An interesting article titled “Asthma medication and risk of dental diseases in children – A prospective cohort study” written by Pia Elisabeth Nørrisgaard and et al. appears in Pediatric Allergy and Immunology (published 9 October 2023). The article seeks to explore if th use of inhaled asthma medication in children is a risk factor for dental caries and enamel defects.
The authors followed 3,983 children from birth to 6 years of age, and assessed their use of inhaled corticosteroids, inhaled β2-agonists, and asthma symptoms. The children underwent examation for caries and enamel defects at 6 years of age. Caries was defined as decayed, missing, or filled surfaces. Enamel defects were defined as demarcated opacity, post-eruptive enamel breakdown, and/or atypical restoration on at least one molar.
A prospective cohort study that included 589 children was also conducted. From these children, 61% received inhaled β2-agonists for asthma, with an average of 60 days of treatment. From ages 3 to 6, 11% used inhaled β2-agonists more than 12 days for one year, 4% more than 12 days per year for two years, and 1% for more than 12 days per year for all three years. Furthermore, around a third of kids were treated with inhaled corticosteroids within their first three years and first six years.
Image by Jenny Friedrichs from Pixabay
The study found no association between the use of inhaled corticosteroids, β2-agonists, or asthma symptoms in early childhood and the risk of caries or enamel defects at 6 years of age. This finding is helpful for making for parents and physicians more comfortable with offering asthma medication for kids. Thus the study found no evidence asthma medication will increases the risk of dental problems in children.
The study also investigated a number of other pre-, peri-, and postnatal risk factors for dental diseases. From these they find nominally significant associations between antibiotic use in pregnancy (OR = 1.25, [1.01–1.54]), maternal education level (OR = 1.57, [1.01–2.45]), and having a dog at home (OR = 0.50, [0.27–0.93]).
The finding that having a dog can cut children’s risk of dental caries and enamel defects is interesting. Some studies have shown gut microbiome development may affect the risk of allergy and asthma through immune modulation, and perhaps exposing kids to dogs can change their gut composition. This alteration may be a possible mechanism decreasing the risk.
The study authors cauation that more research is needed to confirm their findings. On limitation of the study was that children’s dental hygiene was only assessed at age 6.