Oral Health Implications in Asthmatic Patients

Asthma is a chronic inflammatory airway disorder affecting millions worldwide and often managed through inhaled medications. While these therapies control respiratory symptoms, they may exert unintended effects on the oral environment. Reduced salivary flow following β2-agonist and corticosteroid inhalation can impair natural cleansing mechanisms, elevating the risk of xerostomia, dental caries and erosion. Acidic residues from dry-powder inhalers further lower plaque pH, promoting demineralisation of enamel. Concomitant mouth breathing and gastro-oesophageal reflux may exacerbate enamel wear and alter the oral microbiome, favouring opportunistic pathogens such as Candida species. Periodontal health is also compromised by immunomodulatory effects of inhaled steroids and local pH shifts, which can induce gingival inflammation and attachment loss. Behavioural factors—poor oral hygiene, high consumption of sugary or acidic beverages and irregular dental visits—amplify these risks. Recognition of these multifactorial influences has led to calls for integrated care that includes routine dental assessments, patient education on inhaler technique and post-inhalation rinsing, alongside targeted preventive measures such as topical fluoride applications and saliva substitutes. Such a multidisciplinary approach aims to safeguard oral health without compromising asthma control.

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Technical terms

Salivary flow: The rate at which saliva is produced, crucial for buffering acids and clearing food debris.

Xerostomia: A subjective sensation of dry mouth resulting from reduced salivary secretion.

Dental erosion: Loss of tooth enamel by chemical processes not involving bacteria, often acid-mediated.

Periodontal disease: Inflammatory destruction of the supporting structures of teeth, including gingiva and alveolar bone.

Oral candidiasis: Fungal infection of the oral mucosa caused by overgrowth of Candida species.

References

1. Efectos Adversos en la Cavidad Oral Derivados de la Terapia Inhalatoria en Menores con Trastornos Respiratorios Crónicos. Revista Veritas de Difusão Científica (2024).
2. Association between Asthma and Periodontitis. Diagnostics (2023).
3. Association between Asthma and Oral Health Symptoms in Adolescents. International Journal of Environmental Research and Public Health (2023).
4. Oral health in asthmatic patients: a review. Clinical and Molecular Allergy (2020).