Oral health status of asthmatic children using inhaled corticosteroids

Abstract

Background. Due to the increase in the prevalence of asthma, especially in childhood, oral health problems arising from the use of asthma medications have become a major health concern. Inhaled corticosteroids are widely used since they are the cornerstone of asthma management. This study aimed to investigate the effects of inhaled corticosteroids on oral health and various factors regarding active ingredients in inhalers, inhaler-spacer device use, rinsing the mouth after administration of inhaler, oral hygiene practices and parents' education on dental caries susceptibility in young children with asthma. Methods. Children with asthma who were treated with inhaled corticosteroids for at least 6 months were included in the study. A questionnaire related to demographic characteristics and oral health practices of children was conducted with parents and the children were examined using a dental mirror and probe under dental unit lighting after air-drying the teeth. Results. Oral health status was evaluated in 115 children, 54 (42-66) months old, 61% male and 39% female with determination of dmft-dmfs, DMFT-DMFS, ICDAS II, plaque index and gingival index. No statistically significant difference was found between sugar-containing and sugar-free inhalers, duration of inhaled corticosteroid use, inhaler-spacer device use, rinsing the mouth after administration of inhaler and dmft-dmfs, DMFT-DMFS, plaque and gingival index (p>0.05). Long-term inhaled corticosteroid use was significantly associated with oral candidiasis (p=0.029). Also, the results showed that mothers' educational level had a significant effect on children's oral health (p dmft/dmfs <0.001; p gingival index =0.049; p plaque index =0.005). Conclusion. Due to the effect of immunosuppression, long-term use of inhaled corticosteroids enhances the risk of development of the opportunistic pathogen candida. Regular dental visits and preventive dental treatments are needed in these patients for healthy oral status.

Oral Candidiasis in Adult and Pediatric Patients with COVID-19

“…Furthermore, dexamethasone is also internalized by Candida cells and can promote the adhesion of the fungus to oral mucosa cells by interacting directly with surface receptors [ 63 ]. Kuna et al [ 64 ] reported that oral candidiasis occurred in 10–30% of patients using inhaled corticosteroids for long times, and according to Doğan et al [ 65 ], 37.6% of children who use inhaled corticosteroids for asthmatic problems develop oral candidiasis. Ciclesonide is converted to its active metabolite (desisobutyryl-ciclesonide) in the lungs and has a strong antiviral effect in the alveoli [ 20 ].…”

Drugs Prescribed for Asthma and Their Adverse Effects on Dental Health

“…Studies indicate that prolonged use of β2-adrenergic agonists can reduce the salivary secretion rate of the parotid gland by 36%. Therefore, as the salivary flow decreases, the levels of salivary amylase, salivary peroxidase, lysozyme, and immunoglobulin A (IgA-S) decrease [2,30,35,36]. Saliva is composed of water and a variety of inorganic and organic components, which aid in the masticatory process and protect dental structures from existing pathogenic microorganisms.…”

The Association Between Long-Term Corticosteroids Use and Dental Caries: A Systematic Review

“…For cross-sectional studies, Doğan et al conducted a study with 115 asthmatic children aged 44-66 months-old using inhaled CSs for 24 months, in which 74.8% were on flixotide propionate and 25.2% on budesonide combined with lactose. At the end of the study, no significant differences in dmft/DMFT scores were noted [ 22 ]. Rezende et al conducted a study comparing 112 asthmatic patients (68 subjects on long-term bronchodilators and beclomethasone inhalers or budesonide inhalers, as well as systemic CSs, 37 receiving bronchodilators only, and seven, were not on any medication) to 116 healthy subjects [ 24 ].…”