Medication impact on oral health in schizophrenia.

BACKGROUND: Patients with schizophrenia constitute a particularly vulnerable group for oral diseases. Among the different factors involved, we aimed to examine the evidence of how drugs could contribute to the poorer oral health of this population. MATERIAL AND METHODS: An overview of the potential impact of medication on dental/oral health among people with schizophrenia was proposed focusing on selected literature. RESULTS: Studies show a higher dental caries and degree of periodontal diseases in this population and point to drug-induced xerostomia as an important risk factor for oral health deterioration. The risk of dry mouth depends on not only antipsychotics, but also drugs with anticholinergic activity. We hypothesize that antipsychotic induced glycaemic alterations might contribute to reduced oral health, and that the antimicrobial activity of certain antipsychotics could have an impact on oral microbiota affecting oral condition. Pharmacovigilance data show that involuntary movements are caused by typical and some atypical antipsychotics. Dry mouth is most frequently reported for quetiapine and olanzapine, while clozapine is more frequently associated with sialorrhea. CONCLUSIONS: Literature clearly shows higher caries and periodontal disease in schizophrenic patients. However, overall, there is scarce literature about the potential influence of drugs in these disorders. Health professionals should be aware of this issue in order to implement adequate preventive measures in this vulnerable population.

Household smoking impact on the oral health of 5- to 7-years-old children.

BACKGROUND: Children's exposure to secondhand smoke, particularly by their parents, could adversely affect their oral health. Thereby, this study aimed to assess the oral health status of children subjected to household smoking and the impact of smoking patterns on the severity of oral health deterioration. METHODS: A total of 210 healthy children were enrolled in this case-control study and allocated into children subjected to household smoking (HS) and control groups. Participants' guardians were asked to complete a questionnaire regarding sociodemographic characteristics and parental smoking habits. All participants were subjected to clinical dental examination to assess dental caries (ICDAS), hypomineralized primary molars (HSPM), and gingival status (GI). Stimulated saliva samples were collected to assess saliva composition and characteristics. Urine samples were collected and analyzed for cotinine concentration. Data were analyzed using SPSS (v.25) software at a test value of p ≤ 0.05. The t-student test was used to find significant differences between participants' age, gingival index score, saliva pH, flow rate, sIgA, and cotinine level. The Chi-square test was used to test for the significance of parental employment, number of rooms, gender, sweets consumption, brushing frequency, and HMPM. The correspondence analysis was used to test for significance of parents' levels of education, type of house ventilation, ICDAS score, smoking form, frequency, and smoking pattern. The correlation between cotinine level and sIgA was tested for association using Bivariate correlation test. RESULTS: The HS group showed a significantly increased risk for dental caries (p < 0.000), HSPM lesions (p = 0.007), and GI score (p < 0.000). A significant reduction in salivary flow rate, saliva pH, and sIgA were evident in HS group (p < 0.000). Parental consumption of more than 20 cigarettes/day was accompanied by increased dental caries activity (p < 0.000) and higher risk for increased severity of gingival inflammation (p < 0.000) of children in the HS group. Children of parents who smoke cigarettes and use the hubble/bubble anywhere in the house found to have greater distribution of HSPM (p < 0.000). Reduced sIgA values were found to be significantly associated with increased cotinine concentrations in HS children (p < 0.000). CONCLUSIONS: Frequent exposure to household smoking could be associated with an increased risk of dental caries progression, enamel hypomineralization, gingival inflammation, and saliva characteristics changes in children.

Methamphetamine-induced dental caries: a review of the literature.

Clinical picture of patients taking methamphetamine for long duration includes rampant caries of the smooth surfaces of the whole dentition. The increasing use of methamphetamine in homosexuals is leading to the spread of HIV (human immunodeficiency virus). Easy availability and rapidly spreading nature of this drug (methamphetamine) results in worldwide increase of patients with medical and dental problems. Its effect on human dentition is highly damaging as patients with a beautiful smile begin to present a horrible picture of black, broken, and painful teeth within one year of methamphetamine use. Restoration of aesthetics and function of these teeth is not an easy task, and usually the first step to deal with this condition is counselling the patient to stop using this drug. Knowledge of methamphetamine-induced undesirable effects on the human body is important for the general dental practitioner as referral to mental health services is necessary in this condition.

