Use of inhalers and their effects on oral health

Asthmatic attacks and respiratory problems are uncomfortable and even serious situations that nobody wants to suffer. Congratulations, There are treatments that reduce symptoms. But did you know that inhalers can affect oral health?

It is very common for asthmatic patients to receive inhalation treatments. This effective and easy-to-administer drug greatly improves breathing. However, its use can have consequences for oral health. What is this? On this occasion we detail its main side effects.

Inhalers for the treatment of asthma

Asthma is a chronic disease that affects the respiratory system. It is characterized by an increased inflammatory response of the airways to various environmental triggers.

Difficulty breathing, wheezing, coughing and chest pain are the main manifestations of this disorder. It can affect people of any age, although it is most common in childhood.

Often, its treatment includes the use of inhalers. These are devices filled with a drug that reduces airway inflammation and promotes bronchodilation.

In this way it improves the symptoms, facilitates breathing and prevents the progression of the disease. Even during asthma attacks they can save the life of the affected person.

The choice of drug It depends on the severity of the disease and the particularities of each case. Some options are as follows:

  • short-acting bronchodilators.
  • Steroidal anti-inflammatory agents.
  • Long acting bronchodilators.
  • Leukotriene modifiers.

The most common route of administration is inhalation. As, remains of these drugs are deposited in the oropharyngeal areawhich can cause unwanted local effects.

Depending on the drug used, the doses administered and the susceptibility of the patient, side effects can appear in different parts of the body. In this article, we will focus on the impact of inhalers on oral health.

The inhaler can contain different types of medicines. Its purpose is to improve the symptoms suffered by patients with asthma or other respiratory conditions.

Effects of inhalers on oral health

The use of inhalers to treat non-infectious respiratory diseases such as asthma and to prevent acute attacks has an indirect influence on oral health. The drugs cause changes in the oral environment. As a result, adverse reactions appear in the dental tissues and mucous membranes.

The increased risk of suffering from certain oral diseases is mainly related to the reduction in salivary flow. Even with the use of drugs that lower the pH. However, you should know that your lifestyle and the presence of other health conditions also affect your risk.

Below, we mention the most frequent oral health problems in patients treated with inhalers.

Xerostomia or dry mouth

It is very common for patients suffering from asthma to breathe through their mouth as well. This usually happens like response to difficulty breathing and getting all the air they need.

Prolonged and habitual mouth breathing leads to dry mouth. Also, some medications in inhalers reduce saliva production, which aggravates dry mouth.

A mouth without adequate lubrication is not only uncomfortable for the patient but also it hinders oral functions and leaves the oral structures unprotected. In particular, it leads to the following:

  • Decreased mechanical cleaning action.
  • Difficulty maintaining neutral pH.
  • Inhibition of the defense mechanisms of this fluid.
  • Formation of bacterial plaque.
  • Oral diseases, such as tooth decay, gingivitis and halitosis (bad breath).

Alterations of the oral mucosa

Another of the effects of inhalers on oral health are the lesions that can be caused in the oral mucosa. The continued use of corticosteroids added to oral dryness – which we have already talked about – favor the appearance of these alterations:

  • Canker sores and mouth sores, especially on the cheeks.
  • Sore throat.
  • dysphonia.
  • Macroglossia (increase in the size of the tongue), although less frequently.

Bad breath or bad breath

Bad odor in the mouth is another of the oral health effects associated with the use of inhalers. In the absence of adequate lubrication and cleansing through saliva, volatile sulfur compounds are produced which cause bad breath in these patients.

A dry mouth favors the growth of bacteria and the accumulation of food residues on the oral surfaces. These germs and debris trapped on the tongue, gums and teeth, if not removed, cause a bad smell in the mouth.

gum disease

Periodontal disease is another consequence to consider from the use of these drugs. The affection of the supporting tissues it occurs as a consequence of the interaction of several situations encountered in the asthmatic patient.

Indeed, there is a great association between asthma and periodontal disease. This is due to the imbalance of inflammatory and immune processes and the side effects of the drugs contained in the inhalers.

Oral breathing, decrease in saliva, alteration of its composition and defensive capacity, as well as accumulation of bacterial plaque.These situations coincide and favor the onset of periodontal disease.

Some Education suggest that bacterial plaque accumulation is greater in asthmatic children. The inflammation of the gums would arise as a response to this excess of germs on the oral surfaces.

