Asthma and Dental Care Management

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Questions and Answers

What is the primary clinical criterion for diagnosing asthma?

  • Airway obstruction (correct)
  • Tachypnea
  • Shortness of breath
  • Chest tightness

Which condition should be initially assumed in a patient presenting with wheezing and related symptoms?

  • Factitious Asthma
  • Occupational Asthma
  • Asthma (correct)
  • Chronic Obstructive Pulmonary Disease

How might the course of asthma change over time in an affected individual?

  • Symptoms remain constant throughout their life
  • Symptoms are always progressively worsen with time
  • Symptoms may fluctuate in severity at different stages of life (correct)
  • Symptoms disappear completely after puberty

What is the key focus of initial asthma treatment, alongside patient education?

<p>Avoidance of precipitating factors (B)</p> Signup and view all the answers

What is the classification based on etiology mainly used for?

<p>To study the root cause of asthma (D)</p> Signup and view all the answers

Which of the following is NOT a common clinical manifestation of asthma?

<p>Bradycardia (B)</p> Signup and view all the answers

How may a patient's symptoms during an asthma exacerbation be classified?

<p>Mild, Moderate, Severe (C)</p> Signup and view all the answers

Which of the following is NOT a type of asthma?

<p>Allergen-Induced Asthma (C)</p> Signup and view all the answers

What is the projected trend for annual asthma-related deaths in the coming decades?

<p>They are projected to double. (D)</p> Signup and view all the answers

Which population group is disproportionately more affected by asthma?

<p>Children, young adults and racial and ethnic minorities in urban areas (D)</p> Signup and view all the answers

Besides health disparities, what other factors contribute to the increased prevalence of asthma?

<p>Less understood factors (C)</p> Signup and view all the answers

What is a significant social burden associated with asthma, as mentioned in the text?

<p>Numerous hospital stays and missed days of school and work (B)</p> Signup and view all the answers

What role do oral health care providers play in the treatment of asthma?

<p>They play a role that is important for both overall health and the systemic condition's effect on oral health (B)</p> Signup and view all the answers

According to the content, what should the dental care of asthmatic patients consider?

<p>Considerations beyond what has been published in dental literature (B)</p> Signup and view all the answers

What is the most accurate description of the severity of asthma?

<p>A condition with a mortality rate that has almost tripled in the past 20 years (B)</p> Signup and view all the answers

What is a common characteristic of asthma in poverty-stricken areas?

<p>Their disease often has a more severe progression. (D)</p> Signup and view all the answers

What are some local untoward manifestations associated with antileukotriene drugs?

<p>Oral candidiasis (A), Dysphonia (D)</p> Signup and view all the answers

Which of the following is a preferred therapy for mild persistent asthma?

<p>Inhaled corticosteroids (B)</p> Signup and view all the answers

What is a significant risk associated with the use of theophylline?

<p>Narrow therapeutic window (C)</p> Signup and view all the answers

Which medication can be used in addition to inhaled corticosteroids for symptomatic relief in asthma?

<p>Salmeterol (C)</p> Signup and view all the answers

Why is erythromycin contraindicated in patients taking theophylline?

<p>It may elevate theophylline blood levels (D)</p> Signup and view all the answers

What is the common use of cromolyn sodium in asthma therapy?

<p>Prophylactic therapy substitute (C)</p> Signup and view all the answers

How do anticholinergics like ipratropium bromide work in asthma treatment?

<p>No clear role established (D)</p> Signup and view all the answers

What is a key difference between nedocromil and cromolyn sodium in asthma management?

<p>Nedocromil inhibits mediator release (C)</p> Signup and view all the answers

What factors have been found to influence asthma mortality in Chicago?

<p>Racial and socioeconomic factors (D)</p> Signup and view all the answers

What is the standard dose of a 1:1,000 wt/vol solution for adults experiencing asthma?

<p>Three-tenths of a milliliter every 15 minutes (A)</p> Signup and view all the answers

Which treatment was assessed for its impact on caries development in asthmatic patients?

<p>ß2-adrenoceptor agonists (B)</p> Signup and view all the answers

What potential side effect is commonly associated with nebulized corticosteroids?

<p>Dryness of mouth (C)</p> Signup and view all the answers

What was the outcome of long-term isoproterenol treatment in a rat model?

<p>Increased caries development (A)</p> Signup and view all the answers

Which publication provided guidelines for asthma diagnosis and management?

<p>Expert panel report 2 (A)</p> Signup and view all the answers

Which cytokine's effect is particularly targeted by new immunomodulatory therapies in asthma management?

<p>Interleukin-5 (A)</p> Signup and view all the answers

What is a common practice that can help minimize the potential for candida growth after inhalation of steroids?

<p>Rinsing the mouth with water (C)</p> Signup and view all the answers

What aspect of saliva was examined in relation to asthma and dental health?

<p>Saliva proteins (A)</p> Signup and view all the answers

What oral health issue has been linked to the use of inhaled steroids in asthma patients?

