Objectives. To identify treatment indications for symptomatic and asymptomatic Florid Cemento- Osseous Dysplasia in adult patients. To explore the relationship between clinical variables, demographics, and radiographic findings. Methods. A systematic review was conducted by an independent investigator using the electronic databases, PubMed, ProQuest, Embase, Web of Science, Dentistry and Oral Sciences Database (DOSS) and TRIP databases to identify cohort, retrospective, and cross-sectional studies on Florid Cemento-Osseous dysplasia treatment options in adults from 2001-2022. Inclusion criteria for this systematic review included: studies must be in English; open-access; published between 2001-2021. The PRISMA guidelines and Joanna Briggs Institute (JBI) Critical Appraisal checklist were used for reporting and quality assessment of each study. Results. From initial 122 studies, 11 fit the criteria and were analyzed for this systematic review. Black females were reported to have significant presentation for FCOD. Mean age of patients was 40 years old. Eight studies reported symptoms as clinical presentation of FCOD, making it the most common. Six studies reported swelling and three studies reported infection. Five studies recommended surgical treatment in symptomatic patients with disturbances around the lesions such as, presence of necrotic bone, secondary infection, or neoplasia. Treatment of asymptomatic FCOD or biopsies were contraindicated in all studies but one, while dental prophylaxis was recommended. Conclusion. For cases of Asymptomatic FCOD, dental prophylaxis and monitoring were the most common treatment options provided. According to existing literature, symptomatic FCOD may be treated through curettage, blood stimulation, or pulp vitality testing of specific areas with periapical inflammation. Continued dental prophylaxis and monitoring were the most common treatment options suggested. More research should be done using experimental and clinical trials to explore proper treatment options for symptomatic and asymptomatic FCOD to draw clear consensus. / Oral Biology