Asthma Recognition and Understanding

Understanding asthma is essential in the dental office. A patient with asthma symptoms may present with a need for emergency treatment. Additionally patients may need to use rescue medication during treatment in the office. It is important to determine in advance that the rescue inhaler should always be present and easily available to the patient. Of course asthma symptoms and treatment side effects need to be recognized and managed appropriately. For example, side effects of asthma controller medications include throat irritation and oral fungal overgrowth. Patients may be advised to rinse with water after each inhalation to minimize this side effect.

Additionally, a history of asthma is reported commonly by adult dental patients and may be more prevalent in children. An acute episode of asthma in the dental office may be precipitated by extrinsic factors such as inhaled allergens, as well as intrinsic factors such as fear or anxiety. An asthma episode should be considered a medical emergency and must be treated promptly by inhalation of a bronchodilating agent. A history of asthma in the dental patient should alert the dentist to implement strategies that may prevent an acute attack and to be prepared to manage this potentially life-threatening medical emergency appropriately. The chronic use of bronchodilating inhalers and/or glucocorticoids for the management of asthma can increase the likelihood of oral candidiasis, particularly in patients who have additional risk factors such as smoking, denture use, or the use of xerostomic medications.30