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Background <p>Asthma and its treatments are recognized as risk factors for oral health in children. The composition of oral microbiota is linked to asthma, as well as to the development of caries and other oral conditions. This study aimed to assess the impact of asthma and anti-asthmatic therapy on children`s oral health and explore the role of salivary microbiota in this relationship.</p> Methods <p>A cross-sectional study was conducted, including 100 children with asthma, aged 6 to 18 years, and 50 matched healthy controls. Oral health was assessed using the decayed, missing and filled teeth (DMFT/dft) index, the simplified oral hygiene index (OHI-S) to evaluate dental plaque and calculus, and the gingival index. Saliva flow rate and pH were measured, and the salivary microbiota composition was analyzed using 16&#xa0;S amplicon sequencing.</p> Results <p>Children with asthma had a median DMFT/dft index of 4, versus 0 in controls (<i>p</i> &lt; 0.01), a median OHI-S of 0.9 versus 0 (<i>p</i> &lt; 0.01) and a median gingival index of 1 versus 0 (<i>p</i> &lt; 0.01). Daily use of inhaled corticosteroids (ICS) was associated with a higher median OHI-S (1 vs. 0.8, <i>p</i> &lt; 0.01) but had no effect on the DMFT/dft or gingival index. The median unstimulated saliva flow rate and pH were 1.3 mL and 6.25 in children with asthma compared to 2.5 mL and 7.00 in controls (<i>p</i> &lt; 0.01 for both). Children with asthma daily using ICS had a lower saliva flow (1.0 mL) and pH (6.25) compared to non-ICS users (1.5&#xa0;ml and 6.75, <i>p</i> &lt; 0.01 for both). The salivary microbiota composition in children with asthma differed significantly from controls (<i>p</i> &lt; 0.01), showing increased abundances of <i>Streptococcus</i>, <i>Gemella</i>, and <i>Streptobacillus</i>. Alpha diversity was lower in children with asthma, with reduced richness (<i>p</i> &lt; 0.01) and evenness (<i>p</i> = 0.012). However, no significant associations were identified between salivary microbiota and specific oral health indicators.</p> Conclusions <p>Asthma negatively affects children`s oral health, including reduced salivary flow, and is associated with alterations in the oral microbiota. However, the development of caries in children with asthma cannot be attributed solely to medications or microbiota alterations. Therefore, meticulous oral hygiene and other preventive measures are especially important in children with asthma.</p>

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Association of asthma and anti-asthmatic therapy with oral health and microbiota alterations in children - a cross-sectional study

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年1月26日

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  • Vojko Berce,
  • Boris Egić,
  • Anja Pintaric Lonzaric,
  • Maja Rupnik,
  • Aleksander Mahnic

摘要

Background

Asthma and its treatments are recognized as risk factors for oral health in children. The composition of oral microbiota is linked to asthma, as well as to the development of caries and other oral conditions. This study aimed to assess the impact of asthma and anti-asthmatic therapy on children`s oral health and explore the role of salivary microbiota in this relationship.

Methods

A cross-sectional study was conducted, including 100 children with asthma, aged 6 to 18 years, and 50 matched healthy controls. Oral health was assessed using the decayed, missing and filled teeth (DMFT/dft) index, the simplified oral hygiene index (OHI-S) to evaluate dental plaque and calculus, and the gingival index. Saliva flow rate and pH were measured, and the salivary microbiota composition was analyzed using 16 S amplicon sequencing.

Results

Children with asthma had a median DMFT/dft index of 4, versus 0 in controls (p < 0.01), a median OHI-S of 0.9 versus 0 (p < 0.01) and a median gingival index of 1 versus 0 (p < 0.01). Daily use of inhaled corticosteroids (ICS) was associated with a higher median OHI-S (1 vs. 0.8, p < 0.01) but had no effect on the DMFT/dft or gingival index. The median unstimulated saliva flow rate and pH were 1.3 mL and 6.25 in children with asthma compared to 2.5 mL and 7.00 in controls (p < 0.01 for both). Children with asthma daily using ICS had a lower saliva flow (1.0 mL) and pH (6.25) compared to non-ICS users (1.5 ml and 6.75, p < 0.01 for both). The salivary microbiota composition in children with asthma differed significantly from controls (p < 0.01), showing increased abundances of Streptococcus, Gemella, and Streptobacillus. Alpha diversity was lower in children with asthma, with reduced richness (p < 0.01) and evenness (p = 0.012). However, no significant associations were identified between salivary microbiota and specific oral health indicators.

Conclusions

Asthma negatively affects children`s oral health, including reduced salivary flow, and is associated with alterations in the oral microbiota. However, the development of caries in children with asthma cannot be attributed solely to medications or microbiota alterations. Therefore, meticulous oral hygiene and other preventive measures are especially important in children with asthma.