Oral carriage of cariogenic bacteria and Candida albicans in asthmatic adults before and after anti-asthma medication: A longitudinal study
Open accessAbstract
Background: Antiasthmatic medications such as β2 agonists and corticosteroids have shown potential side effects such as increased caries risk and oral candidiasis. Studies evaluating microbial changes in adult asthmatics are very scanty in the literature. The present study aimed to evaluate the effects of asthma and its medication on cariogenic bacteria and Candida albicans in adult asthmatics. Aim and Objectives: Our aim was to evaluate and compare counts of Streptococcus mutans (SM) and lactobacilli in plaque and C. albicans in saliva samples of adult asthmatics with controls and during the course of medication longitudinally. Methodology: Samples were collected from twenty recently diagnosed asthmatic adults and twenty controls for estimation of microbial counts at baseline and at 3rd and 6th month after initiation of medication among cases. Results: Asthmatics at baseline had higher microbial counts than controls, but the difference was not statistically significant. Comparison between asthmatics at baseline and 3rd month after initiation of medication showed an increase in counts of SM, lactobacilli and decreased C. albicans counts though the difference was not significant. Comparison between asthmatics at baseline and 6th month and also between 3rd and 6th month showed significantly increased counts of SM. Although there was an increase in counts of lactobacilli and decreased C. albicans counts, significant results were not noted. Asthmatics showed increased microbial counts than controls overall. Conclusion: Asthmatics were found to have higher microbial counts than controls at baseline. Increase in SM and lactobacilli counts in asthmatics after medication emphasizes the need to monitor these patients regularly.
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The relationship between inhaled corticosteroids and oral candidiasis is mainly due to decreases in salivary IgA and histamine from immunosuppressant actions, and to suppression of cellular immunity and phagocytosis.
“in addition to suppressing cellular immunity and phagocytosis.”
From Drugs Prescribed for Asthma and Their Adverse Effects on Dental Health (2023) · cites this paper as [50]
The Introduction says corticosteroid use increases the risk of oral candidiasis, and the Discussion identifies cell-mediated immunity and macrophages as host factors in candidal pathogenicity. Neither section says inhaled corticosteroids suppress cellular immunity or phagocytosis, or that reduced salivary IgA and histamine explain the relationship. The Discussion also reports no significant change in candidal counts in this study. (LLM, conf=0.82)
Experimental — accuracy not yet measuredOnly 20% of the inhaled corticosteroid dose actually reaches the lungs; most remains in the oral cavity and oropharynx.
“considering that only 20% of the inhaled dose actually reaches the lungs, so most of the inhaled drug remains in the oral cavity and oropharynx”
From Drugs Prescribed for Asthma and Their Adverse Effects on Dental Health (2023) · cites this paper as [50]
The Introduction discusses oral side effects of corticosteroids, and the Methodology records inhaler use, but neither gives the proportion of an inhaled dose reaching the lungs or remaining in the mouth and oropharynx. Searches for the 20% figure and for lung and oropharyngeal deposition found no supporting passage in our copy. (LLM, conf=0.72)
Experimental — accuracy not yet measuredOral mucosal immunity normalizes upon discontinuation of corticosteroids.
“However, it has been reported that oral mucosal immunity normalizes upon discontinuation of corticosteroids [50,59,89,90,91,92].”
From Drugs Prescribed for Asthma and Their Adverse Effects on Dental Health (2023) · cites this paper as [50]
The Introduction (page unavailable) says corticosteroid use increases the risk of oral candidiasis, and the Results (page unavailable) compare asthmatic adults before and after starting medication. Neither passage addresses whether oral mucosal immunity normalizes after corticosteroids are discontinued. Searches for discontinuation, withdrawal, and immune recovery found no such finding in our copy. (LLM, conf=0.76)
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Research works printed but not linked: 24
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Cited by
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Drugs Prescribed for Asthma and Their Adverse Effects on Dental Health
Pacheco-Quito, E.-M., Jaramillo, J., Sarmiento-Ordoñez, J., & Cuenca-León, K. (2023) · Dentistry Journal · doi:10.3390/dj11050113 · Cited by 33 · see citing works
- Authors
- Nandini, D., Ashuja, R., Vidyasagar, B., Ashwini, R., Donoghue, M., & Madhushankari, G.
- Affiliations
- Regional Institute of Medical Sciences (IN)
- Corresponding author
- Nandini, DB
- Venue
- Journal of Oral and Maxillofacial Pathology
- Published
- 2018
- Volume
- 22
- Issue
- 1
- Pages
- 144
- ISSN
- 0973-029X (ISSN-L)
- PMC
- PMC5917526
- OpenAlex
- W2807198543
- Cited by
- 4
- References
- 0
- Citations by year
- 2024: 1 · 2023: 1 · 2020: 2
- FWCI
- 0.57
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- cc-by-nc-sa
- Locations
- Journal of Oral and Maxillofacial Pathology (publishedVersion, cc-by-nc-sa)
- Europe PMC (PubMed Central) (publishedVersion, cc-by-nc-sa)
- PubMed Central (publishedVersion, cc-by-nc-sa)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Dentistry › Periodontics › Oral microbiology and periodontitis research
- Health Sciences › Dentistry › Periodontics › Dental Health and Care Utilization
- Health Sciences › Dentistry › Periodontics › Oral Health Pathology and Treatment
- Keywords
- asthma, Streptococcus mutans, lactobacilli, Candida albicans, oral candidiasis, beta2-adrenergic agonists, corticosteroids, dental plaque, saliva, caries risk, adults
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