Asthma and teeth

[Madbiker1]

I was wondering if anybody had suffered with their teeth possibly due to their asthma medication?

[Lysistrata Administrator Community Ambassador]

I had sensitive teeth when on pred (prednisone, oral steroids, for anyone reading who doesn't know). Was especially painful in cold weather/wind. My dentist suggested rubbing toothpaste for sensitive teeth over them as a barrier and gave me a small tube of Colgate sensitive - sounds odd but it did work for me.

I also, after never ever having any cavities, needed several fillings over a couple of years during the time when my consultant had a thing for not using Ventolin and wanted me to use Atrovent (ipratropium) as a reliever. Apparently because it dries saliva it can increase bacteria in the mouth and therefore tooth decay - and I was using it a lot more than normal because I was poorly controlled.

I've not needed fillings for years so I would say that was either the pred or the Atrovent as I don't take either now regularly (pred doesn't work for me and I only have Atrovent as nebs in hospital). I do still take tiotropium (Spiriva) as a preventer which is related to ipratropium, but I rinse my mouth out after and it's fine - so anyone worried about taking it for this reason, no need to be.

I would say to ask your dentist - they're often helpful and knowledgeable about these things.

I'd also say that teeth can be affected by oral steroids in the same way bones can. You should be on bone protection anyway if you have regular courses of pred - if not, ask for it. It could help your teeth as well as your bones.

They're not dentists but I'd also suggest talking to the nurses on the helpline, as they may have suggestions on what to talk to your dentist about: 0300 2225800 or WhatsApp on 07999 377 775 Monday-Friday 0915-5pm

[Xlizixx in reply to Lysistrata]

What do you take for bone proection pls?

[Lysistrata Administrator Community Ambassador in reply to Xlizixx]

Hi, I just take a Vitamin D spray but I'm not on oral steroids and have plenty of calcium in my diet. I also have had bone density (DEXA) scans showing all ok.

I'd discuss this with your GP, especially if you're on regular oral steroids or need a lot of courses. They should be on top of it so push them if they're not thinking about bone protection, as you do need it with the steroids. You're very welcome to ask here and no one will mind but you really need some medical input on what works best for your situation.

You could also call the asthma nurses on the helpline and chat through your situation - they can help you with what to ask your GP about if the GP isn't being helpful. 0300 2225800 or WhatsApp on 07999 377 775 Monday-Friday 0915-5pm.

[Xlizixx in reply to Lysistrata]

Thank you

[Poobah]

Quite a while ago, a retired dental nurse/practitioner shared some info on the forum about dental care while taking inhaled and systemic steroids. I've tried searching for it, to no avail, but the gist was, that our dentists should be giving specific advice about products to use in order to prevent the side effects of the steroids as far as possible, including prescribed dental care products.

They stressed 1) never rinse after brushing with toothpaste, 2) wait at least 30 mins before using mouthwash. The idea being that it's important not to dilute the affect of the toothpaste.

I now use Densify toothpaste and have a high fluoride mouthwash for occasional use.

There are stronger products available on prescription. Duraphat by Colgate is available without prescription. BUT I would seek advice from your dentist or hygienist first. The hygienist can go over dental care in general, like rinsing after inhaler use and other regimes to combat residual traces of inhaled meds that can weaken enamel and cause thrush. So rinse BEFORE brushing.

Calcium in the diet is important and good levels of VitD (that helps the dietary calcium absorption), for both dental and bone health. It's not just oral health, but the mechanisms that keep the bones & teeth in good condition. Before thinking of VitD supplementation, getting your VitD levels checked would be prudent, just to inform where you are and what you need to achieve without over doing it. If your VitD levels are good, there shouldn't be a need for calcium supplements.

[lilacs15 in reply to Poobah]

My vitimin D levels have been very bad hence I developed problem teeth, thinning hair, tiredness ect. The doctor put me on a course of vit D and after I finished that I take Vit D 400iu with k2. My blood tests came back okay now for vit D but borderline anemia so now on an iron supplement.

[Poobah in reply to lilacs15]

If you take some elemental magnesium with that (10% of the amount of VitD) that will help the absorption. VitD & VitK are both fat soluble, so taking them with something fatty, if it's not oil based, will help it do its thing.

Magnesium only comes combined with other things, so if you're on iron, magnesium citrate is best as it's slightly laxative (whereas iron causes the opposite). When you look at the ingredients label, it should show the % of elemental magnesium (a good one is around 40%). Avoid anything that says it's "buffered", suggesting fillers.

We don't store VitD, so it's probably best to take it throughout the winter, when we don't get sufficient sun exposure. The adequate range is 50 to 75 nmol/L, so if you can maintain 100 nmol/L that's an optimum level. Anything above 150 nmol/L is considered toxic.

[Lynneypin]

I have super sensitive teeth. Can’t rinse my mouth with cold water or eat an apple straight from the fridge! Agony!

[Patk1]

I do ok with my teeth,no caps or bridges,or false teeth x

[Madbiker1]

Thank you for your replies. Fortunately I have not had steroids for a couple of years however prior to this I had a LOT of prednisone. I clean my teeth three times a day but I struggled to see a dentist since covid - I had an extraction in October which floored me afterward - I am having another in January as the tooth is broken in two.

[Hisue]

Dry mouth will cause tooth decay.

[Pilgrimoldboys]

Not directly related to this question , my memory goes back to 1957 when my asthma was so prolonged since 18 months old that doctors advised all my milk teeth be removed !!! Presumably to ‘treat’ asthmatic spasms. At that time I was using the system of inhaler , rybarvin, and under treatment at Gr. Ormand Street, I was prescribed with a full false denture set of teeth !!! I was soon to be sent to an asthmatic boarding school , Wanstead House , Margate and you can imagine the jokes I had levelled at me !!!