The prevalence of dental caries and periodental disease in asthmatic patient

The prevalence of asthma has been increasing since the 1980. Asthma and tooth decay are the two major causes of school absenteeism. There are few studies present in the literature. The objectives of the present study were to know the severity of dental caries and periodental problems in children before and after taking antiasthmatic medication. The present study was conducted on 105 six-to fourteen year-old asthmatic children to determine the condition of the dental caries and their periodental status. Before and after taking antiasthmatic medication for a period of 1 year and these were matched with their countries, The results showed that salbutamol inhaler shows inceased caries rate with high significance over other groups, which was followed by salbutamol tablets and beclamethasone inhaler respectively. It has been concluded that antiasthmatic medication has its effects on dental caries and periodental disease and asthmatic patients are recommended to adopt more precautionary oral hygiene practices and keep their caries activity and periodental health under constant check.


Introduction
Asthma is a chronic inflammatory condition of the airways characterized by hyper-responsiveness and episodic, reversible symptoms of airflow obstruction. The prevalence of asthma has been increasing since the 1980s across all ages, gender and racial groups and are higher among children than adults. Asthma and tooth decay are the two major causes of school absenteeism. Asthma is viewed by many as a fairly benign disorder; the mortality rate for this disease has almost tripled during the last 20 years, reaching a peak of more than 3,000 annual deaths, This number is projected to be doubled within the next, two decades . (4) Children with chronic medical disorders requiring long-term medication are at a risk of dental caries as a side effect (5) A possible mechanism for an effect on dental .caries cod's be the involvement of padrenoceptors in asthma, with an effect also on salivary gland function, Asthma is frequently treated with B adrenoceptor agonists, which promote bronchial relaxation, B adrenoceptors are also present in the secretory system and have a strong impact on salivary composition . (6) A dose-response effect of the treatment with P2 adrenoceptor agonists is the impairment of salivary secretion and it also has an effect on its composition in asthmatic patients.

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This study was performed with an objective to determine the effect of antiasthmatic medication, i.e., salbutamol inhaler, salbutamol tablets and beclamethasone inhaler on dental caries and periodental disease over a period of 1 year.

Materials and method
A case control study with 1 -year follow-up was chosen, which included 143 asthmatic children as cases, but 38 children did not report after the study period. One hundred five asthmatic children in the age group of 6-14 years were followed up after 1 year, one hundred six controls were taken from different schools

Results
The results revealed that salbutamol inhaler group exhibited increased caries rate with high significance over other groups; which was followed by salbutamol tablet group, which had significant increase in caries as compared to controls, but not significant, compared to beclamethasone inhaler group [  i.e., those children taken from government hospitals. It is well documented that higher socioeconomic groups have better dental health than groups with lower socioeconomic -status (9) In addition, asthmatic children lead a restricted lifestyle, missing so much school not being able to play sports-and participate in formal activities; these children may frequently consume sweets, leading to increase in caries levels. Also, due to increased attention given to their genera! asthmatic condition, they may give little importance to oral hygiene procedures.1105 Drummond suggested that the association between asthma and dental caries is seen primarily in younger children and there is 9 no evidence of an association between asthma and dental caries in older children.
Factors related to chronic asthmatic condition and/or asthma medication might increase the risk of caries . (12) Patients with bronchial asthma are affected both by the disease and the drug.
It is therefore difficult to dissociate the effects of the two, but there are indications that the drug treatment exerts the stronger effect . This study ever is that asthmatic patients using salbutamol inhaler had a significant increase in caries as compared to other groups, which was followed by salbutamol tablets. Ryberg et al, showed that the increase in caries is associated with use of p, agonists, which leads to reduced salivary flow. The secretion rates of whole and parotid saliva is decreased by 26% and 36% respectively in asthmatic patients when compared with healthy control group. As reduced salivary flow is accompanied by concomitant increase in  Conclusion, asthmatic patients using beclamethasone inhaler showed an increase in dental caries, which was not statistically significant as compared to other groups inhaled beclamethasone compromises the oral immunity and interferes with the