Okul Öncesi Dönemde Astım Tanısı İle İzlenen 2-6 Yaş Arası Çocuklarda İnhale Kortikosteroidlerin Ağız-Diş Sağlığı Üzerine Etkilerinin Belirlenmesi

Abstract

Şener, M. The effect of inhaled corticosteroids on oral health in pre-school children, 2 to 6 years of age, with asthma. Hacettepe University, Faculty of Dentistry, Specialty Thesis in Pediatric Dentistry, Ankara, 2016. Asthma is a growing public health problem affecting over 300 million people worldwide. Although individuals from all age groups are affected by asthma, the disease usually begins in childhood. Depending on the increase in the prevalence of asthma, oral problems arising from the use of asthma medications have become a major health problem all over the world. The children, aged 2 to 6 years, who referred to Hacettepe University Medical Faculty Allergy and Asthma Unit were included in this study. 115 children, who have been treated with inhaled corticosteroids for at least 6 months and did not have any other systemic health problems, were examined. After approval of the Local Ethics Committee of Hacettepe University, a questionnaire was conducted to the parents before oral examination. Written informed consents were obtained from the parents and the children were examined using dental mirror and probe under dental unit lighting after air-drying the teeth. Oral health status was evaluated with dmft-dmfs, DMFT-DMFS, ICDAS II, plaque index and gingival index. Furthermore posterior, anterior and canine occlusal relationships were also evaluated. The average duration of inhaler use in children was 19.84 ± 11.46 months. The use of budesonide+lactose inhaler resulted in higher prevalence of caries in permanent teeth than that of fluticasone propionate inhaler (p=0,046). Increased inhaled corticosteroids use was associated with high dmft-dmfs/DMFT-DMFS, plaque and gingival index without statistically difference (p>0,05). However, increased inhaled corticosteroid use was associated with oral candidiasis and it was statistically significant (p=0,027). As a result; inhaled corticosteroid is an important risk factor for tooth decay and gum disease. In addition, due to the effect of immunosuppression, increased usage of inhaled corticosteroid increases the risk of developing opportunistic pathogen candida. Families should be educated about the effects of asthma medications on oral health and should be encouraged for attending to regular dental visits. Also patients should be advised to rinse their mouths after inhaler use.