Publication: Astımlı çocuklarda kullanılan inhale B2- agonist ve steroidlerin tükürük kompozisyonunda oluşturduğu değişikliklerin ağız florasına ve diş çürüğüne etkisi
Abstract
Astım hastalığı ve tedavisinde kullanılan ilaçların oral flora ve stimüle olmuş tükürük akış hızı üzerine etkisini incelemeyi amaçladığımız çalışmamız Marmara Üniversitesi Tıp Fakültesi Pediatrik Göğüs Hastalıkları Bilim Dalı ve Marmara Üniversitesi Diş hekimliği Fakültesi Pedodonti nda gerçekleştirildi. 6-11 yaşları arasında 40 kız, 47 erkek olmak üzere toplam 87 çocuk araştırma kapsamına alındı. Araştırma 3 gruptan oluşturuldu. Astım tanısı konmuş henüz tedaviye başlanmamış çocuklar ilk grubu (Grup 1) oluşturdu. İkinci grup en az 1 yıl süre ile düzenli olarak sadece inhale kortikosteroidleri veya inhale kortikosteroidler ile birlikte gerektiğinde b2-agonistlerini de kullanan çocuklardan (Grup 2) oluşurken, üçüncü grup sistemik herhangi bir hastalığı bulunmayan çocukları (Kontrol Grubu) içeriyordu. Grup 1 ve Grup 2'nin yüksek DMF, DMFS, df ve dfs değerlerine sahip oldukları gözlendi. Grupların tükürük Mutans Streptokok, Laktobasil ve stimüle olmuş tükürük akış hızları arasında istatistiksel olarak anlamlı bir fark bulunmazken, tükürük Kandida değerlerinde istatistiksel olarak anlamlı bir fark (p<0.05 ) bulunmuştur. En az 1 yıl süre ile düzenli olarak inhale kortikosteroidleri (İlaç 1) ve inhale kortikosteroidler ile birlikte gerektiğinde b2-agonistlerini de (İlaç2) kullanan çocukların stimüle olmuş tükürük akış hızları ve tükürük Kandida değerleri karşılaştırıldığında İlaç 1'in stimüle olmuş tükürük akış hızları ve tükürük Kandida değerleri yüksek bulunmuştur (p<0.05). Kullanılan inhale kortikosteroidlerin dozunun oral florada ve stimüle olmuş tükürük akış hızında istatistiksel olarak anlamlı derecede bir fark oluşturmadığı tespit edilmiştir. Son olarak astım tanısı konmuş fakat tedaviye başlanmamış çocuklarda tükürük Kandida seviyelerinin yüksek olduğu tespit edilmiştir. Bu gözlem, astımlı çocuklarda görülen kronik üst solunum yolu enfeksiyonları sonucu kullanılan antibiyotiklere ya da ağızdan solunuma bağlı olabilir. Aynı zamanda, çeşitli sistemik hastalıklarda görülen mantar kolonilerindeki artışın bu sonuçla ilişkisi olabileceği de düşünülmektedir. Araştırma bulgularımız sonucunda astımlı çocuklara düzenli olarak koruyucu dental yöntemlerin uygulanması gerekmektedir.
Effects of inhaled b2 - agonists and steroids on oral flora and caries due to the changes in salivary composition of asthmatic children This research which focused on the effect of asthma disease and the medications used for treatment of asthma on oral flora and the stimulated salivary flow rate was conducted in Marmara University, Faculty of Medicine, Department of Pediatric Pulmonology and Faculty of Dentistry, Department of Pedodontics. A total of 87 children, 40 girls and 47 boys from 6 to 11 years old participated in this study. This research was conducted on three test groups. Children diagnosed with asthma but not taking any medicines made up the first group (Group 1). The second group consisted of asthmatic childeren who have regularly been treated with inhaled corticosteroids and inhaled corticosteroids with inhaled ß2 agonists as needed for at least one year (Group 2), while the third group included children with no diagnosed systemic disease (Control group). It was observed that Group 1 and Group 2 had high DMF, DMFS, df and dfs scores. While the test groups did not show any statistically significant difference for the salivary streptococcus mutans, lactobacillus counts and stimulated salivary flow rates, statistically significant difference (p<0.05) were observed between the test groups for salivary candida counts. When the salivary flow rates and salivary candida counts of asthmatic children who have regularly been treated with inhaled corticosteroids (Medicine 1) and treated with inhaled corticosteroids with inhaled ß2 agonists (Medicine 2) as needed were compared, it was observed that asthmatic children using only medicine 1 had higher salivary flow rates and candida scores (p<0.05). The dosage of corticosteroids consumed does not have a statistically significant effect on the oral flora and the stimulated salivary flow rate. Finally it was reported that children diagnosed with asthma but not taking any medicines had high salivary candida counts. This result may be due to the usage of antibiotics for chronic airway disease by asthmatic children or mouth breathing. At the same time, it is possible that the increase in yeast colonies occuring during various systemic diseases may have an effect on this observation. Based on the results of this study, it is concluded that the asthmatic children should receive periodic supervision with prophylactic dental care.
Effects of inhaled b2 - agonists and steroids on oral flora and caries due to the changes in salivary composition of asthmatic children This research which focused on the effect of asthma disease and the medications used for treatment of asthma on oral flora and the stimulated salivary flow rate was conducted in Marmara University, Faculty of Medicine, Department of Pediatric Pulmonology and Faculty of Dentistry, Department of Pedodontics. A total of 87 children, 40 girls and 47 boys from 6 to 11 years old participated in this study. This research was conducted on three test groups. Children diagnosed with asthma but not taking any medicines made up the first group (Group 1). The second group consisted of asthmatic childeren who have regularly been treated with inhaled corticosteroids and inhaled corticosteroids with inhaled ß2 agonists as needed for at least one year (Group 2), while the third group included children with no diagnosed systemic disease (Control group). It was observed that Group 1 and Group 2 had high DMF, DMFS, df and dfs scores. While the test groups did not show any statistically significant difference for the salivary streptococcus mutans, lactobacillus counts and stimulated salivary flow rates, statistically significant difference (p<0.05) were observed between the test groups for salivary candida counts. When the salivary flow rates and salivary candida counts of asthmatic children who have regularly been treated with inhaled corticosteroids (Medicine 1) and treated with inhaled corticosteroids with inhaled ß2 agonists (Medicine 2) as needed were compared, it was observed that asthmatic children using only medicine 1 had higher salivary flow rates and candida scores (p<0.05). The dosage of corticosteroids consumed does not have a statistically significant effect on the oral flora and the stimulated salivary flow rate. Finally it was reported that children diagnosed with asthma but not taking any medicines had high salivary candida counts. This result may be due to the usage of antibiotics for chronic airway disease by asthmatic children or mouth breathing. At the same time, it is possible that the increase in yeast colonies occuring during various systemic diseases may have an effect on this observation. Based on the results of this study, it is concluded that the asthmatic children should receive periodic supervision with prophylactic dental care.