Association between tamoxifen and tooth loss in women with breast cancer.

OBJECTIVES: Investigate the effect of tamoxifen on the occurrence of tooth loss (TL) in breast cancer (BC) survivors. METHODS: A cross-sectional study was conducted with 140 BC survivors using tamoxifen therapy. Sociodemographic, medical, and dental data were evaluated. TL was determined using the M component of the Decayed, Missing and Filled Teeth (DMFT) index. Logistic regression models were run to determine associations between the independent variables and outcome (TL). RESULTS: Mean TL was 12.96 (SD 8.88). Only three participants had lost no teeth and 10.7% were completely edentulous. Participants who used tamoxifen for more than 1 year had a higher mean missing teeth (13.99 vs. 10.45; P = 0.030). After the adjustments, the occurrence of more than 12 missing teeth was 2.75-fold higher among women who used tamoxifen for more than 1 year (95% CI: 1.06-7.12). Moreover, age over 65 years, referral for treatment by the public healthcare system, less use of dental services, xerostomia, and a lower occurrence of dental caries remained associated with the loss of more than 12 teeth. CONCLUSION: Longer use of tamoxifen was associated with greater tooth loss in breast cancer survivors. CLINICAL RELEVANCE: Based on estimates of the increase in cases of breast cancer, the prolonged use of tamoxifen for the treatment of this disease can exert an impact on oral health through the occurrence of tooth loss. These findings can contribute to the planning and implementation of oral health care and prevention strategies for such patients.

Chemotherapy as a risk factor for caries and gingivitis in children with acute lymphoblastic leukemia: A retrospective cohort study.

BACKGROUND: Dental and oral anomalies are among the most common long-term side effects of childhood cancer therapy. AIM: To evaluate chemotherapy as a risk factor for caries lesions and gingivitis in children with acute lymphoblastic leukemia (ALL) treated with the ALL IC-BFM 2009 chemotherapy protocol. DESIGN: A retrospective cohort study was designed. Clinical records of 23 paediatric patients with ALL exposed to chemotherapy in the Regional Hospital in Valdivia, Chile, and 46 unexposed patients assessed every 3 months for 24 months were analyzed. The data on gender, age, index of the number of decayed, missing, or filled teeth, and the presence of gingivitis were recorded (Mann-Whitney U test and logistic regression analysis, p ≤ .05). RESULTS: A significantly greater frequency of gingivitis (69.57%; p < .002) and a mean of new caries lesions were observed in children treated with chemotherapy than in the unexposed children (p < .01). The chemotherapy protocol presented a relative risk of 2.15 (95% CI = 1.22 - 2.66; p = .01) for new caries lesions and 2.29 (95% CI = 1.76 - 3.82; p = .002) for gingivitis. CONCLUSION: The ALL IC-BFM 2009 chemotherapy protocol in patients with ALL is a risk factor for new caries lesions and gingivitis.

Artificial Caries Lesion Characteristics after Secondary Demineralization with Theobromine-Containing Protocol.

Developing artificial caries lesions with varying characteristics is needed to adequately study caries process in vitro. The objective of this study was to investigate artificial caries lesion characteristics after secondary demineralization protocol containing theobromine and fluoride. Sixty bovine enamel slabs (4 × 3 mm) were demineralized using a Carbopol-containing protocol for 6 days. A baseline area (2 × 3 mm) was protected with acid-resistant nail varnish, after which specimens were exposed for 24 h to a secondary demineralization protocol containing acetic acid plus one of four fluoride/theobromine combinations (n = 15): theobromine (50 or 200 ppm) and fluoride (0 or 1 ppm). Specimens were sectioned and analyzed using transverse microradiography for changes in mineral content, lesion depth, and surface layer mineralization. Data was analyzed using paired t-test and analysis of variance followed by Bonferroni test at 0.05 significance level. After secondary demineralization, fluoride-containing groups had significantly deeper lesions (p = 0.002 and 0.014) compared to the group with 0 ppm fluoride and 50 ppm theobromine. Mineral content and lesion depth were significantly different compared to baseline for all groups. Theobromine did not show an added effect on mineral uptake. Theobromine-containing groups exhibited particularly deep lesions with a more uniform mineral profile in the presence of fluoride.

