Can staying on top of oral hygiene help asthma sufferers breathe easy?
While it may not always be top of mind, oral health is something you do not want to unnecessarily compromise. Fortunately, there are some easy ways to help the mouth stay healthy while using asthma medications.
One of the main problems faced by people with asthma in relation to their oral health is a reduction in the quantity and quality of the saliva. Saliva provides protection to the teeth, gums and soft tissues of the mouth, and if there is inadequate saliva produced, a dry mouth can be the result. If the mouth is dry there is more potential for dental decay, erosion, gum disease and oral candidiasis.
Asthma sufferers are at high risk of dry mouth, with evidence showing that some asthma medications, such as beta-2 agonists, can reduce salivary flow. People with asthma are also more likely to breathe through their mouths, which also dries out oral tissue.
If we focus on dental decay and erosion there are some other issues to consider, including the fact that some asthma medications, for example dry powder inhalers, can be acidic, which means that tooth minerals are likely to be lost for up to 30 minutes after each use. If teeth are brushed vigorously during this 30-minute period, the softened tooth enamel can be removed, contributing to tooth wear or erosion.
Asthma sufferers also have a higher incidence of gastro-oesophageal reflux which is well documented as a contributor to tooth erosion.
In an attempt to make the mouth more comfortable and wash away the taste of medication, sugary drinks may also be consumed by asthma sufferers more often than is ideal. This habit can contribute to increasing the risk of dental decay.
Evidence suggests that those suffering with more severe asthma are more prone to oral disease. If a child is very unwell with asthma, there is more likelihood that oral hygiene will become a low priority and may be neglected for a period of time.
Obviously, there are many factors to manage. However, by following a few simple steps, people living with asthma can proactively protect their oral health.
• To help prevent oral disease, visit your dental practitioner regularly (every six months or more), and ask for a preventive program to be put in place including extra fluoride interventions. Fluoride helps to strengthen teeth and makes them more resistant to decay and erosion.
• Chewing sugar-free gum is a great way to stimulate saliva flow and make a dry mouth more comfortable. It is wise to rinse the mouth with water after using your inhaler to wash away residual powder. A fluoride mouth-rinse could also be helpful in protecting the teeth – use it after your inhaler once or twice a day.
• Using a ‘spacer’ device can help to deliver more medication directly to the lungs and has been shown to leave less medication residue in the mouth.
• If your asthma medication has an acidic pH, wait at least 30 minutes after taking it before brushing your teeth. This allows the enamel on your teeth to ‘remineralise’ and become less at risk of being brushed away during your oral hygiene routine.
• Limiting sugary drinks and foods is very important in the fight against tooth decay and has the added benefit of reducing the likelihood of obesity and diabetes.
By following these simple tips, we hope you will be able to keep your teeth strong and not have to worry about another health issue on top of managing your asthma.
Asthma affects one in 10 Australians and 45% have poorly controlled asthma1, leaving them at risk of asthma flare-ups and related health issues, including poor oral health. I urge all dental practitioners to talk to patients with asthma about oral health risks and vice versa. Even people with well controlled asthma may be unaware of the oral health risks and how to reduce them. A two way conversation is very much needed.
1 Asthma control in Australia: a cross-sectional web-based survey in a nationally representative population
The Oral Health Advisory Panel (OHAP), is a group of independent healthcare professionals with the aim of raising awareness of the importance of good oral health and its impact on general wellness. The Panel aims to take oral health beyond the dental clinic.
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