Asthma

Question 1

What is Asthma?

Answer 1

Defined as a chronic inflammatory condition characterised by variable and reversible episodes of airflow obstruction and bronchospasm

Question 2

What are the symptoms of Asthma?

Answer 2

Wheezing
Shortness of breath
Chest tightness
Coughing

Question 3

What are the dental implications of inhalers?

Answer 3

Caries
–They contain lactose monohydrate (fermentable carbohydrates)
–Beta 2 agonists reduce salivary flow with prolonged use

Question 4

What common medications are patients with asthma on?

Answer 4

Long-term preventative medications - in the form of inhaled corticosteroids (ICS)
Sustained bronchodilation may be achieved by the use of inhaled long-acting beta-2 agonists
Increased symptoms may be treated by shorter acting medications including inhaled beta-2 agonists or anti-cholinergic drugs

Question 5

What contributes to dental erosion in asthma sufferers?

Answer 5

Increased incidence of GORD
Acid reflux can be exacerbated by the increased respiratory effort of coughing, which increases the pressure gradient across the abdomen

Question 6

What can contribute to periodontal disease in patients with Asthma?

Answer 6

A decrease in salivary flow and secretory IgA caused by long term use of asthma medication, reduces its protective qualities
Gingival tissues of asthma patients have elevated IgE levels, which are responsible for periodontal destruction

Question 7

Why do asthmatics have higher incidence of oral candidal infections?

Answer 7

Generally immunosuppressed and the anti-inflammatory effects of corticosteroids
In particular, affected by pseudomembranous candidosis (thrush)

Question 8

What treatment can be contraindicated in children with asthma?

Answer 8

Fluoride varnish application
usually only those requiring hospitalisation with their asthma
due to COLOPHONY (used in certain fluoride varnishes as a natural resin to help varnish adhere to the tooth surface)

Question 9

What is in local anaesthetic that could cause a hypersensitivity reaction?

Answer 9

Sodium Metabisulfate

Question 10

How do you manage an acute asthma attack?

Answer 10

If the patient is conscious, sit them upright and administer 2 puffs of salbutamol (short-acting beta agonist) and repeat if necessary
Do not take them outside- cold air can make symptoms worse
Loosen tight clothing
If they do not start to feel better, take more of the inhaler
If still no improvement, call 999 or 112