An indication of the safety of various medicines commonly used by dentists in patients with acute porphyria is given. When considering the safety of medicines in acute porphyria, individual patient factors should also be taken into account. Fasting, stressful situations, pain and infection can trigger acute attacks in patients with acute porphyria, and measures to avoid these circumstances are advisable. Local expert opinion is that all topical preparations are considered safe in patients with porphyria, when applied to intact skin or mucosa, but for topical dental preparations, it is often not possible to be certain that the mucosa within the oral cavity is intact, and systemic exposure through swallowing should be taken into account.