Guest Author - Cheryl Tidball, DO

Asthma affects not only your lungs, but can have direct and indirect implications for the rest of the body as well, including your teeth. Not only can asthma and its treatment influence the health of the teeth, problems can arise both during and after dental treatment.

Several studies have observed that asthmatics often have a higher incidence of cavities. This is felt to be at least partially due to decreased salivary flow due to the drying effects of beta-agonist inhalers such as albuterol. This in turn may lead to an increase in bacteria in the mouth. Nebulized corticosteroid inhalers can also cause an increase in oral dryness, along with throat irritation, gingivitis (gum disease), and oropharyngeal Candidiasis (oral thrush). This can be prevented by rinsing the mouth after using steroid inhalers. Mouth-breathing, common among asthmatics, is also speculated to worsen gum disease.

Dental treatment may also set off asthma attacks. Ideally, asthmatics should only undergo dental treatment when their asthma is under good control. If an asthmatic is coughing or wheezing prior to treatment, the dental appointment should be rescheduled. Many potential asthma triggers can cause severe problems during treatment even in well-controlled individuals. Tooth enamel dust, sealants, fluoride treatments, and other dental materials have been known to trigger attacks. Local, inhaled, and intravenous anesthesia may also cause asthma exacerbations. Asthmatics should discuss their health status with their dentist prior to treatment about how they should time their inhaled bronchodilators to prevent problems. Make sure to bring your inhaler with you to your dental appointment. Oxygen should be available in case of emergencies. Anxiety can also trigger asthma attacks, so mild benzodiazepines such as Xanax and Valium may be used prior to treatment. Having dental treatments done in multiple short sessions rather than one long session may also be helpful. Asthmatics who are not under good control or who are prone to sudden, severe attacks may need to be hospitalized to have dental treatment done safely.

After dental work, asthmatics may be more prone to oral infections due to the use of inhaled or systemic steroids. Talk to your dentist about whether prophylactic antibiotics might be necessary. Many asthmatics have allergies to aspirin or non-steroidal anti-inflammatories such as ibuprofen and naproxen, so acetaminophen (Tylenol) is usually felt to be the safest mild pain reliever.

Although asthmatics may have special concerns regarding the health of their teeth and how to best manage dental treatment, regular dental checkups and good communication with your dentist should prevent most problems.