Association of sugar-sweetened drinks with caries in 10- and 15-year-olds.

BACKGROUND: Sugar-sweetened drinks (SSDs) are known to be cariogenic, but this association has not been well investigated in population-based repeated cross-sectional studies in recent years. Therefore, this study examined whether SSD intake is associated with higher caries experience in 10- and 15-year-olds. METHODS: The study sample included participants from the Munich study centre of two birth cohorts with data on non-cavitated caries lesions (NCCL/S), caries experience (DMF/S index), overall caries burden (DMF + NCCL/S) and SSD intake. In total, 915 and 996 children were included from the 10- and 15-year follow-ups, respectively. Intake (g/day) of SSDs, comprising cola, lemonade, ice-tea, sport/energy drinks, fruit squashes and nectars, was calculated from food frequency questionnaires. For analyses, the SSD intake was converted into portions (250 ml/day). Multiple logistic regression and prospective analysis models were performed to test associations between SSD intake and various definitions of caries, adjusting for sex, parental education, body mass index (BMI) categories, study cohort, plaque-affected sextants, mode of SSD consumption, energy content of SSDs, and total energy intake. RESULTS: The mean overall caries burden at 10 and 15 years of age was 1.81 (SD: 2.71) and 6.04 (SD: 8.13), respectively. The average consumption of SSDs at the 10- and 15-year follow-ups was 0.48 (SD: 0.85) and 0.83 (SD 1.40) portions/day, respectively. After adjusting for confounders, in 10-year-olds, SSD intake was significantly associated with higher caries experience based on the indices DMF/S (adjusted odds ratio: 1.29; 95% CI: 1.06-1.57), NCCL/S (1.24; 1.03-1.49) and DMF + NCCL/S (1.27; 1.05-1.55). At the 15-year follow-up, SSD consumption was significantly associated with increased DMF/S index (1.12; 1.01-1.25) only. Prospective model associating 10-year SSD intake with 15-year caries experience was not significant. CONCLUSIONS: SSD intake significantly increases the caries burden in 10-year-olds, with attenuated effects in 15-year-olds. To prevent caries, SSD consumption should be reduced, especially in children and adolescents.

Long-term scopolamine treatment and dental caries.

OBJECTIVES: To investigate whether scopolamine, an anticholinergic agent which induces hyposalivation, represents a risk factor for the occurrence of dental caries. MATERIALS AND METHODS: A retrospective cohort study was carried out among sailors treated with scopolamine for seasickness. The study population included 370 young healthy male adults (18-30 years old) who served in the Israel Navy between 2012 and 2016. Of these, 66 subjects who were chronically treated with intermittent administration of scopolamine, either by the oral or transdermal route, were assigned to the study group. Documented subject characteristics included age, socioeconomic status, level of education, body mass index, smoking history, and dental hygiene. Follow-up lasted 1 to 3.5 years. RESULTS: Two- to 3.5-year follow-up revealed a higher risk of dental caries in 15 of 16 subjects (93.8%) treated with an average of 50.9 mg scopolamine, in contrast to only 71 of 108 control subjects (65.7%) (RR = 1.43, p = 0.02 [95% CI = 1.18-1.72]). Follow-up for 1-1.5 years revealed a lower occurrence of dental caries in both the study group (11/22, 50.0%) and the control group (46/104, 44.2%). Follow-up of 1.5-2 years also revealed less dental caries, in 16/28 subjects (57.1%) in the study group and 51/92 subjects (55.4%) in the control group. The differences were not statistically significant. CONCLUSIONS: In healthy young adults, prolonged intermittent use of scopolamine was found to be a risk factor for the development of dental caries. CLINICAL SIGNIFICANCE: Dental care and hygiene should be intensified when administering hyposalivatory anticholinergic agents.

