# The Effect of Inhaled Corticosteroid Therapy on Periodontal Status in Patients with Asthma
###### Abstract  
Asthma belongs to a broad group of allergic diseases and is the most common chronic disease found in children and adults up to four decades of age. Already published studies suggest that the use of inhaled anti-asthmatic medications affects both general health and oral health. The study included 120 adult patients aged 18 to 71 divided into three groups: 1 \"PERIO-ASTHMA\"--with asthma and periodontitis, II \"ASTHMA\"--with asthma without periodontitis, and control group III \"CONTROL\"--without asthma and periodontitis. The patients were monitored for oral health status for six months. Oral health was assessed by dental indices: DMF index, PI, BoP, PD, and CAL at interproximal sites. Significantly deeper pockets in the lateral segments of the dentition were observed in all study groups. In addition, the bronchial-only group had significantly deeper pockets in the lateral sextants than the control group at all time points. There was no significant worsening of periodontal status by CAL and PD in asthma patients treated with inhalation, irrespective of baseline periodontal status. Depending on the severity of asthma, an increase in BOP was observed in the central sextant in patients without periodontitis. The history of asthma and the use of ICS has an impact on the periodontal status of patients. Keywords:asthma; periodontitis; periodontal status; inhaled corticosteroids; oral hygiene +
Footnote †: journal: Medical  
questioned. The problem is all the more critical because ICSs are currently the mainstay of treatment in children, adolescents, and adults. There are often indications for the use of medium or high doses. It is estimated that 20% of patients with asthma need to take high doses of ICS. Therapy is usually carried out over weeks, months, or even years. The primary function of these agents is anti-inflammatory. These drugs prevent the remodeling and fibrosis of the affected bronchial mucosa and prevent the development of permanent and irreversible changes in the respiratory system. The decision to start treatment with ICSs and determine its intensity and duration should be preceded by a risk-benefit balance [10]. When deciding whether to start treatment with inhaled corticosteroids, potential side effects should be considered. Inhaled corticosteroid therapy results in the deposition of the drug substance in the mouth and throat. Since there is a need to take these drugs for many years, the contact with and effect on the oral cavity is prolonged and repeated [11]. Local side effects of inhaled corticosteroid therapy occur in approximately 10-30% of patients [12]. The primary treatment contributes to the development of candidiasis accompanied by hoarseness and cough, dysphonia, thirst sensation and dry mouth, changes in the composition and rate of saliva secretion, disturbances in the hard tissues of the teeth, periodontitis, and irritation of the oral mucosa and the area around the corners of the mouth [13]. Studies already published indicate that the use of inhaled anti-asthmatic drugs affects general health and oral health. Compared to healthy individuals, patients treated with ICS are characterized by: more severe caries, more frequent periodontal disease, significantly impaired oral hygiene, more frequent malocclusions and parafunction, which are attempts to extinguish stress and emotional disturbances resulting from the symptoms and course of the disease [14; 15; 16]. In conclusion, treatment with ICSs is not an indifferent therapy; however, the benefits of stabilizing the patient's condition and improving his quality of life, controlling respiratory symptoms, and preventing irreversible changes in the airways outweigh the negative effects of the therapy [17]. In the published literature, few studies address the relationship between asthma, chronic use of inhaled corticosteroids, and the presence or development of periodontal disease in adults.