Evaluation of cariogenic potential of dry powder inhalers: A case-control study

OBJECTIVE: Dry powder inhalers (DPIs) are commonly employed in the management of asthma and other diseases with airway obstruction. A causal relationship of DPI use and occurrence of dental caries has been speculated. The present case-control study was therefore designed to examine the potential link between dental caries and specific use of dry powder inhalers in patients with bronchial asthma. MATERIALS AND METHODS: The present study was conducted on 100 asthmatic patients aged between 10 and 45 years who were using DPIs for at least one year. The control group (n = 100) was selected from non-asthmatic individuals and were matched with the study group with respect to age, gender, and socio-economic status. RESULTS: The results revealed that asthmatic subjects exhibited higher occurrence of dental caries in comparison to control group, but the difference was statistically non-significant. The mean decayed, missing, and filled teeth (DMFT) indices scores in asthmatic and control group were found to be 1.71 ± 2.34 SD and 1.46 ± 1.89 SD (P = 0.408), respectively. Likewise, the mean decayed, missing, and filled surfaces (DMFS) indices scores in both the groups were 2.41 ± 3.84 SD and 2.34 ± 4.48 SD (P = 0.90). However, increased frequency of DPI use was associated with significant risk of caries (P = 0.01). It has been observed that oral rinsing after an inhaler use limited the occurrence of dental caries to a certain extent although was non significant. CONCLUSIONS: Dry powder inhaler use in patients with bronchial asthma was not associated with significant risk of dental caries.