Cariogenic Potential of Sucrose Associated with Maltodextrin on Dental Enamel.

Maltodextrin is a hydrolysate of cornstarch and has been widely used in the food industry associated with sucrose. The addition of starch can increase the cariogenic potential of sucrose; however, there are sparse data regarding the cariogenicity of sucrose associated with maltodextrin. Therefore, the aim of this study was to test in situ if maltodextrin could increase the cariogenic potential of sucrose. This was an in situ, randomized, crossover, split-mouth, and double-blind study. Volunteers wore palatal appliances containing bovine enamel blocks for 2 periods of 14 days. They dripped the following solutions on the enamel blocks 8 times per day: deionized distilled water (DDW), maltodextrin (M), sucrose + maltodextrin (S+M), or sucrose (S). At the end of each experimental period, biofilms were collected and analyzed for microbiological (mutans streptococci, lactobacilli, and total microorganisms counts) and biochemical (calcium, inorganic phosphate, fluoride, and insoluble extracellular polysaccharides concentrations) compositions. The enamel demineralization was assessed by microhardness. Treatments S and S+M resulted in a lower inorganic composition and higher concentration of insoluble extracellular polysaccharides in the biofilms, and higher enamel mineral loss compared to DDW and M. It can be concluded that the cariogenic potential of sucrose is not changed when this carbohydrate is associated with maltodextrin (dextrose equivalent 13-17).

[Drugs and dosage forms as risk factors for dental caries]. / Léciva a lékové formy jako rizikové faktory pro zubní kaz.

Dental caries is a multifactorial disease which, despite a series of preventive measures, remains the most common infectious disease worldwide. Susceptibility or resistance to caries may be a result of the presence of risk or protective factors, genetic predisposition, inappropriate lifestyle associated with education, behavioural and socioeconomic factors. The aim of this review is to highlight the risks associated with the use of some drugs and dosage forms in relation to the formation and development of dental caries. Drugs are classified by the mechanism of their action in this process, into those that 1. influence the tooth development, especially enamel, 2. directly or indirectly damage the tooth structure and/or 3. disrupt the protective function of saliva, causing oral microflora dysbiosis. The review article assesses the current possibilities in the treatment and prevention of dental caries using drugs, dietary supplements and supporting measures. The conclusion of the study deals with recommendations for prevention of adverse effects of drug therapy in the oral cavity, through preventive measures and/or by considering the duration of the treatment to achieve an optimal balance between benefits and risks. Since the topic of the study is of an interdisciplinary character, information on prevention within the oral health improvement in the population can be used not only by pharmacists, who should primarily warn patients about the risks associated with pharmacotherapy, but also dentists, paediatricians/general practitioners and the public.Key words: dental caries prevention drug dosage form adverse effect.

The oral adverse effects of isotretinoin treatment in acne vulgaris patients: A prospective, case-control study.

