Asthma: dental considerations

For the medical management of asthma, see the Respiratory Guidelines.

In dental practice, first-aid management of acute asthma is outlined here.

Advise patients with asthma to bring their reliever inhaler and spacer to dental appointments.

Patients with severe asthma are at increased risk of adverse outcomes from sedation and general anaesthesia. Dental procedures requiring sedation or general anaesthesia in a patient with severe asthma should be undertaken in a hospital with an anaesthetist present.

Nonselective nonsteroidal anti-inflammatory drugs (NSAIDs) (eg aspirin, ibuprofen, naproxen) can cause bronchoconstriction in patients with NSAID-exacerbated respiratory disease. Cyclo-oxygenase-2 (COX-2)–selective NSAIDs (eg celecoxib) do not cause bronchospasm in patients with NSAID-exacerbated respiratory disease. If analgesia is required in asthmatic patients with known NSAID-exacerbated respiratory disease, use a COX-2–selective NSAID or paracetamol (see Choice of analgesic for acute dental pain).

Patients with asthma can develop oral candidiasis secondary to the use of inhaled corticosteroids. For treatment of oral candidiasis, see here; to prevent recurrence, advise patients to rinse their mouth and throat with water and spit out after inhalation.

Patients are sometimes prescribed a short course of systemic corticosteroids following an asthma exacerbation—consider delaying elective dental treatment until the course is complete.