<p>Gingivitis (D)</p> Signup and view all the answers

What is a health concern associated with inner-city asthma?

<p>Limited access to medications (D)</p> Signup and view all the answers

What percentage of the inhaled dose actually reaches the lungs when using an inhaler?

<p>10% to 20% (B)</p> Signup and view all the answers

What outcome was seen in studies regarding caries prevalence among urban children?

<p>Association with lower income levels (D)</p> Signup and view all the answers

What is a potential risk when treating asthmatic children with beta 2-adrenoceptor agonists?

<p>Development of dental caries (C)</p> Signup and view all the answers

What common behavior in asthmatic individuals can contribute to gingival inflammation?

<p>Mouth-breathing (B)</p> Signup and view all the answers

What is a potential oral condition that can arise from the use of nebulized corticosteroids?

<p>Oral thrush (B)</p> Signup and view all the answers

What is the main concern regarding the use of erythromycin in patients taking theophylline?

<p>Erythromycin may increase the risk of developing toxic levels of theophylline. (C)</p> Signup and view all the answers

What is the recommended alternative to erythromycin when treating patients taking theophylline?

<p>Azithromycin (B)</p> Signup and view all the answers

What is the potential consequence of using phenobarbital with theophylline?

<p>Reduced effectiveness of theophylline (C)</p> Signup and view all the answers

What is the main reason cited for the concern about using sulfites in corticosteroid-dependent asthmatic patients?

<p>Sulfites can trigger allergic reactions in patients with asthma. (D)</p> Signup and view all the answers

What is NOT a valid concern about the use of erythromycin with theophylline?

<p>The risk of developing an allergic reaction to erythromycin. (C)</p> Signup and view all the answers

What is the primary reason for recommending the use of azithromycin instead of erythromycin in patients taking theophylline?

<p>Azithromycin does not interact with theophylline as significantly. (A)</p> Signup and view all the answers

What is the main reason for recommending the use of inhaled steroids for asthma management?

<p>They have fewer side effects than oral corticosteroids. (C)</p> Signup and view all the answers

What is the underlying assumption behind the recommendation to avoid using erythromycin in patients taking theophylline?

<p>Erythromycin can increase the risk of developing toxic levels of theophylline. (B)</p> Signup and view all the answers

Flashcards

What is asthma?

Asthma is a chronic respiratory disease characterized by inflammation and narrowing of the airways, leading to difficulty breathing.

What is the current trend in asthma mortality?

Although often perceived as a minor condition, asthma mortality rates have tripled in the last 20 years, highlighting its seriousness.

Who is most at risk of developing asthma?

Children, young adults, and racial and ethnic minorities living in urban areas are disproportionately affected by asthma.

How does poverty impact asthma prevalence?

Poverty and social factors contribute to a higher prevalence and severity of asthma in inner-city residents.

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What role do oral health care providers play in asthma management?

Oral health care providers play a crucial role in managing asthma, considering its impact on both overall health and oral health.

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How does asthma affect oral health?

Asthma can affect oral health, highlighting the importance of understanding the relationship between the two conditions.

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What are some special considerations for dental care of asthmatic patients?

Dental care for asthmatic patients requires special considerations beyond standard procedures.

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What is the goal of this article?

This article aims to provide dentists with updated information on asthma and its link to oral health, offering safe and appropriate dental care recommendations.

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Exercise-Induced Asthma

A type of asthma where the symptoms worsen during physical activity.

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Extrinsic Asthma

A type of asthma triggered by allergens such as pollen, dust mites, or pet dander.

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Intrinsic Asthma

A type of asthma caused by factors within the body, such as exercise, stress, or cold air.

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Mixed Asthma

A type of asthma that combines both extrinsic and intrinsic triggers.

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Occupational Asthma

A type of asthma that occurs due to exposure to substances at work, such as dust, fumes, or chemicals.

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Factitious Asthma

A type of asthma where symptoms are faked or exaggerated.

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Cough-Equivalent Asthma

A type of asthma where the symptoms are similar to those of chronic obstructive pulmonary disease (COPD).

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Potentially Fatal Asthma

A type of asthma that can lead to life-threatening complications.

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What are inhaled corticosteroids used for in asthma?

When inhaled corticosteroids alone don't provide enough relief, these medications are used as an additional treatment for asthma.

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What are the alternatives to inhaled corticosteroids for asthma?

These medications are added to inhaled corticosteroids or substituted when those aren't effective.

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What are the mast cell stabilisers used for in asthma?

These drugs help stop the release of inflammatory substances in the airways. This helps reduce asthma symptoms and attacks.

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How do antileukotriene drugs help with asthma?

These medications are sometimes used in addition to, or instead of, inhaled corticosteroids.

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What is the role of theophylline in treating asthma?

This drug can be used to help with asthma, but it needs careful monitoring due to its potential side effects.

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Why is erythromycin contraindicated in patients taking theophylline?

It is essential to avoid this medication in patients taking theophylline due to potential harmful interactions.

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What is the role of anticholinergics in asthma management?