BACKGROUND: Isotretinoin is the most effective therapy to treat severe acne vulgaris and its systemic adverse effects have been well documented, but little is known on dental side effects over the course of treatment. OBJECTIVES: This prospective case-control study aimed to evaluate the oral adverse effects of isotretinoin in Turkish patients with acne vulgaris; compare oral conditions between patients and normal controls; and investigate the association between salivary parameters and International Caries Detection and Assessment System (ICDAS) scores. MATERIALS AND METHODS: For 6 months, the patients (n = 45) received isotretinoin daily (0.5 mg/kg). The age-matched untreated controls (n = 45) were patients without acne. Both groups were examined before the study and at 6 months for salivary flow, buffer capacity, microbiologic tests, and caries status (based on the ICDAS). Salivary parameters and ICDAS scores were analyzed by Spearman's rank correlations. Data were statistically analyzed by the Mann-Whitney U test, Wilcoxon signed rank tests, and McNemar's Chi-square tests (P < 0.05). RESULTS: Twenty-two isotretinoin-treated patients and 18 controls completed the study. At baseline, the groups were not significantly different in the evaluated parameters (P > 0.05). At 6 months in the isotretinoin-treated group, salivary flow and buffer capacity significantly decreased, and the ICDAS scores significantly increased (P < 0.05). The changes in these criteria from baseline were insignificant in the controls (P > 0.05). Intraoral pathogen counts were not significantly different between the groups, compared to baseline (P > 0.05). Stimulated salivary parameters in both groups were not correlated significantly with the ICDAS scores. CONCLUSIONS: Isotretinoin significantly affected salivary flow, buffer capacity, caries lesion activity scores for 6 months. However, salivary parameters and caries lesion activity scores had no significant correlations.

The impact of the new scene drug "crystal meth" on oral health: a case-control study.

OBJECTIVE: The use of methamphetamine (MA), a highly addictive stimulant, is rapidly increasing, with MA being widely abused as the scene drug "Crystal Meth" (CM). CM has been associated with severe oral health effects, resulting in so-called "Meth mouth". This term appeared for the first time in 2005 in the literature and describes the final complex of symptoms including rampant caries, periodontal diseases and excessive tooth wear. The aim of this study was to investigate the effects of chronic CM abuse on teeth and intraoral tissue with respect to potential symptoms of Meth mouth. MATERIALS AND METHODS: In cooperation with two centres for addiction medicine, we performed clinical intraoral investigations in 100 chronic CM users and 100 matched-pair controls. We undertook a caries and periodontal examination by using the clinical parameters DMF-T/DMF-S, bleeding on probing index (BOP) and periodontal screening index (PSI) and tested individual oral hygiene by using approximal space plaque index (API). All clinical data were analysed by the t test for independent samples. RESULTS: We found significantly larger numbers of caries (p < 0.001) and higher levels of gingival bleeding (p < 0.001) and periodontal disease (p < 0.001) among CM users. Oral hygiene was significantly lower in CM users (p < 0.024). CONCLUSION: Chronic CM use can lead to extensive potential damage within the intraoral cavity. When CM is used over a long period of time and in the absence of treatment, clinical symptoms in terms of Meth mouth syndrome cannot be excluded. CLINICAL RELEVANCE: Based on our results, we recommend a specific prevention and therapeutic concept including educational campaigns for MA users and specialized dental care for CM patients.

Effect of Biodentine on secondary caries formation: An in vitro study.

PURPOSE: To compare the effects of two materials, Biodentine and conventional glass-ionomer cement (CGIC), on secondary caries formation around restorations when used as a dentin replacement material. METHODS: 30 approximal cavities were prepared on mesial and distal surfaces of 15 caries-free human premolar teeth extracted for orthodontic or periodontal reasons. Cavities were filled with A: Biodentine as a base + Filtek Z250 composite (n = 15) or B: CGIC as a base + Filtek Z250 composite (n = 15). The materials were applied according to the manufacturers' instructions. Teeth were thermocycled, and placed in a demineralizing solution for 5 weeks. Secondary caries formation was assessed using the International Caries Detection and Assessment System (ICDAS) II and quantitative computer- aided image measurement of caries depth. RESULTS: The computer-aided measurements showed that the Biodentine group had significantly lower lesion depth measurements than the CGIC group (P = 0.004). However, there was no significant difference among the groups based on the ICDAS II scores (P > 0.05).

Effect of 3 cements on white spot lesion formation after full-coverage rapid maxillary expander: A comparative in-vivo study.

