A Trip To The Dentist Could Cause Symptoms In Asthmatic Kids

November 30, 1998

COLUMBUS, Ohio -- New research suggests a dental visit may trigger asthma symptoms in some children with the disorder.

Researchers found that nearly one out of three children with asthma developed some symptoms within 30 minutes after visiting their dentists. And about 15 percent of the kids had a clinically significant decrease in lung function.

“Dental treatment is not a benign experience for some children with asthma,” said Paul Casamassimo, co-author of the study and professor and chair of pediatric dentistry at Ohio State University.

Asthma -- the leading serious chronic illness of children in the United States -- is a condition that obstructs airflow into the lungs. Symptoms include coughing, wheezing and shortness of breath. Potential causes for the illness include cigarette smoke, physical exercise, changes in weather, emotional stress and allergens such as pollen and house dust.

The study did not determine exactly what triggers an asthma
attack after a dental visit. But Casamassimo suggests that allergens may be a key culprit. Allergens may take the form of cotton swabbing placed in the mouth or small clouds of water vapor that normally occur during dental procedures.

The researchers did determine, however, that stress and anxiety over a dental visit did not play a role in causing an attack. They found that patient history, such as a recent asthma-related emergency room visit, did not predict a post-dental asthma attack.

The study appears in a recent issue of the Journal of the American Dental Association. The lead researcher, Tanya Mathew, conducted this study for partial fulfillment of a master of science degree. She is now a clinical assistant professor of dentistry at Ohio State.

Casamassimo and his colleagues examined 57 6- to 18-year olds with histories of active asthma. The children participated in a total of 74 cleaning or operative visits or both.

The researchers wanted to see if dental treatment caused a change in the children’s airways. Each child blew into a spirometer, a machine used to measure the volume of air in a lung. The researchers took spirometer readings before, immediately after and 30 minutes after dental treatment. They also recorded any asthma-related symptoms that occurred before, during or after treatment.

“The spirometer reading showed a significant decrease in lung function in about 15 percent of the patients,” Casamassimo said. A 10 to 20 percent decrease in lung function -- depending on the spirometer test used -- is considered significant. Most of the asthma-related symptoms recorded, such as coughing and congestion, were considered mild. However, five patients (6.75 percent) showed wheezing or difficulty breathing a half-hour after the visit.

About 38 percent of the subjects in the study had mild asthma, 44 percent had moderate asthma and 17.5 percent had severe asthma.

Parents of asthmatic children should be aware that a trip to the dentist may cause symptoms to flare up. For some kids, the respiratory effects could show up later.

“Dental treatment could potentially cause discomfort within 24 to 36 hours,” Casamassimo said. “Controlling asthma during a dental visit may be as simple as having the kids take a dose of their inhaler before they come to the office.”Other study co-authors included James Preisch, clinical assistant professor of pediatric dentistry at Ohio State and Children’s Hospital; Stephen Wilson, associate professor of pediatric dentistry at Ohio State and Children’s Hospital; Elizabeth Allen, assistant clinical professor of pediatrics at Ohio State and Children’s Hospital; and John Hayes, clinical instructor of pediatrics at Ohio State.

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Ohio State University

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