Elsevier

Dental Abstracts

Volume 62, Issue 2, March–April 2017, Pages 91-93
Dental Abstracts

Hands On
Treating asthma patients

https://doi.org/10.1016/j.denabs.2016.07.034Get rights and content

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Background

Asthma is a common chronic inflammatory condition characterized by variable and reversible episodes of airflow obstruction and bronchospasm. Patients experience wheezing, shortness of breath, chest tightness, and coughing, often after a specific trigger. Worldwide an estimated 300 million persons are affected and the number is increasing. Estimates indicate that up to 75% of the hospital admissions for asthma could be avoided and up to 90% of deaths could be prevented. The classification,

Classification

Although the traditional classification of asthma considered symptoms only, the Global Initiative for Asthma (GINA) now classifies asthma as controlled, partly controlled, or uncontrolled. Thus a patient with controlled asthma would experience minimal symptoms, no exercise limitation, minimal need for rescue medications, nearly normal lung function, and few exacerbations of his or her disease.

Medications

Most asthma patients take a form of long-term preventive medication, usually an inhaled corticosteroid to prevent exacerbations of their symptoms. Inhaled long-acting beta-2 agonists may achieve sustained broncodilatation. When symptoms increase, shorter-acting medications are given. These include inhaled beta-2 agonists or anticholinergic drugs. Depending on the severity of symptoms, other agents patients may require include inhaled mast cell stabilizers, oral anti-leukotriene agents, systemic

Dental Conditions

The current evidence indicates that asthma doubles the risk of dental caries in primary and permanent dentitions. However, the mechanism by which this occurs is likely multifactorial. A reduced quantity and quality of saliva may increase caries risk. Some inhalers contain fermentable carbohydrates to mask the bitter taste of the medication and improve patient tolerance, but they also provide a medium for caries development. Asthmatics may also have a higher colonization with the cariogenic

Management Guidelines

Fluoride varnish application can be contraindicated in children with severe asthma because the colophony (i.e., rosin) used in some preparations may trigger a sensitivity reaction. In addition, clinicians should follow stress reduction protocols with these patients to avoid triggering any acute asthma attack. For patients with mild to moderate asthma, nitrous oxide inhalation sedation is appropriate in most cases, but for those with severe asthma, consultation with a medical care provider is

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Harrington H, Prado N, Barry S: Dental treatment in children with asthma—a review. Br Dent J 220:299-302, 2016

Reprints available from N Harrington, Oral and Maxillofacial Surgery, Countess of Chester Health Park, Liverpool Rd, Chester, CH2 1UL; e-mail: [email protected]

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