Gingivitis associated with the use of inhalers it is more frequent in the anterior-superior area of ​​the jaw. It manifests itself with swollen, red, shiny and bleeding gums. There may also be gum recession and tooth sensitivity.

And in more advanced and untreated cases, the process can evolve into periodontitis. There is a higher risk of suffering from this condition the more severe the asthma condition is. Here the deep tissues that support the teeth are compromised, which can lead to loss of the elements.

However, the use of inhaled corticosteroids Is associated to reduced bone mineral density. This jaw alteration could have an impact on the onset and progression of periodontal disease in asthmatic patients.


Dental caries is one of the most common chronic pathologies in the entire world population. It not only affects the teeth, but also affects the general health, nutrition and quality of life of those who suffer from it.

This disorder is multifactorial in origin. The confluence of bacterial, dietary, behavioral, anatomical and genetic factors They lead to mineral loss of the hard tissues of the teeth.

there’s a strong association between asthma and dental caries, especially in children. And this ratio increases in the most severe cases and with longer treatments.

However there are other studies who failed to find a correlation between asthma and caries. It is true that, since it is a pathology caused by various factors, whether or not the disease looks varies from person to person.

The decrease in salivary flow, the increase in bacterial plaque and the added sugar in some drugs are factors that favor the development of the pathology in asthmatic patients.

Caries in a teenager.
Caries is one of the frequent diseases among patients who regularly use an inhaler.

dental erosion

Dental erosion is the loss of enamel and dentin as a result of the action of acids present in the mouth. An oral pH lower than 5.5 is able to demineralize the dental tissues.

People who use inhalers can suffer from this type of oral health problem, as the changes in the saliva caused by the medicine contribute to the occurrence of the disorder.

In fact, asthmatic patients not only have less saliva; the composition of the fluid is also altered. Most inhaled drugs create a pH below 5.5.

Therefore, their saliva tends to be more acidic and they have a harder time neutralizing the action of intrinsic acids, such as stomach acid that can reach the mouth through gastroesophageal reflux. The extrinsic acids in sodas, juices and fruits suffer the same fate.

The stretch relation also between asthma and gastroesophageal reflux favors this oral acidity which demineralizes the teeth. In this sense, it is advisable to look for external measures that help neutralize the pH to reduce dental erosion. For example, the following:

  • Do mouth rinses with baking soda.
  • Use neutral sodium fluoride mouthwashes after using inhalers.

yeast infection

The inhalation of steroidal anti-inflammatories has a great influence on the development of this mycosis in the mouth. Infection with the fungus called candida albicans It is common in areas where aerosol is deposited.

There is a correlation between the degree of candidiasis and the frequency of corticosteroid use. The changes this medicine causes in saliva have been observed to decrease the protection against this infection. Therefore, patients experience symptoms such as throat discomfort and difficulty swallowing.

How to prevent the effects of inhalers on oral health?

There are some measures that can help prevent side effects from occurring in oral health due to the use of inhalers. The most important ones are discussed below.

  • Drink enough water: To counteract dry mouth and its consequences in the mouth, it is necessary to be properly hydrated.
  • Rinses after inhalation: rinsing the mouth with water, a baking soda solution, or a neutral fluoride mouthwash helps remove drug residue. It also decreases the feeling of dry mouth and the acidity of the oral environment.
  • Chewing sugarless gum: chewing favors the production of saliva. Using sugar-free chewing gum can reduce dry mouth.
  • Use spacers: When applying the drug, the use of spacers reduces the contact of the drug with the oral cavity. These are devices that allow the dose to be directed more directly to the respiratory tract.
  • Maintain good oral hygiene: brushing your teeth, gums and tongue helps remove plaque bacteria. It is also important to use dental floss and fluoride toothpastes.
  • Take care of the diet: Acidic foods and drinks rich in simple sugars should be avoided, which favor the proliferation of bacteria and acidify the oral environment.
  • To visit the dentist: Seeing your dentist regularly and providing your medical history will help you manage oral health problems associated with inhaler use. Timely treatment and the application of preventive measures will avoid complications.

Avoid negative effects of inhalers on oral health

Treatment of asthma reduces respiratory symptoms and prevents acute attacks. But drugs that stay in the mouth when using inhalers also cause unwanted effects on oral health.

Be aware of these possible consequences of your asthma treatment It allows you to anticipate its appearance. With proper care, many oral diseases can be prevented. Thus, you will not only be able to breathe better, but also calmly smile.

The post Using Inhalers and Their Effects on Oral Health first appeared in research-school.



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