Bronchial Asthma and Factors Influencing the Development of Periodontal Pathology
Keywords:
bronchial asthma, periodontitis, risk factors, oral microbiota, inhaled corticosteroids, microcirculation, laser Doppler flowmetryAbstract
Background: Bronchial asthma and periodontitis are common chronic inflammatory diseases, and a growing body of evidence suggests that they are associated. Aim: To summarise current evidence on the general somatic and local factors that influence the development of periodontal pathology in patients with bronchial asthma, with particular attention to the oral microbiota, immune-inflammatory mechanisms and microcirculatory disorders of the periodontium. Methods: A narrative review of international and national publications indexed in PubMed, Scopus, Google Scholar and eLIBRARY was carried out; the evidence was grouped into thematic blocks and summarised in tables and schematic figures. Results: Systematic reviews report higher plaque, gingival and bleeding indices in patients with asthma, and a meta-analysis of pulmonary diseases reported a pooled odds ratio of 3.03 for the association between asthma and periodontitis. Plausible mechanisms include the effects of inhaled corticosteroids and β2-agonists on salivary flow, mouth breathing, shared Th2/Th17-mediated inflammation, aspiration of periodontal pathogens and disorders of gingival microcirculation that can be assessed by laser Doppler flowmetry. Conclusion: Patients with bronchial asthma should be regarded as a risk group for inflammatory periodontal diseases; regular periodontal examination, hygiene education and assessment of gingival microcirculation are recommended, and prospective studies are needed to establish causality.
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