The effects of combination treatment with a long-acting beta(2)-Agonist and a corticosteroid on salivary flow rate, secretory immunoglobulin a, and oral health in children and adolescents with moderate asthma: A 1-month, single-blind clinical study

Abstract

Background: Asthma is a common chronic disorder of childhood, and it is frequently accompanied by dental and other oral abnormalities. As such, oral and dental effects of asthma medications have been investigated in several studies. However, the effect of combination therapy with a long-acting beta(2)-agonist and a corticosterold on oral health in children and adolescents has not been reported in the literature. Objective: The aim of this study was to examine whether combination treatment with a long-acting beta(2) agonist (salmeterol) and a corticosterold (fluticasone propionate) administered by dry powder inhaler (DPI) affects oral health in children and adolescents with moderate asthma. Methods: This 1-month, single-blind clinical study was conducted at the Department of Periodontology, Ondokuz Mayis University Faculty of Dentistry, Samsun, Turkey. Male and female children and adolescents aged 7 to 17 years with moderate persistent asthma, as classified by the Global Initiative for Asthma guidelines, were studied before and after 1 month of treatment with combination salmeterol 50 mu g and fluticasone propionate 100 mu g administered by DPI BID. Salivary flow rate and secretory immunoglobulin A (sIgA) level were measured, and periodontal health was assessed by gingival and dental plaque indices for buccal surfaces and periodontal pocket depth. Results: The study enrolled 15 children and adolescents (8 girls, 7 boys; mean [SD] age, 11 years [45 months]; median age, 13 years; [range, 7-17 years]). 1 month, mean sIgA, gingival index, buccal surface index, gingival index, dental plaque index, and periodontal pocket depth were not changed significantly from baseline, whereas mean (SD) salivary flow rate was significantly decreased (from 153.21 [39.29] to 113.16 [46.99] mu L/5 s; P = 0.015) and dental plaque index on the buccal surface was significantly increased (from 1.43 [0.63] to 1.61 [0.67]; P = 0.01). Conclusions: In this small study, combination treatment with salmeterol 50 mu g and fluticasone propionate 100 pg inhaled twice daily was associated with changes in oral health among these children and adolescents with moderate asthma. Regular follow-up of oral health status may be warranted in children and adolescents during long-term use of a long-acting beta(2)-agonist and a corticosteroid.