Aim: Macrophages play a crucial role in the oral immune defense system, which is essential for maintaining oral health. However, they are also implicated in the onset and progression of various oral diseases. This study investigates emerging trends, key research areas, and potential therapeutic strategies related to macrophages in oral diseases, focusing on OSCC, PD, AP and OTM, using the bibliometric method. Methods: Citation data were obtained from Web of Science Core Collections (WOSCC) database. Bibliometric analysis and visualization of countries/regions, institutions, authors and keywords were conducted by VOSviewer and CiteSpace. Results: Included were 1277 articles published between 1994 and 2023. China and the US led in publication volume and citations. Major research institutions were Sichuan University, Wuhan University (China), and Universidade de Sao Paulo (Brazil). Eun Young Choi and In Soon Choi were the most prolific authors, while Fuhua Yan received the most citations, and George Hajishengallis was most co-cited. Keyword clustering analysis identified OSCC, PD, AP, and OTM as active research areas. Specifically, OSCC research focused on macrophage expression, inflammation, TAMs, and polarization. In PD, TNF-α, P. gingivalis, and macrophage differentiation were prominent. For AP, LPS and osteoclast differentiation were significant. In OTM, T cell involvement and bone resorption were notable topics. Conclusion: This study summarizes macrophage research hotspots in OSCC, PD, AP, and OTM using bibliometric analysis. We outline general treatment directions based on findings, highlighting key achievements and identifying research challenges to provide valuable insights and guidance future investigators.