Dental Asthma Flashcards
Definition of Asthma
Chronic (long-term) inflammatory disease of the airways, potentially reversible
Symptoms of Asthma
Narrowed airway (limited air flow)
Tightened muscles constrict airway
Inflamed/Thickened airway wall.
Explain why asthma is relevant to the Dental-Medical professional
6.2% males have asthma
9.1% females have asthma
Allergic and drug-induced asthma are the 2 most relevant cases of asthma in a dental practice
Risk Factors of Asthma
Atopy (Genetic predisposition to allergic reactions) : Strongest risk factor
Race: occurs in all, but mostly in AAs
Environmental: greater role than race
Sex: Childhood: male to female 2:1, Puberty: 1:1, Adults: Females more
Age: More in young due to lower airway responsiveness
4 Different Asthma Triggers
Intrinsic Factors: Emotional stress,, Endogenous, non-allergic/non-atopic
Extrinsic Factors: Most common. IgE-mediated, pollen dust, allergic/atopic
Drug-Induced: Aspirins, NSAIDS,
Exercise-induced: Physical activity, thermal changes, cold weather inhalation
Basic Pathophysiology of Asthma
Trigger factor -> Airway inflammation -> a.) hypersecretion of Mucus b.)
Airway Muscle constriction c.) Swelling Bronchial Membranes -> Narrow Breathing Passages -> Wheezing, Cough, Shortness of Breath, tightness in Chest
Classifications of Asthma by Etiology
By Etiology: Intrinsic: Non-allergenic, Non-atropic, Non-immunologic
Triggers: Respiratory infection, exercise, inhalation of fumes, dust, cold air, aspirin
Extrinsic: Allergenic, Atopic, Immunologic
Triggers: pollen, Animal Danders, Dust Molds.
Classification of Asthma by Trigger-factor
Aspirin induced
Exercise induced
occupational
extrinsic
intrinsic
mixed
Classification of asthma by presentation
coexistent asthma and COPD
Cough-equivalent
Factitious
Night-time
Potentially fatal
Intermittent vs persistant
Classification of Asthma by Severity
Classification: Mild, Moderate severe, Severe, Imminent respiratory failure
General Examination: Complete Sentences - agitation, unable to speak in full sentences, breathless at rest - inability to lie down - agitated, diaphoresis - altered mental status
Exercise-induced asthma (EIA) or Exercise-induced bronchospasm (EIB)
Exercise-induced bronchospasm is often a neglected diagnosis, and the underlying asthma may be silent in as many as 50% of patients, except during exercise.
Asthma and Oral Health social disadvantage
The 2000 report of US Surgeon General titled Oral Health in America indicated that asthma and caries, together with learning difficulties and social problems, are correlated closely enough with social disadvantage to be designated sentinel diseases
Genetic -
Asthmatic patient may have increased….
Genetic - 90% for asthma, 40-60% for dental caries
Asthmatic patient may have increased cavities, bad breath, gum problems.
Studies show 2 fold increase in caries in primary teeth of children with asthma compared to without asthma.
role of asthma medication
Inhaled b2-agonist and corticosteroid, asthmatics have significantly lower saliva secretion rate and higher streptococcus mutans counts in saliva and healthy controls.
Common genetic / environmental determinants predisposing to both asthma and caries
Secretory immunoglobulin A in saliva
Excess or lack of IG A has been related to prevalence of caries
IG A has been linked to asthma
