : official publication of the American Association of Hospital Dentists, t},
year = {2026},
doi = {10.1111/scd.70228},
note = {PMID: 42499297},
}
TY - JOUR AU - Júnior ARG AU - Velane CM AU - Magario CAM AU - Pina PS AU - Domaneschi C AU - Esteves CV TI - Adverse Oral Mucosal Reaction to Sublingual Captopril: A Case Report With Exploratory Insights Into AI-Assisted Clinical Reasoning. T2 - Special care in dentistry : official publication of the American Association of Hospital Dentists, t PY - 2026 DO - 10.1111/scd.70228 AN - PMID:42499297 ER -
AIMS: To describe a probable oral mucosal injury associated with the off-label sublingual administration of captopril in a medically complex patient, and to illustrate the role of structured clinical reasoning in identifying route-related adverse drug reactions, with exploratory insights into AI-assisted reasoning. METHODS AND RESULTS: A 77-year-old patient presented with persistent burning pain and a progressive oral mucosal lesion on the floor of the mouth. Despite appropriate management of local infectious and mechanical factors, symptoms worsened over time. A consistent temporal relationship was observed between lesion exacerbation and repeated sublingual captopril use during hypertensive episodes. Structured clinical reasoning, including iterative causal analysis, supported identification of a probable route-related adverse drug reaction. Discontinuation of sublingual captopril, combined with topical corticosteroid therapy, resulted in complete resolution of the lesion. An exploratory interaction with a large language model was conducted to examine how structured clinical input may influence the coherence and clinical relevance of AI-assisted reasoning. CONCLUSION: Sublingual administration of captopril may cause localized chemical injury to the oral mucosa, particularly in vulnerable patients with complex medical conditions. Recognition of route-specific adverse effects is essential to avoid unnecessary interventions and improve patient outcomes. This case also illustrates that AI-assisted reasoning is highly dependent on the structure and quality of clinical input, supporting its role as a complementary cognitive tool rather than an autonomous diagnostic system.