There are over 30 different puffers known as inhalers that are available to treat respiratory disease in Australia, to treat asthma and chronic pulmonary disease (COPD), which are very common conditions.
The ingredients in the inhalers have significant effects of dental health, so it is important to let your dentist know the brand name of any inhaler that use, even if it is occasionally.
Most of us are familiar with the typical asthma inhaler Ventolin, which has been around for 60 years and is still widely used, and which relieves the constriction that causes ashtma in the short term. Most patients are now managed with long acting preventive medicines to control the inflammation in the lungs, rather than waiting for acute symptoms and treating those.
Most inhalers are either bronchodilators - to open up the airway, or anti-inflammatories. Ashtma medications are called RELIEVERS or PREVENTERS. COPD medications are known as RELIEVERS and MAINTENANCE.
Inhalers devices appear simple, but are quite difficult to use correctly, which then created a decreased effect, and places the active ingredients in the inhalers into the mouth, which increases the chance of adverse effects on the teeth. Spacers are used to make inhalers easier to use, to provide a pressurised metered dose, and to reduce the effects on the mouth. Nebulisers are no longer recommended.
The common dental side effects of inhalers are dry mouth, dental decay, periodontal disease, taste changes, changes in the tissues in the mouth and ulceration, bad breath, changes to the voice and fungal infections in the mouth.
The very large problem is the dry mouth that they cause because the saliva flow slows down. Firstly this causes difficulty in talking, eating, swallowing, altered taste, soreness in the mouth, ulceration, sores in the mouth and tissue breakdown. To try to prevent these issues using a correct technique, spacer devices, dose reduction, and increased hydration with water. There is an increased risk of tooth decay in permanent teeth in children and adults if inhalers are used in the long term because of the slow down and changes to the saliva, the acidity of plaque bacteria in the mouth, the suppression of the immune system from steroid use, and even the powder depositing on the teeth is thought to increase bacterial activity in the mouth.
When we form a treatment plan, we assess all impacts on your mouth, and it is important to record the brand name of any inhaler, because it indicates the exact type of device being used, and a different technique or lower dose may create a better environment in the mouth.