The use of anti-asthmatic inhalation therapy and the risk of dental caries in a group of Polish children: a prospective study

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ABSTRACT

Aim

Assessment of the effect of inhaled therapy with anti-asthmatic medications on the development of caries in children between 3 and 17 years old.

Methods

Study design: The study involved 208 patients, 114 in the study group and 94 in the control group. Data on general health condition of patients, use of medications, dietary habits and oral hygiene were obtained. Information on the onset of asthma, its severity and type, doses and method of administration of asthma medications were obtained from the available medical records by the paediatrician. Dental examination was performed using the DMFT/dmft and DMFS/dmfs index, ICDAS II classification and Nyvad’s criteria for noncavitated white spot lesion differentiation. Additionally, an assessment of salivary S. mutans (SM) and Lactobacillus spp. (LA) was carried out using the CRT Bacteria (Ivoclar Vivadent) test.

Results

The analysis did not reveal any statistically significant differences in the mean values of dmft/ DMFT/ DMFs/ dmfs indices, and in the presence of noncavitated white spot lesions or bacterial colony densities between the groups. However, a significant correlation was found between DMFt/dmft >0 and combined therapy, duration of the inhaled corticosteroid (ICS) therapy and the use of DPIs (p=0.0375*, 0.0459* and 0.0104* respectively). What is more, a positive correlation between DMFT/dmft/DMFS/dmfs indices and the combined therapy, the duration of ICS therapy and the use of DPIs was found. A significant odd ratio of 2.602 (1.078-6.28) (p=0.034*) was observed for the type of drug administration (DPIs) and DMFt+dmft>0 index. Additionally, among the confounding factors, consumption of sweet snacks was the most significant for caries prevalence (DMFt+dmft>0) (p=0.032*, AOR=2.671; 1.087-6.566). Statistics: The analysis was carried out in Statistica 13.3 and the following tests were used: t- student test, C2 test, Mann Whitney U-tests, Spearman’s correlation coefficient (a<0.05). Odd ratio (OR) and adjusted odd ratio (AOR) were calculated.

Conclusion

There is still no clear consensus among the authors as to whether asthma and medications used in its treatment increase the risk of caries. Nowadays, despite better access to various sources of information, there is still a need for increased awareness in patients and medical doctors on the dental care and caries prevention in patients with asthma.

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