Is there a relationship between asthma and dental caries? A critical review of the literature

Background. The authors conducted a critical review of the literature to ascertain the strength of the scientific and professional evidence supporting an association between dental caries and the experience and severity of asthma. Types of Studies Reviewed. In March 2010, the authors searched Medline (1976-2010) by using the Ovid Web Gateway for the terms asthma and [dental caries or dental caries susceptibility] appearing in studies of humans published in English. The authors eliminated conference proceedings and abstracts, opinion pieces and unpublished studies; they included case series, cross-sectional, case-control and cohort studies and clinical trials. Results. The review yielded 27 studies described in 29 articles. The authors found that researchers have investigated the hypothesized relationship between asthma and caries by means of diverse strategies, often using asthma cases clustered in pools of patients seeking clinical care. The strongest methodological designs were more likely to reveal little support for a positive association. The authors found no strong evidence suggesting that a causal link exists. Future research incorporating better-defined covariates and longitudinal designs is needed. Clinical Implications. Asthma per se may not be a risk factor for caries. Patients who have extreme dryness of the mouth, whose use of nebulizers is persistent, whose consumption of carbohydrates is frequent, and who have used multiple medications or have used medications over the long term necessitate cautious dental health care.