Inhaled anti-asthmatic therapy and tooth wear in children and adolescents: a case-control study

Objective This case-control study evaluated the association between inhaled anti-asthmatic therapy and tooth wear in children and adolescents, considering medication type, treatment duration, and delivery method. Materials and methods A total of 129 patients aged 3-7 years (primary dentition) and 10-17 years (permanent dentition) were included. The study group comprised 70 asthmatic children receiving inhaled corticosteroids (ICS) or combination ICS/long-acting beta-agonist (LABA) therapy. The control group included 59 healthy children. Clinical interviews and medical records provided data on asthma severity, dietary habits, oral hygiene, parafunctions, and GERD symptoms. Tooth wear was assessed using the Smith and Knight Tooth Wear Index (TWI). Statistical analysis included t-tests, Spearman correlations, and logistic regression. Results Asthmatic patients exhibited significantly more tooth wear than controls (p = 0.0025), particularly on buccal/labial surfaces and in permanent dentition. Wear correlated with combination therapy, high ICS doses, longer treatment duration, and use of dry powder inhalers (DPIs). GERD was more common in asthmatic patients (p = 0.0016) and linked to palatal/lingual wear. Sweetened beverage consumption also contributed to wear. Conclusions Inhaled asthma therapy-especially with DPIs and combination regimens-is associated with increased tooth wear. Emphasizing mouth rinsing after inhaler use and preventive dental care may reduce the risk in pediatric asthma patients. These findings underline the need for interdisciplinary collaboration between medical and dental professionals to minimize oral health risks in asthmatic children.