Periodontal Condition in Patients with Bronchial Asthma: Influence of the Disease and Its Pharmacotherapy

Bronchial asthma is a chronic inflammatory respiratory tract disease which affects more than 300 million people worldwide and is expected to increase substantially. Its treatment mainly includes inhaled bronchodilators, corticosteroids and anticholinergic agents that improve patency of airways. Prolonged use of these medications has been linked to negative oral health effects such as decreased salivary secretion, enamel demineralization and susceptibility to periodontal inflammation and candidiasis. However, the mechanisms and degree of periodontal impairment in asthmatic patients under long term pharmacotherapy are insufficiently explored. In spite of the association of asthma drugs with oral changes, few studies have comprehensively assessed the multifactorial effect of asthma drugs on periodontal tissues and salivary function, especially in the populations of Central Asia. The purpose of this study was to analyze the impact of bronchial asthma and its pharmacological treatment on periodontal health taking into consideration the connection between decreased salivation, changes of immunity and periodontal inflammation. Studies have shown that beta-2-agonists and corticosteroids have significant effects in reducing the secretion and protective function of saliva, which results in the accumulation of plaques, enamel demineralization and inflammatory periodontal disease. Inhaled corticosteroids have also been associated with decreased bone mineral density and increased IgE-mediated inflammatory responses. The study shows the regional aspect from Uzbekistan and CIS countries, with a focus on the clinical evidence of periodontal changes in asthmatics and offers recommendations for special preventive measures. Understanding the interaction between asthma treatment and oral health can be used to guide individual preventive and therapeutic approaches to ensure periodontal integrity of patients on long-term inhalation therapy.