Their role in asthma treatment is uncertain, with some patients responding well while others don't.

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What is salmeterol used for in asthma?

This is a potent bronchodilator that is frequently prescribed for asthma.

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1:1,000 wt/vol

A standard concentration for asthma medication, expressed as weight per volume. It means 1 gram of active ingredient per 1000 milliliters of solution.

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What are the side effects of inhaled corticosteroids?

The use of inhaled corticosteroids can lead to irritation, soreness, and dryness in the throat, mouth, and voice.

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How can inhaled corticosteroids affect oral health?

Inhaled corticosteroids can cause oral candidiasis, also known as thrush, an infection caused by a fungus.

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How much of inhaled corticosteroids reaches the lungs?

Only a small portion of inhaled corticosteroids reaches the lungs, with the rest affecting the mouth and throat.

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How can we prevent oral candidiasis caused by inhaled corticosteroids?

Using a spacer and rinsing the mouth with water after using inhaled steroids helps prevent oral candidiasis.

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How does good oral hygiene impact asthma management?

Frequent dental checkups, fluoride treatments, and good oral hygiene practices are essential for asthma patients.

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How do inhaled corticosteroids affect gingivitis?

Inhaled corticosteroids are linked to increased gingivitis, which is inflammation of the gums.

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What is the relationship between asthma and oral health?

Although asthma is primarily a respiratory disease, it can significantly impact oral health.

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Theophylline-Erythromycin Interaction

Theophylline levels can increase significantly when combined with erythromycin.

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What triggers asthma?

Asthma can be triggered by various factors, including allergens, exercise, stress, cold air, infections, and even strong emotions.

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Who is most affected by asthma?

Asthma affects children more than adults, with higher rates found in urban areas, particularly among children living in poverty.

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How is asthma linked to oral health?

Asthma is associated with oral health issues like dry mouth, tooth decay, and gum disease, making it essential for dentists to understand the connection.

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What are the effects of asthma medication on oral health?

Beta-2 agonists are commonly used to treat asthma, but their long-term effects on saliva composition and dental health are being investigated.

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How should dentists provide dental care for asthma patients?

Dentists need to adapt their approach for patients with asthma, considering their medication, triggers, and potential complications.

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What is the role of dentists in asthma management?

Dentists can play a vital role in asthma management by identifying potential oral health issues related to asthma and providing appropriate care.

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Study Notes

Asthma and Dental Patients

  • Asthma is a significant global health problem, affecting over 100 million people worldwide. Prevalence has risen steadily in the US in recent decades.
  • Asthma mortality has nearly tripled in the past 20 years.
  • Children, young adults and minorities in urban areas are disproportionately affected. This likely stems from various health disparities, including factors like poverty.
  • Oral health care providers play a crucial role in managing a patient's overall health and how systemic conditions like asthma affect their oral health.

Asthma Pathophysiology

  • Asthma is a chronic inflammatory disorder, chiefly affecting bronchioles. Symptoms include wheezing, chest tightness, and labored breathing.
  • Airway obstruction results from a combination of smooth muscle spasm and inflammation.
  • Airway inflammation can be acute, subacute or chronic varying in duration and cell types involved.
  • Allergens and environmental factors are key in causing airway inflammation and obstruction.
  • Asthma frequently worsens during certain seasons.

Asthma Diagnosis and Classification

  • Asthma classification can consider etiology or severity.
  • Diagnosis often relies on symptom evaluation and physical examination, potentially including pulmonary function tests, with a focus on reversibility of symptoms with bronchodilators.
  • Severity is categorized based on symptom frequency (e.g., none, mild, moderate persisting), nighttime awakenings, and interference with daily activities.

Asthma Management and Treatment

  • Asthma treatment largely focuses on controlling symptoms and preventing exacerbations.
  • Initial treatment might include short-acting bronchodilators, such as metered-dose inhalers (MDIs).
  • Sustained treatment may involve daily inhaled corticosteroids, as well as leukotriene antagonists.
  • Systemic corticosteroids might be needed for severe cases.

Asthma and Dental Care

  • The dental setting can trigger acute exacerbations, especially in patients with unstable or uncontrolled asthma.
  • Certain dental materials or procedures can trigger asthma attacks, especially in people with a hypersensitivity to these agents.
  • Dental procedures requiring long-term, or higher risk manipulations, which might include prolonged supine positioning, and excessive use of aerosols, should be done under careful supervision.
  • Risk factors such as compromised immune function (due to medications), and history of severe or frequently occurring attacks are important considerations.
  • Vasoconstrictors present in certain local anesthetics may be problematic for patients who use other medications for asthma or have associated conditions.
  • Patients on long-term corticosteroid therapy may require special considerations like possible steroid replacement therapy before dental treatment, and antibiotic prophylaxis.
  • Asthma patients should bring their rescue inhaler to appointments.
  • Acute exacerbations can be mitigated by early recognition, discontinuing dental procedures, and appropriate management of symptoms as in an emergency protocol.

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