Association between age at asthma diagnosis and tooth loss

The relationship between dental caries with asthma, disease duration, and type of medications in the Azar cohort population

INTRODUCTION

Due to the high prevalence of asthma worldwide, paying attention to oral health is important. This study explores the relationship between DMFT (decayed, missing, and filled teeth) and asthma, disease duration, and related medications in the Azar cohort population.

METHODS AND MATERIALS

In this cross-sectional analytical study, the part of the data related to asthma, disease duration, type of medications, and DMFT were extracted from the Azar cohort study. Azar cohort started among 15,006 adults (35-70 years old) in 2014 in the northwest of Iran. In the present study, all 538 asthmatic people in Azar cohort population included in asthma group and 1076 of non-asthmatic people included in the control group. The outcome variable was DMFT, D, M and F. A negative binomial with loglink was used to adjust the effect of confounding variables in regression models.

RESULTS

Among the asthmatics, 28.3% were using anti-asthmatic medications. In 38.3% of the asthmatic group, the disease duration was ten years or more. In the asthmatic group, the mean DMFT was 23.15 ± 8.67, and the greatest section of the DMFT was related to M component. The relationship of DMFT and M component with asthma, disease duration, and medication were insignificant but D component showed significant relationship with asthma.

CONCLUSION

It can be assumed that the history of asthma does not have an effective role in DMFT index and M component in adults but decayed teeth were higher in asthmatics.

A comparative evaluation of the effects of respiratory diseases on dental caries

PURPOSE

The aim of this study is to evaluate the susceptibility of patients suffering from asthma and chronic obstructive pulmonary disease (COPD) to dental caries by analyzing the physical, chemical, and microbiological characteristics of saliva, which are influenced by the medications they use.

METHODS

A cohort of 104 individuals, spanning from 18 to 70 years of age, underwent a meticulous categorization based on their unique medical profiles and prescribed medication routines. Subsequently, a comprehensive evaluation was conducted to elucidate potential risk factors associated with dental caries. Alongside the assessment of decayed, missing, and filled teeth (DMFT index), decayed, missing, and filled surfaces (DMFS index), and Green and Vermillion Oral Hygiene Index-Simplified (G&V OHI-S) values, measurements were performed to gauge salivary flow rate, buffering capacity, and the presence of S. mutans, L. casei, S. aureus, and C. albicans. The acquired data were then inputted into the Cariogram software, enabling the derivation of personalized caries risk profiles for each individual.

RESULTS

The diseased group exhibited significantly elevated levels of DMFT, DMFS, and G&V OHI-S values in comparison to the control group (p < 0.01). Moreover, the caries risk levels derived from the Cariogram were found to be significantly higher in patients diagnosed with asthma and COPD (p < 0.01). Notably, no substantial distinction was observed between these two experimental groups. Furthermore, it was discerned that COPD patients utilizing two or three distinct medications did not display any discernible variation in terms of their susceptibility to dental caries (p > 0.05).

CONCLUSION

Asthma and COPD patients exhibit an increased susceptibility to dental caries as a result of their medication regimens. Hence, it is highly advisable for these individuals to demonstrate heightened vigilance in terms of oral hygiene practices and seek regular dental check-ups for continuous monitoring and preventive care.

Drugs Prescribed for Asthma and Their Adverse Effects on Dental Health

Asthma is a chronic, heterogeneous respiratory pathology characterized by reversible airway inflammation. Therapeutics focus on symptom reduction and control, aimed at preserving normal pulmonary function and inducing bronchodilatation. The objective of this review is to describe the adverse effects produced by anti-asthmatic drugs on dental health, according to the reported scientific evidence. A bibliographic review was carried out on databases, such as Web of science, Scopus, and ScienceDirect. Most anti-asthmatic medications are administered using inhalers or nebulizers, making it impossible to avoid contact of the drug with hard dental tissues and oral mucosa, and thus promoting a greater risk of oral alterations, mainly due to decreases in the salivary flow and pH. Such changes can cause diseases, such as dental caries, dental erosion, tooth loss, periodontal disease, bone resorption, as well as fungal infections, such as oral candidiasis.

