Oral Health in Individuals With Asthma

Abstract

Objective. The prevalence of bronchial asthma is increasing globally by 50% every decade. With more individuals presenting with a medical history of asthma and concurrent medication usage, its impact on oral cavity needs to be recognized. The present study was conducted with an aim to assess the oral health status of individuals with asthma aged 12 years and older and to evaluate the effect of various antiasthma medications on oral health. Materials and Methods. Forty individuals with asthma (22 females and 18 males) between 12 and 66 years of age were included in the study after following extensive exclusion criteria. For all subjects a detailed case history was taken. A thorough oral examination was conducted to determine caries experience, periodontal status, and candidiasis. Furthermore, whole unstimulated saliva was collected for pH estimation and cytological smears obtained for the screening of candidiasis. Results. Of the 40 subjects examined, a history of xerostomia was found in 55%, stomatopyrosis in 22%, and halitosis in 5%. The mean DMFT (decayed, missing, filled teeth) was 4.97. Periodontal treatment need evaluation revealed the requirement for oral hygiene education and professional prophylaxis in most of the subjects. However, no significant correlation was found between use of antiasthma medications and periodontal needs. An acidic pH was found in 52.5% of the subjects and candidiasis was detected in 65%. Conclusion. A high incidence of xerostomia, acidic pH, and candidiasis was found in those having asthma. Studies with a larger sample size may help confirm these findings. However, it is suggested that asthma patients on regular antiasthma treatment need special attention in the area of oral health care.

Intraoral pH and temperature during sleep with and without mouth breathing

“…It is also reported to show the maximum variation of intraoral temperature, due to the airflow during inhalation (17,23). Other intraoral sites, for instance the buccal cervical area where caries and erosion are commonly found in individuals with xerostomia due to mouth breathing, should be considered for measurements in future studies (1,2,7,10,11). Moreover, various acidic drinks have been found to increase the risk of erosion.…”

“…Those symptoms arise from ‘sleep‐related xerostomia’, which can be defined as a sensation of dry mouth, associated with a report of throat discomfort, particularly during sleep and awakenings . The evidence suggests ‘sleep‐related xerostomia’ has a link with sleep and respiratory disorders, for example obstructive sleep apnoea (OSA) and asthma, respectively . Such links come from a reduction in saliva production due to circadian rhythm and dehydration of the intraoral cavity, mainly caused by mouth breathing during sleep .…”

“…Patients with OSA are found to spend greater time mouth breathing during sleep (5,6,9). Individuals with respiratory disorders, such as asthma, are also known to spend greater time mouth breathing during daytime and sleep time, compared with healthy people (7,10,11).…”

“…Mouth breathing increases the chance of developing dental caries, gingival inflammation and dental erosion as it results in the saliva drying out, decelerating salivary flow rate resulting in a reduction in the antimicrobial function of saliva and less saliva to buffer the acid . The imbalance of intraoral pH due to the reduced acid‐neutralising ability leads to the destruction of the existing dental integuments as well as dental restorative materials present in the oral cavity .…”

Cross Sectional Study on the Association between Dental Caries and Life Habits in School Age Italian Children

“…In-depth studies have shown that those patients who breathe through their mouth for different reasons complain of having a dry mouth, especially during their sleep or upon awakening [21,22]. These symptoms result from sleep-related xerostomia, which may reduce local antibacterial effects of saliva or reduce its salivary cleansing action [23], leading consequently to a possible increase in dental caries, erosion and gingival inflammation [24][25][26][27][28][29].…”