Asthma is a common respiratory challenge with major implications for oral health. It , affects an estimated 2.7 million people in Australia, or 11% of the population, according to data from the 2020–21 National Health Survey (NHS) and the Australian Bureau of Statistics (ABS) in 2022. Despite being prevalent in the community, its impacts on oral health go largely overlooked.

Managing the ins and outs of asthma is already a significant task, and dealing with additional health issues is the last thing anyone wants. The risks extend beyond respiratory concerns to oral health problems like tooth decay, tooth erosion, gum disease and oral thrush. This is mainly due to dry mouth, a condition triggered by reduced saliva levels. Habits such as regular mouth breathing and certain side effects from asthma medications may contribute to oral dryness, requiring a comprehensive approach to health.

Fortunately, exceptional oral hygiene and preventative care can significantly minimise the risks and help maintain the health of your teeth and gums.

Asthma

Asthma is a chronic respiratory condition characterised by inflammation and narrowing of the airways, which makes breathing difficult. This chronic inflammation can result in recurring episodes of wheezing, shortness of breath, coughing and chest tightness. Asthma symptoms can range from mild to severe, and they often vary over time. Triggers for asthma symptoms can include exposure to allergens, respiratory infections, exercise and environmental factors.

Management typically involves long-term control medications and quick-relief (rescue) medications to alleviate symptoms during asthma attacks. It’s a common condition affecting people of all ages, and while there is no cure, proper management allows individuals with asthma to lead active and healthy lives.

Nursing Old Woman

Asthma medications and your oral health

Using inhaler medications is crucial for managing asthma. However, roughly 80% of the inhaled dose doesn’t make it to the lungs; instead, it lingers in the oropharynx (soft palate, tongue base, tonsils and the throat’s back). This leftover medication in the mouth can impact salivary characteristics, the oral microbiome and gum hygiene.

Saliva, a crucial component for oral health, helps wash away bacteria and maintain the correct pH in the mouth. Reduced saliva flow, often caused by inhaled medicines, can result in dry mouth, increasing the risk of dental issues. Conditions such as dental caries, dental erosion, periodontal (gum) disease and oral candidiasis (thrush) may be exacerbated when there is a lack of saliva.

Although not all asthma medications cause dry mouth, the risk might vary depending on the specific medication and how you use it. Remember to consult your dentist and doctor for personalised advice and potential adjustments to medications or treatment plans.

Common oral health concerns for asthmatics

1. Dry mouth

A prevalent problem among asthmatics is the decrease in saliva flow caused by the use of bronchodilators, such as beta-2 agonists. Staying hydrated throughout the day is crucial to counteract dry mouth. Rinsing your mouth with water after using your inhaler can be helpful, but other methods like using a spacer might also be effective depending on your medication. Talk to your doctor or dentist about the best approach for you.

2. Sensitivity to hot, cold or sweet foods

The erosion of dental enamel due to acid exposure is more noticeable in individuals with asthma who use inhalers or nebulisers. To mitigate this heightened sensitivity, it’s essential to control inhaler usage, uphold excellent oral hygiene practices and exercise caution when consuming acidic foods and beverages.

3. Inflammation of gums and pockets between teeth

Periodontal diseases like gingivitis and periodontitis are associated with asthma. Watch for signs such as red, inflamed gums, bleeding while brushing or pockets between teeth. Regular dental check-ups and thorough oral care routines can help reduce these risks.

4. Painful swallowing and white bumps on the throat

Oral candidiasis, or thrush, can result from using inhalers that contain sugars. Consistent inhaler use may introduce sugar to the throat, creating an environment conducive to candida growth. To prevent and manage thrush, it is essential to maintain good inhaler hygiene, rinse your mouth after use and consult with your dentist for professional guidance.

5. Toothaches, pits or discolouration on teeth

Increased susceptibility to cavities is a concern for asthmatics, especially if their inhalers contain sugars. Adhering to proper oral care, staying mindful of dietary choices and addressing dry mouth can significantly reduce the risk of cavities.

Asthma medications and your oral health

Protecting your oral health while managing asthma

  • Stay hydrated: Make sure you're drinking enough water throughout the day to combat that dry mouth feeling.
  • Rinse your mouth: After using your inhaler, do a quick water rinse or brush your teeth. It helps offset the impact on saliva flow.
  • Optimal inhaler use: Be mindful of how you use your inhaler. Consider using a spacer to minimise how much medication comes into contact with your mouth.
  • Regular dental check-ups: Don't forget to book your dental visits ideally every 6 months or as recommended by your dentist. These visits are essential for catching and dealing with any oral health issues early on, ensuring your general oral health remains in good condition.
Senior woman tooth discolouration

Striking a balance for comprehensive well-being

Asthma doesn’t solely affect your lungs; it subtly yet significantly influences your oral health. Understanding these connections and taking preventive action allows you to maintain a healthy balance between addressing asthma symptoms and preserving your oral well-being. Make sure you do a great job managing the impacts of asthma on your oral health by discussing this aspect of your health with your healthcare providers and dentist.