Clinical and radiological assessment of effects of long-term corticosteroid therapy on oral health

Abstract

Background: Corticosteroids (Cs) are used widely for their anti-inflammatory and

immunosuppressive properties. They have the potential to cause dramatic improvement as well

as produce equally dramatic adverse effects. The clinical misuse like over prescription of the drug

should be avoided. Long-term administration may cause many adverse effects leading to impaired

oral health. Oral health is usually not considered during management of patients on long-term

corticosteroid therapy. The aim of this study was to assess the oral health status and radiological

changes in the jaw bones of the patients under long-term corticosteroid therapy.

Materials and Methods: Oral health of 100 patients under long-term corticosteroid therapy

with a minimum of 3 months duration was compared with sex- and age-matched 100 healthy

controls. The clinical examination included complete examination of the mouth and periodontal

status. Radiographic evaluation of bone with the help of intra oral periapical radiograph and digital

orthopantomograph and levels of serum calcium, alkaline phosphatase, and random blood sugar

were assessed. ‘Chi-square test’, ‘Kolmogorov-Smirnov test’ and ‘Mann-Whitney U test’ were used

for statistical analysis. P < 0.05 was considered significant.

Results: Patients on steroids exhibited significantly higher levels of candidiasis and clinical

attachment loss of the periodontal ligament, probing pocket depth. Bone density was significantly

lower in the study group than that in the control group. Random blood glucose was significantly

higher and significant lower levels of calcium were observed in patients on steroids.

Conclusion: Long-term use of Cs may affect oral health adversely leading to candidiasis as well as

impair bone metabolism leading to a considerable decrease in the mandibular bone mineral density.

Key Words: Bone mineral density, corticosteroids, oral manifestations, periodontal health