INTRODUCTION: The aim of this study was to assess the effects of 3 luting agents (glass ionomer cement, compomer, and polycarboxylate cement) on white spot lesion formation in patients with full-coverage bonded acrylic splint expanders. White spot lesion formation was assessed with quantitative light-induced fluorescence. METHODS: Full-coverage rapid maxillary expanders were cemented with glass ionomer cement, compomer, and polycarboxylate cement in groups 1, 2, and 3, respectively. A control group comprised patients who never had orthodontic treatment. Quantitative light-induced fluorescence images taken before and after rapid maxillary expansion treatment were analyzed for these parameters: the percentages of fluorescence loss with respect to the fluorescence of sound tooth tissue (ΔF) and maximum loss of fluorescence intensity in the whole lesion; lesion area with ΔF equal to less than a -5% threshold; and the percentage of fluorescence loss with respect to the fluorescence of sound tissue times the area that indicated lesion volume. RESULTS: All 3 groups showed statistically significantly greater demineralization than the control group. The 3 experimental groups differed from each other in half of the parameters calculated. Teeth in the polycarboxylate group developed the most white spot lesions. CONCLUSIONS: With the highest rate of white spot lesion formation, polycarboxylate cements should not be used for full-coverage bonded acrylic splint expanders. Compomers may be preferred over glass ionomer cements, based on the findings of this study.

Evaluation of Fluorescence Imaging with Reflectance Enhancement (FIRE) for Quantifying Enamel Demineralization In vitro.

OBJECTIVES: To assess the ability of fluorescence imaging with reflectance enhancement (FIRE) to quantify early enamel demineralization in vitro. METHODS: A total of 30 bovine enamel specimens were immersed in demineralizing solution to produce artificial caries. Specimens were examined by FIRE, quantitative light-induced fluorescence (QLF), and polarized light microscopy (PLM) at baseline and after 0.5, 1, 2, 4, 8, 24, 48 and 72 h of immersion. Fluorescence loss measured by FIRE and QLF was compared with lesion depth measurements by PLM. RESULTS: Over all time points, measurement of fluorescence loss by FIRE correlated well with the measurement of x0394;F by QLF and of x0394;Q by QLF. Both FIRE and QLF techniques showed significant correlation with PLM. CONCLUSION: FIRE technology may be useful for quantifying enamel demineralization in vitro.

Secondary Caries Development in in situ Gaps next to Composite and Amalgam.

This in situ study investigated the secondary caries development in dentin in gaps next to composite and amalgam. For 21 days, 14 volunteers wore a modified occlusal splint containing human dentin samples with an average gap of 215 µm (SD=55 µm) restored with three different materials: Filtek Supreme composite, Clearfil AP-X composite and Tytin amalgam. Eight times a day, the splint with samples was dipped in a 20% sucrose solution for 10 min. Before and after caries development, specimens were imaged with transversal wavelength independent microradiography, and lesion depth (LD) and mineral loss (ML) were calculated. The LD and ML of the three restoration materials were compared within patients using paired t tests (α=5%). In total 38 composite samples (Filtek n=19 and AP-X n=19) and 19 amalgam samples could be used for data analysis. AP-X composite presented the highest mean values of LD and ML of the three restorative materials. Amalgam showed statistically significantly less ML (Δ=452 µm×vol%) than the combined composite materials (p=0.036). When comparing amalgam to the separate composite materials, only AP-X composite showed higher ML (Δ=515 µm×vol%) than amalgam (p=0.034). Analysis of LD showed the same trends, but these were not statistically significant. In conclusion, amalgam showed reduced secondary caries progression in dentin in gaps compared to composite materials tested in this in situ model.

Prosthodontics treatment considerations for methamphetamine-dependent patients.

Overt dental disease is a distinguishing comorbidity associated with methamphetamine abuse, necessitating the need for special management to maximize treatment benefits. As this highly addictive stimulant increases in popularity, it has become imperative that clinicians are equipped to thoughtfully provide comprehensive care for these patients. This article reviews the impact of methamphetamine to systemic and oral health and proposes a comprehensive treatment plan and sequence for the methamphetamine-dependent patient. A multidisciplinary approach is recommended. Destructive oral and psychological changes must be identified and controlled. A thorough risk assessment, caries control, and preventative plan should be established before initiating prosthodontic treatment. Patient motivation, support, and a timely recall schedule are integral for dental longevity.

