Asthma and Cavities Common in Children but not Linked

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"Is There a Relationship between Asthma and Dental Caries: A Critical Review of the Literature" examined the 27 separate studies which looked for a link between asthma and cavities that were reported in 29 papers published between 1976 and March 2010.

"The notion that there is a link between asthma and tooth decay may have its origin in anecdotal statements by emergency room workers who see children with poorly managed asthma. These children could also be more likely to have poorly managed dental conditions, and therefore tooth decay. It's reasonable to believe that poor clinical management may be associated with both conditions, not the asthma that is causing the cavities," said Gerardo Maupome, B.D.S., M.Sc., Ph.D., professor of preventive and community dentistry at the Indiana University School of Dentistry and a Regenstrief Institute affiliated scientist, who is the first author of the new JADA study.

"We found little evidence to suggest that asthma causes tooth decay. In fact, the two largest studies we reviewed found that children with asthma appear to have fewer cavities than others. This may be because their parents are used to taking them to health-care providers, and routinely bring them to the dentist," said Dr. Maupome.

The large number of variables involved, including severity of asthma symptoms and the variety of types of treatment for the disease, has made it difficult to unequivocally determine whether there is a causal link between the two.

While not apparently associated, tooth decay and asthma are the two most prevalent chronic childhood diseases in the United States.

Routine home and professional dental care are critical for all children. Parents of children with asthma do not need to be concerned about an increased risk of tooth decay but Dr. Maupome points out that children who use nebulizers to control their asthma may be inadvertently increasing their frequency of exposure to sugars because these nebulizers use fructose to deliver therapy. The frequency and the amount of certain sugars consumed are major factors leading to cavities.

He also recommends that children who are mouth breathers or who have mouth dryness be checked periodically by their dentists. These conditions may be associated with asthma but they are also found in children who do not have asthma. Many medications used for the long term (such as asthma medications) have been found to reduce the amount of saliva, which is the first protection of teeth.

In addition to Dr. Maupome, the study was authored by Jay D. Shulman, D.M.D., M.A., M.S.P.H. of Baylor College of Dentistry; Carlo Eduardo Medina-Solis, B.D.S., M.C., of the Instituto de Ciencias de la Salud de la Universidad Autonoma del Estado de Hidalgo in Mexico; and Oyebola Ladeinde, B.D.S., M.S. of the IU School of Dentistry.

The study was funded by the Oral Health Research Institute of the Indiana University School of Dentistry. Both are located on the campus of Indiana University-Purdue University Indianapolis.

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