Effect of Long-term Use of Steroidal Anti-inflammatory Drugs on the Periodontal State: A Review

Abstract

Corticosteroids are chemically similar to endogenous cortisol and mostly prescribed for their antiinflammatory and immunosuppressive properties, which are due to the inhibition of phospholipase A2 activity. These drugs are extensively used in the treatment of a plethora of autoimmune disorders such as rheumatoid arthritis, various breathing disorders and also disorders of connective tissue. In the field of dentistry these drugs are prescribed in most of the mucocutaneous disorders such as they are mostly used in inflammatory diseases such as oral lichen planus, pemphigus, and oral stomatitis to alleviate postoperative discomfort and swelling. These drugs can be administered systemically,topically or asinhalational therapy. Evidence concludes that short term corticosteroids possess antiresorptive properties and its local application shows a favourable effect on the periodontal ligament, but when administered systemically for a long period could lead to periodontal diseases as it has shown to increase attachment with alveolar bone and destruction of transseptalfibers. Oral manifestations are dependent on duration,dose and frequency of use. It is commonly associated withmoniliasis, dental caries,altered taste sensation, ulceration of the tongue, buccal mucosa, and gingiva due to xerostomia,gingival inflammation, periodontal inflammation,and immune suppression. They can either cause dramatic improvement or dramatic adverse reactions which can lead to a considerable increase in the distributionof periodontal disorders. In patients on long-term corticosteroid therapy, oral health is generally not given importance during management. Hence this review explains about various effects of different types of corticosteroids on periodontium used in dentistry.