title: Clinical and radiological assessment of effects of long-term corticosteroid therapy on oral health.
abstract: BACKGROUND
  Corticosteroids (Cs) are used widely for their anti-inflammatory and immunosuppressive properties. They have the potential to cause dramatic improvement as well as produce equally dramatic adverse effects. The clinical misuse like over prescription of the drug should be avoided. Long-term administration may cause many adverse effects leading to impaired oral health. Oral health is usually not considered during management of patients on long-term corticosteroid therapy. The aim of this study was to assess the oral health status and radiological changes in the jaw bones of the patients under long-term corticosteroid therapy.
  
  
  METHODS
  Oral health of 100 patients under long-term corticosteroid therapy with a minimum of 3 months duration was compared with sex- and age-matched 100 healthy controls. The clinical examination included complete examination of the mouth and periodontal status. Radiographic evaluation of bone with the help of intra oral periapical radiograph and digital orthopantomograph and levels of serum calcium, alkaline phosphatase, and random blood sugar were assessed. 'Chi-square test', 'Kolmogorov-Smirnov test' and 'Mann-Whitney U test' were used for statistical analysis. P > 0.05 was considered significant.
  
  
  RESULTS
  Patients on steroids exhibited significantly higher levels of candidiasis and clinical attachment loss of the periodontal ligament, probing pocket depth. Bone density was significantly lower in the study group than that in the control group. Random blood glucose was significantly higher and significant lower levels of calcium were observed in patients on steroids.
  
  
  CONCLUSIONS
  Long-term use of Cs may affect oral health adversely leading to candidiasis as well as impair bone metabolism leading to a considerable decrease in the mandibular bone mineral density.
authors.affiliation: Department of Oral Medicine and Radiology, Narayana Dental College and Hospital, Nellore, Andhra Pradesh, India.
authors.forename: Swapna Sridevi
authors.initials: SS
authors.lastname: Beeraka
authors.affiliation: Department of Oral Medicine and Radiology, Narayana Dental College and Hospital, Nellore, Andhra Pradesh, India.
authors.forename: Kannan
authors.initials: K
authors.lastname: Natarajan
authors.affiliation: Department of Oral Medicine and Radiology, Narayana Dental College and Hospital, Nellore, Andhra Pradesh, India.
authors.forename: Rajendra
authors.initials: R
authors.lastname: Patil
authors.affiliation: Department of Oral Medicine and Radiology, Narayana Dental College and Hospital, Nellore, Andhra Pradesh, India.
authors.forename: Rakesh Kumar
authors.initials: RK
authors.lastname: Manne
authors.affiliation: Department of Oral Medicine and Radiology, Narayana Dental College and Hospital, Nellore, Andhra Pradesh, India.
authors.forename: Venkata Sarath
authors.initials: VS
authors.lastname: Prathi
authors.affiliation: Department of Oral Medicine and Radiology, Narayana Dental College and Hospital, Nellore, Andhra Pradesh, India.
authors.forename: Venkata Suneel Kumar
authors.initials: VS
authors.lastname: Kolaparthi
keywords: Bone mineral density; corticosteroids; oral manifestations; periodontal health