Is It Possible to induce Artificial Caries-affected Dentin using the Same Protocol to Primary and Permanent Teeth?

AIM: This in vitro study compared the mineral loss of natural and artificially-created caries-affected dentin in primary and permanent teeth using the same protocol to induce caries lesions. MATERIALS AND METHODS: Twenty molars presenting natural occlusal dentin caries lesions (10 primary-PriC and 10 perma-nent-PermC; control group), and 20 sound molars (10 primary -PripH and 10 permanent-PermpH; experimental group), were selected. Occlusal cavities were prepared in teeth of the experimental group that were submitted to pH-cycling for 14 days to simulate caries-affected dentin. All specimens were longitudinally sectioned and prepared in order to obtain Knoop micro-hardness values from 15 to 250 urn depth, starting in bottom of center of natural lesions or cavities. The microhardness (KHN) data were submitted to three-way repeated measures analysis of variance (ANOVA) and Tukey's tests (α = 0.05). RESULTS: Considering all depths, there was no statistically significant differences (p > 0.05) between the mineral loss of the control (PriC = 30.9 ± 6.4 and PermC = 40.8 ± 8.6) and experimental (PripH = 27.3 ± 11.1 and PermpH = 35.5 ± 14.0) groups, neither between primary and permanent teeth. CONCLUSION: The mineral loss of the artificially-created caries-affected dentin is similar to that from naturally developed dentin caries lesions. CLINICAL SIGNIFICANCE: The pH-cycling model may be a suitable method to simulate caries-affected dentin in both permanent and primary teeth.

Drugs that promote dental caries.

Dental caries result from erosion of tooth enamel or cementum by acidic substances produced by bacteria found in dental plaque. Caries can lead to pulp necrosis and tooth loss. Risk factors include certain dietary habits, poor oral hygiene, and dry mouth. Diabetes and Sjogren's syndrome can also promote dental caries. Psychotropic substances such as cocaine, methamphetamine, heroin and cannabis can promote dental caries. Many medicinal drugs facilitate the formation of dental caries, through various mechanisms; they include formulations with a high sugar content; drugs that cause dry mouth (especially antimuscarinics); drugs that lower the buccal pH (inhaled powders, etc.); and drugs that cause demineralisation (tetracyclines, etc.). In practice, patients (and parents) should be informed that some drugs can increase the risk of dental caries. They should be encouraged to adapt and reinforce dental hygiene, and advised to visit a dentist regularly.

Cariogenic Potential of Inhaled Antiasthmatic Drugs.

INTRODUCTION: The organism of children with asthma is exposed to the effects of the disease but also the drugs for its treatment. Antiasthmatic drugs have different modes that promote the caries formation which varies according to their basic pharmacological composition. Namely, these drugs have a relatively low pH (5.5), can contain sweeteners such as lactose monohydrate in order to improve the drug taste or both. Frequent consumption of these inhalers in combination with reduced secretion of saliva increases the risk of caries. MATERIAL AND METHODS: The study sample consisted of 200 patients, age from 7-14 years, divided into two groups: control group (n1 = 100) consisted of healthy children and the experimental group consisted of children suffering from asthma (n2 = 100). In both groups of respondents are determined the DMFT index, plaque index value and hygienic-dietary habits using the questionnaire. The subjects in the control group had significantly higher DMFT index than subjects in the experimental group (p = 0.004). It is determined that there are no significant differences in the values of plaque index (p>0.05). CONCLUSION: The effect of different diseases or medications from their treatment, diet and fermentable carbohydrates in the etiology of dental caries cannot be observed outside the living conditions of subjects, their social epidemiologic status, age, habits, oral hygiene, fluoride use, etc.