The effects of combination treatment with a long-acting beta2-agonist and a corticosteroid on salivary flow rate, secretory immunoglobulin A, and oral health in children and adolescents with moderate asthma: a 1-month, single-blind clinical study.
BACKGROUND
Asthma is a common chronic disorder of childhood, and it is frequently accompanied by dental and other oral abnormalities. As such, oral and dental effects of asthma medications have been investigated in several studies. However, the effect of combination therapy with a long-acting beta(2)-agonist and a corticosteroid on oral health in children and adolescents has not been reported in the literature.


OBJECTIVE
The aim of this study was to examine whether combination treatment with a long-acting beta(2)-agonist (salmeterol) and a corticosteroid (fluticasone propionate) administered by dry powder inhaler (DPI) affects oral health in children and adolescents with moderate asthma.


METHODS
This 1-month, single-blind clinical study was conducted at the Department of Periodontology, Ondokuz Mayis University Faculty of Dentistry, Samsun, Turkey. Male and female children and adolescents aged 7 to 17 years with moderate persistent asthma, as classified by the Global Initiative for Asthma guidelines, were studied before and after 1 month of treatment with combination salmeterol 50 microg and fluticasone propionate 100 mug administered by DPI BID. Salivary flow rate and secretory immunoglobulin A (sIgA) level were measured, and periodontal health was assessed by gingival and dental plaque indices for buccal surfaces and periodontal pocket depth.


RESULTS
The study enrolled 15 children and adolescents (8 girls, 7 boys; mean [SD] age, 11 years [45 months]; median age, 13 years; [range, 7-17 years]). At 1 month, mean sIgA, gingival index, buccal surface index, gingival index, dental plaque index, and periodontal pocket depth were not changed significantly from baseline, whereas mean (SD) salivary flow rate was significantly decreased (from 153.21 [39.29] to 113.16 [46.99] microL/5 s; P = 0.015) and dental plaque index on the buccal surface was significantly increased (from 1.43 [0.63] to 1.61 [0.67]; P = 0.01).


CONCLUSIONS
In this small study, combination treatment with salmeterol 50 microg and fluticasone propionate 100 microg inhaled twice daily was associated with changes in oral health among these children and adolescents with moderate asthma. Regular follow-up of oral health status may be warranted in children and adolescents during long-term use of a long-acting beta2-agonist and a corticosteroid.
Department of Pediatric Allergy, Ondokuz Mayis University Faculty of Medicine, Samsun, Turkey.
Cigdem
C
Sag
Feyza Otan
FO
Ozden
Gokhan
G
Acikgoz
Fehim Yasar
FY
Anlar
D000280:Administration, Inhalation; D000293:Adolescent; D000305:Adrenal Cortex Hormones / Q000008:administration & dosage / Q000009:adverse effects; D000318:Adrenergic beta-Agonists / Q000008:administration & dosage / Q000009:adverse effects; D000420:Albuterol / Q000008:administration & dosage / Q000009:adverse effects / Q000031:analogs & derivatives*; D000730:Androstadienes / Q000008:administration & dosage / Q000009:adverse effects; D001249:Asthma / Q000188:drug therapy*; D002648:Child; D003692:Delayed-Action Preparations; D003773:Dental Plaque / Q000139:chemically induced; D004338:Drug Combinations; D005260:Female; D000068297:Fluticasone-Salmeterol Drug Combination; D006801:Humans; D007071:Immunoglobulin A, Secretory / Q000097:blood*; D008297:Male; D009330:Nebulizers and Vaporizers; D009909:Oral Health; D010512:Periodontal Index; D011208:Powders; D012463:Saliva / Q000378:metabolism*; D016037:Single-Blind Method
D000305:Adrenal Cortex Hormones; D000318:Adrenergic beta-Agonists; D000730:Androstadienes; D003692:Delayed-Action Preparations; D004338:Drug Combinations; D000068297:Fluticasone-Salmeterol Drug Combination; D007071:Immunoglobulin A, Secretory; D011208:Powders; D000420:Albuterol