Impact of inhaler use on dental caries in asthma pediatrics patients: A case-control study

Abstract

Introduction. Asthma is a chronic inflammatory disease that is highly prevalent among pediatric patients. The results about the effect of asthma on the rate of dental caries are contradictory. The objective of this study was to determine the prevalence of dental caries in asthma pediatric patients using inhaled drugs. Population and methods. Case-control study in a sample made up of pediatric patients who attended Centro Médico Naval "Cirujano Mayor Santiago Távara" between December 2014 and March 2015. Patients were divided into two groups: group A (cases) included asthma patients using inhalers as part of their treatment; group B (controls), healthy subjects who attended the same facility. A medical examination was done to determine the type, time, and frequency of treatment and an oral exam, to establish the prevalence of dental caries and the decayed, missing, and filled teeth (DMFT) index. Results. The prevalence of dental caries was 34.2 % in the control group and 28.3 % in the case group (p = 0.094). In relation to the rate of dental caries, the DMFT index in the control group was 4.73 ± 0.32, and 3.98 ± 0.31 in the case group (p = 0.08). However, it was evidenced that a longer duration of inhaler use led to a significantly higher DMFT index (p = 0.04). Conclusions. Inhaled drugs do not increase the prevalence of dental caries in asthma pediatric patients. However, there is a direct relationship between treatment duration and the prevalence of dental caries.

Influence of childhood asthma on dental caries: A longitudinal study

“…Children used glucocorticoid daily and bronchodilatator as circumstances required, making it impossible to study the impact of glucocorticoid or bronchodilatator alone. The results are consistent with previous studies that reported association between increased caries experience and increased frequency and duration of asthma medication use (Chellaih et al, 2016 ; Chumpitaz‐Cerrate et al, 2020 ; Milano et al, 2006 ; Rezende et al, 2019 ) or increased severity of asthma (Reddy et al, 2003 ). Previous studies also reported an inverse relationship between asthma severity and salivary flow rate (Paganini et al, 2011 ), a negative correlation between the duration of medication and salivary pH, and a positive correlation between duration of illness and the salivary levels of Streptococcus mutans in the asthmatics (Botelho et al, 2011 ; Ersin et al, 2006 ), which are well‐known risk factors for increased caries experience (Selwitz et al, 2007 ).…”

Structural Relationships between Asthma and Dental Caries in Children: A Birth Cohort Study in Southern Brazil

“…We believe that those previous studies demonstrating a positive effect of asthma drugs and caries failed to properly control for covariates and did not consider the relations of base-and post-confounders or were conducted in small and convenience samples or used a cross-sectional design in which causality bias is inherent of the design [10,36,37]. Indeed, our finding corroborates with previous studies that failed to detect significant association of asthma with dental caries in primary dentition or pediatric patients [13,32,38]. Despite that, we must see the results with caution since we do not stratify the medication use for single or long-term use.…”

“…[12,13]. Despite the controversial evidence about asthma medicament use, it seems that the treatment duration significantly increases the individuals' caries experience according to previous study [32]. However, it could not be found in a causal way using SEM.…”

Drugs Prescribed for Asthma and Their Adverse Effects on Dental Health

“…Thus, it is considered a public health problem. It has a prevalence of 80% in children and 100% in adults [54,[74][75][76]. The appearance of carious lesions results from an alteration in the balance between dietary-bacterial factors, the components of the host, and the use of various medications [77,78].…”