<p>The rehabilitation of oral and dental tissues remains a topic of intense debate among practitioners and scientists, primarily due to the intricate anatomical and histological characteristics and the limited regenerative capabilities of these tissues. Extracellular vesicles (EVs) have gained momentum as promising therapeutic surrogates for regenerative cells. The remarkable attributes of EVs, such as their small size, target specificity, immune safety, and prolonged half-life, have positioned them at the forefront of oral regeneration. Nevertheless, the application of EVs through direct administration routes raises significant challenges in the harsh microenvironment of the oral cavity, leading to rapid dispersion of EVs and reduced therapeutic efficacy. The recent decade has witnessed growing interest in the application of tissue engineering for oral health conditions. Scaffolds, which are designed to mimic the extracellular matrix (ECM), have long been used as 3D frameworks for the loading and transportation of cells, drugs, and biomolecules. The integration of EVs with scaffold technologies opens new avenues for oral tissue engineering by ensuring the protected, localized, and sustained release of EVs, while also enhancing their stability in the harsh oral microenvironment. The current review highlights/emphasizes emerging roles of EV-loaded scaffolds in modelling oral and dental diseases. Moreover, we aim to address the current limitations and research gaps of EV-loaded scaffolds in the field of oral tissue engineering, thereby proposing valuable insights and directions for their future use as clinical or off-the-shelf therapeutics.</p>