Association between Asthma and Oral Health Symptoms in Adolescents

Oral health is an indicator of patients' overall quality of life. Poor oral health among adolescents with asthma can affect their health in adulthood. This study researched the association between asthma and oral health symptoms in South Korean adolescents. Data from the 2020 Korea Youth Risk Behavior Web-based Survey were used. A total of 44,940 students participated in this study. The dependent variables were self-reported oral health symptoms. Asthma was the primary independent variable based on diagnosis in the past 12 months. The chi-squared test and multivariable logistic regression analysis were used. Students with asthma were associated with oral health symptoms, compared with those without asthma (boys, odds ratio (OR): 1.29, 95% confidence interval (CI) = 1.01-1.66; girls, OR: 1.94, 95% CI = 1.40-2.69). Poor health habits, such as low physical activity, higher sweetened beverage consumption, and fewer sleeping hours, were associated with oral health symptoms. Students who did not receive asthma treatment also had higher oral health symptoms (boys, OR: 1.29, 95% CI = 1.13-1.48, girls, OR: 1.34, 95% CI = 1.15-1.57). Students with absence due to asthma had a higher risk of oral health than those without asthma (boys, OR: 1.31, 95% CI = 1.17-1.46, girls OR: 1.28, 95% CI = 1.12-1.46). Students with asthma had a high risk of poor oral health among South Korean adolescents, suggesting more attention be given to regular dental check-ups and maintaining oral hygiene.

Association between asthma and oral conditions in children and adolescents: a systematic review with meta-analysis

OBJECTIVE

To investigate the association between asthma and oral conditions in children and adolescents.

MATERIAL AND METHODS

Observational studies that evaluated the association between asthma and oral conditions in children and/or adolescents were retrieved from five databases, grey literature and reference lists up to April 7^th, 2022. Meta-analyses were performed, and I² statistics were calculated. The mean difference was used as a measure of effect for continuous variables. Event frequencies were evaluated to determine odds ratios for dichotomous variables. Publication bias was investigated using Egger's test. The methodological quality (JBI) and certainty of the evidence (GRADE) were assessed.

RESULTS

Forty-two studies were eligible, and sixteen were included in the meta-analysis. Mean dmft (MD: 1.11, 95%CI: 0.48-1.73), DMFT (MD: 1.01, 95% CI: 0.45-1.56), dmfs (MD: 3.62, 95%CI: 2.60-4.63) and DMFS (MD: 4.47, 95%CI: 0.98-7.96) indices were significantly higher in asthmatic children and adolescents compared to those without asthma. In the analysis of biofilm, asthmatic children and adolescents had a higher Plaque Index compared to those without asthma (MD: 0.18, 95%CI: 0.03-0.33).

CONCLUSION

Asthmatic children and adolescents may be more likely to develop tooth decay and build up biofilm compared to those without asthma. It is suggested that there are no differences between asthmatic and non-asthmatic children and adolescents regarding gingivitis, developmental defects of enamel or erosive tooth wear. The certainty of the evidence was classified as 'very low'.

CLINICAL RELEVANCE

Knowledge of the risks that asthma and asthma medications for oral health can assist in counselling families of children and adolescents with this condition in terms of control and prevention measures for oral problems.

Association between asthma and severe tooth loss in the adult population of the United States

OBJECTIVE

This study aimed to investigate the association between asthma and severe tooth loss in the U.S. (United States) adult population.

METHODS

Data were analyzed from the national health and nutritional examination survey (NHANES), 2009-2014. Study-participants were classified into current, former, and never asthmatics based on their asthma status. Former-asthmatics were excluded. The case definition of severe tooth loss (outcome variable) was having 9 or fewer remaining permanent teeth. Characteristics of our study-sample were identified based on the descriptive statistical analyses. Logistic regression analyses were performed to examine the association between asthma and severe tooth. Multivariable models were constructed to control for the known common clinical, demographic, and lifestyle factors. Each analysis accounted for the examination sample weights and the complex clustered design of the continuous NHANES.

RESULTS

Total study-participants were 14,184 representing ≈185.77 million U.S. adults. Prevalence of asthma was 8.99% in our study-sample, and 8.78% had severe tooth loss. Current-asthmatic adults had 34% higher odds of severe tooth loss as compared to their reference group of never-asthmatics adults in the U.S. after controlling for age, race or ethnicity, gender, diabetes, smoking, body mass index, education, and family income-to-poverty ratio.

