Most asthma patients and health care practitioners are familiar with the common oral side effects of
inhaled and systemic medications to control asthma. This may be a review for some of you, but may
contain new information for others.
SOME OF THE MOST COMMON SIDE EFFECTS OF INHALED AND SYSTEMIC ASTHMA MEDICATIONS:
1.) Thrush-the dreaded yeast infection that can arise from frequent use of inhaled corticosteroids.
2.) Mucous membrane irritation
3.) Dry mouth
SOME OF THE LESS FREQUENT SIDE EFFECTS:
1.) Low ph — acidity in the mouth
2.) Gastroesophageal reflux
3.) Tongue enlargement
4.) Burning sensation in the mouth or tongue
5.) Mouth breathing
Let’s look at these:
Oral inhaled and systemic medications can alter the “normal” bacterial counts in the mouth allowing the
yeast organisms to dramatically increase. This whitish, painful infection needs to be treated with
medication and is best prevented as we will talk about later.
Mucous membrane irritation is also associated with inhaled medications and can lead to oral infections
in the mouth and even further in the throat and esophagus.
Dry mouth-many medications, not just those associated with asthma, have as a side effect “dry mouth”.
The clinical manifestation of this is a dry mouth can lead to an increase in dental cavities, bad breath,
and gum disease(periodontitis).
In the less common side effect category is the possibility of lower ph in the mouth(higher acidity), again
leading to an increase in dental cavities(caries). Gastroesophageal reflux means that stomach acid
normally contained in the stomach backs up into the esophagus, again causing irritation and burning in
the esophagus and increasing the acid content in the mouth. Tongue enlargement, although rare,
obviously leads to more difficulty in breathing, swallowing, and even speaking . Burning mouth/tongue-
this is a very difficult to diagnose and control condition that is extremely uncomfortable to those
afflicted-making eating and speaking a painful experience. Mouth breathing-once again here we have
the beginnings of dry mouth, increase in dental caries, mouth soreness and the potential of yeast
growth due to the lack of saliva “bathing” the teeth to remove plaque and bacteria.
THEREFORE: BE VERY PROACTIVE IN YOUR DENTAL HEALTH
1.) RINSE YOUR MOUTH THOROUGHLY AFTER USING AN INHALER!!!!!!!
2.) Brush, floss, and rinse after each meal
3.) See your dentist for a thorough cleaning and exam every 3-4 months
4.) Look for “white spots” on the enamel of your teeth-a sign that acids are starting to weaken the
enamel possibly causing future problems
5.) Drink lots of water frequently. We are supposed to have 8 glasses of water(8X8 ounces) every
day-people with asthma should consume at least that and more
6.) AVOID SUGARY FOODS AND SNACKS-THIS IS THE “FOOD” BACTERIA NEED TO ATTACK THE TEETH
AND CAUSE CAVITIES AND GUM PROBLEMS
7.) Try sugarless gum (Xylitol containing) to increase saliva flow and to help clean the teeth if
brushing and flossing are not possible after a meal
8.) Use a spacer for your inhaler and make sure your health care professional has observed that
you are correctly inhaling the medication. This is to insure that the meds are not just stopping in
your mouth, but are actually getting deeply in to the lungs
9.) If you have a history of dental caries, dry mouth, or periodontal disease, talk to your dentist
about using fluoride rinses and/or fluoride trays. This use of topical fluoride can decrease the
possibility of cavities, gum disease and can even decrease sensitivity to cold and sweet things
Charles A. Matlach, DDS
Clinical Director AEGD
Advance Education in General Dentistry
A.T. Still University Arizona School of Dentistry and Oral Health
5835 E Still Circle
Mesa, Az 85206