What is Asthma?
Asthma is a common disease involving the airways within the lungs. The airway (also known as bronchial tubes) transports air to and from the lungs. An asthmatic patient’s airway is narrower and is often filled with excessive mucus.
How does Asthma affect the oral health of children?
The medications that an asthmatic child uses could have effects on the oral mucosa.
Oral health considerations for Asthma
- Lack of saliva has been associated with an increase of cavity-causing bacteria therefore higher rates of caries. Children with asthma may have dry mouth due to prolonged use of bronchodilators.
- The use of nebulize corticosteroids can cause throat irritation, difficulty speaking, dry mouth, and increase risk for fungal infection.
- Inhaled steroids have also been associated with higher rates of gingivitis.
- These children may present an increased facial height, high palate, and a higher prevalence of posterior cross bites.
Dental Management and Prevention
Prevention is essential in managing the dental health of the child with Asthma. Scheduling the child for early professional dental examination is recommended.
Tips for Proper Dental Hygiene
- Always bring the child’s bronchodilator (inhaler) with you to all dental appointments.
- After using the bronchodilator or inhaled corticosteroids, it is recommended to rinse with water this will help prevent thrush (fungal infection).
- Apply topical fluoride and visit the dentist every 6 months.
- Parents should begin brushing when the first baby tooth erupts and should assist their child in brushing until the child reaches 8 years of age.
- Use fluoridated toothpaste; for children under 3 years old use a smear amount of fluoridated toothpaste and for children above 4 years old use a pea size amount.
- Parents should monitor dietary practices (i.e. avoid prolonged use of bottle, reduce amounts of sugar consumed, reduce frequency of sugar consumed).
Preparing an Asthmatic Child for a Dental Appointment
Discuss the medications currently being taken with the child's dentist. Your child should take the most recent scheduled dose of asthma medication prior to his/her dental procedure. A medical clearance might be requested for children that have moderate to severe asthma.
Behavior and stress management techniques should be used to decrease the child’s level of anxiety. In some cases inhalation sedation may be useful, ask the dentist about sedation options. Dental treatment (not including emergency treatment) should only be performed if your child is not showing symptoms of asthma.
Cassandra R. Stewart, DDS - Nicklaus Children's Pediatric Dentistry Residency Program
References
Maupome, G., Shulman, J., Medina-Solis, C., Ladeinde, O. Is there a relationship between asthma and dental caries? Journal of the American Dental Association. 2010; 141 (9); 1061-74.
Steinbacher, DM., Glick M. The dental patient with asthma: an update and oral health considerations. Journal of the American Dental Association. 2001; 132; 1229-39.
Center for Disease Control and Prevention website. Retrieved August 21,2017 from https://www.cdc.gov/asthma/default.htm
Casamassimo, P., Fields, H., McTigue, D., Nowak A. In: Pediatric Dentistry: Infancy Through Adolescence. St. Louis: Elsevier 2013.
National Institutes of Health website. Retrieved August 21, 2017 from https://www.nhlbi.nih.gov/health/health-topics/topics/asthma