CONCLUSION

In the United States, as compared to never-asthmatic adults, current-asthmatic adults were more likely to have severe tooth-loss. Oral health promotion is therefore recommended through medical-dental integration to ensure overall health for asthmatic adults.

Oral health in asthmatic patients: a review : Asthma and its therapy may impact on oral health

Different drugs used to treat asthma, such as beta 2 agonists and inhaled steroids, may promote a higher risk of caries, dental erosion, periodontal disease and oral candidiasis. This article reviews the evidences of mechanisms involved in oral diseases in patients affected by asthma. The main mechanism involved is the reduction of salivary flow. Other mechanisms include: acid pH in oral cavity induced by inhaled drugs (particularly dry powder inhaled), lifestyle (bad oral hygiene and higher consumption of sweet and acidic drinks), gastroesophageal reflux, and the impairment of local immunity. In conclusion asthma is involved in the genesis of oral pathologies both directly and indirectly due to the effect of the drugs used to treat them. Other cofactors such as poor oral hygiene increase the risk of developing oral diseases in these patients. Preventive oral measures, therefore, should be part of a global care for patients suffering from asthma.

Asthma, chronic obstructive pulmonary disease, tooth loss, and edentulism among adults in the United States: 2016 Behavioral Risk Factor Surveillance System survey

BACKGROUND

Adults with chronic respiratory conditions, specifically asthma or chronic obstructive pulmonary disease (COPD), may be at risk of experiencing poor oral health due to systemic inflammation, challenges in routine oral health care, and adverse effects of medications used to treat these conditions. The authors examined the association of asthma, COPD, and coexisting asthma and COPD (asthma-COPD overlap syndrome [ACOS]) with tooth loss among US adults.

METHODS

The authors conducted a cross-sectional study using 2016 Behavioral Risk Factor Surveillance System data (N = 387,217). The authors categorized the participants with missing permanent teeth into 4 groups: asthma only (n = 38,817), COPD only (n = 19,819), ACOS (n = 13,494), no asthma, no COPD (n = 315,087). The authors used adjusted multinomial logistic regressions to examine the associations between asthma and COPD categories and tooth loss.

RESULTS

According to the authors, 5.3% of study participants reported they were edentulous; 10.7% reported 6 or fewer missing teeth. Participants with asthma only, COPD only, and ACOS had higher odds of reporting tooth loss (6 or more teeth) than those in the no asthma, no COPD group; adjusted odds ratios were 1.12 (95% confidence interval, 1.00 to 1.26) to 2.04 (95% confidence interval, 1.85 to 2.26). A lower percentage of participants with COPD and ACOS visited dentists in the past year than those with no asthma and no COPD. Interactive associations suggested participants with asthma or COPD with dental visits were less likely to report edentulism than those with neither asthma nor COPD and no dental visits.

CONCLUSIONS

Participants with asthma or COPD had higher odds of tooth loss compared with those with neither asthma nor COPD.

PRACTICAL IMPLICATIONS

People with asthma or COPD should maintain routine dental visits to reduce the risk of experiencing tooth loss.

Allergic rhinitis and periodontitis among Korean adults: results from a nationwide population-based study (2013-2015)

BACKGROUND

The purpose of this study was to examine whether allergic rhinitis is associated with periodontal disease in a representative sample of elderly Korean people that was adjusted for socio-demographic factors, oral and general health behaviors, and systemic health status.

METHODS

A total of 10,643 subjects who were between 20 and 59 years of age participated in the Korean National Health and Nutrition Examination Survey and underwent cross-sectional examination. Medical history of allergic rhinitis was collected from participants by questionnaire; additionally, periodontal status was assessed using a Community Periodontal Index score of 3 or 4. Multivariate logistic regression analysis was conducted to adjust for socio-demographic variables, oral health status and behaviors, and general health status and behaviors. All analyses were performed using a complex sampling design.

RESULTS

Allergic rhinitis and periodontitis showed a significant inverse association. After adjusting for all confounders, a trend of decreasing periodontitis risk was observed as allergic rhinitis increased. The adjusted odds ratio of periodontitis was 0.79 (0.66-0.95) for patients with allergic rhinitis.

CONCLUSION

A significant inverse association between allergic rhinitis and periodontal status was demonstrated in this patient population.