# The Effect of Inhaled Corticosteroid Therapy on Periodontal Status in Patients with Asthma
###### Abstract
It seems that the determination of the influence of these drugs on the development of periodonopathic pathology may significantly contribute to the improvement of control, treatment, and prevention of adverse consequences of chronic therapy in everyday dental and periodontal practice. The literature emphasizes the strong association of periodontal disease with normal salivary flow [18]. The influence of asthma on periodontal disease may be due to immunological and inflammatory processes in the patient's organism, taking anti-asthmatic medications, especially inhaled ones, or both [19]. The influence of saliva secretion on periodontal disease, highlighted earlier, is also essential when considering the impact of asthma on periodontal disease. The impairment of the physiology of periodontal tissues may result from a reduced protective effect of saliva, which is combined with increased dry mouth resulting from the process itself, which is asthma, which may cause mouth breathing in the patient, as well as changes in the composition of saliva and changes in the amount of saliva, but may also result from the effects of ICS [20]. This can affect changes in the amount of bacterial and immunological factors, significantly decreasing immunoglobulin A [19]. In addition, changes in the amount of immunoglobulin E and microelements, such as calcium and phosphorus, affect susceptibility to increased tartar accumulation [19]. The increased prevalence of periodontal disease in asthmatic patients, especially those taking ICS, may also be due to the effect of ICS on bone mineral density, including that in the maxilla and mandible [21]. The literature emphasizes that long-term use of ICS, especially in high doses, may increase bone fragility [22]. These facts may suggest an influence on the onset and progression of periodontitis in patients using ICS [23; 24]. Because of the chronicity of therapy, it is worth evaluating the side effects of these medications on the oral cavity and, if possible, trying to reduce or eliminate them. The literature emphasizes the occurrence of various lesions frequently on the labial surfaces of the anterior teeth and the occlusal surfaces of the posterior teeth. Therefore, the authors decided to evaluate the oral cavity as a whole and divide it into frontal and lateral [25]. The purpose of this study was to evaluate the effect of ICS use on periodontal tissue status in different areas of the oral cavity, with particular emphasis on the central and lateral sextants. As a null hypothesis, it was assumed that ICS use by patients with asthma affects the deterioration of periodontal status. The following null hypothesis was postulated: H0--There are no differences in periodontal status between groups of asthma and periodontal disease patients taking ICS, asthma patients without periodontal disease taking ICS, and generally healthy individuals. Alternative hypothesis: H1--There are differences in periodontal status between groups of asthma and periodontal disease patients taking ICS, asthma patients without periodontal disease taking ICS, and generally healthy individuals.