The condition of the oral cavity in patients receiving chronic steroid therapy - practical remarks.

A significant increase is currently being observed in the number of patients hospitalized due to respiratory system diseases, such as chronic obstructive pulmonary disease (COPD), and bronchial asthma with a predominantly allergic component. Treatment of COPD and bronchial asthma is mainly based on the use of beta-2-mimetics and glucocorticosteroids (GCS). However, the GCS inhalation therapy may be associated with developing a risk of various types of complications, which are especially manifested in the initial part of the respiratory system. In the paper the side effects resulting from the chronic use of inhaled GCS was presented with discussion how to reduce their negative effects. The negative side effects of chronic GCS therapy for the treatment of pulmonary diseases result mainly from their modifying effect on the proper functioning of the immune system, and on their generation of salivary secretion disorders. When using inhaled GCS, drugs deposit on the mucosa membrane of the throat and oral cavity, which promotes the development of candidiasis which accompanied by xerostomia leads to difficulty in swallowing and speaking. The reduced salivation promotes the development of caries disease due to the impairment of the physiological mechanism of tooth surface cleaning. Attention to proper oral hygiene is fundamental and an appropriate antifungal therapy is required. When conducting a physical examination, it is important to pay attention to those patients using inhaled steroids, especially on a chronic basis. This is because with careful clinical evaluation, the side effects of these drugs can be detected at an early stage and the appropriate treatment of their negative effects can be applied.