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 (pdmft/dmfs <0.001; pgingival index =0.049; pplaque 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.