Impact of inhalation therapy on occurrence of oral manifestations in patients with bronchial asthma, in Jeddah, Saudi Arabia

Abstract

Background: Inhalation therapy for asthma includes cortisol and bronchodilators. High dosage and long duration of inhalation therapy has been linked with several adverse effects on the oral tissues. Objectives: To explore the oral manifestations associated with the use of inhalation therapy among patients with asthma in Jeddah city. Method: This was a cross sectional study; the non-probability convenient sampling method was used to select 215 subjects (99 with Doctor diagnosed asthma and 116 without asthma), from the outpatient clinics of two private hospitals. Data were collected using interview questionnaire, the standard 5th ed. WHO survey on oral manifestations, measurement of vital signs and anthropometric parameters, as well as clinical oral examination. Data were analyzed using SPSS version 22, and Logistic multinomial regression was used to study the Odds ratio and its 95% confidence interval between the variables. Level of significance for the study was 0.05. Results: The majority of patients with asthma (95%) used inhalation therapy, without use of spacers. Ulceration, pigmentation and candidiasis of the tongue, buccal mucosa and palate weresignificantly more encountered among patients with asthma compared to those without asthma (p < 0.001, 0.002 and 0.046 respectively). Xerostomia and salivary gland affection, also, were significantly more encountered among patients with asthma compared to those without asthma (p < 0.000, and 0.002 respectively). Patients with asthma were 7.7 times more likely to develop tongue disorders (OR: 7.7, p < 0.013), 3 times more likely to develop buccal mucosal disorders (OR: 3, p < 0.039), and 15 times more likely to develop palate disorders (OR: 15, p < 0.004) compared to subjects without bronchial asthma. Conclusion: Use of inhalation therapy in patients with asthma was significantly associated with increased occurrence of oral health problems. Health education programs about proper use of inhalers and oral hygiene should be implemented by primary health care personnel. Key words: Inhalation therapy, Asthma, Oral manifestations, Jeddah.