Steroids, commonly prescribed for various medical conditions, impact the entire body, including oral health. Understanding their specific influences on the mouth is important for managing potential risks and maintaining good oral hygiene.
Understanding Steroids and Oral Health
Steroids primarily encompass two main types: corticosteroids and anabolic steroids. Corticosteroids are medications that resemble cortisol, a hormone naturally produced by the adrenal glands, and are primarily used to reduce inflammation and suppress the immune system. Anabolic steroids are synthetic versions of testosterone, the male hormone, and are known for their muscle-building properties. While both are steroids, their mechanisms of action and effects on the body, including oral tissues, are distinct. Medications, in general, can have systemic effects that extend to oral health, influencing everything from salivary flow to gum tissue and bone density.
Corticosteroids and Dental Concerns
Corticosteroids are widely used to treat inflammatory conditions such as asthma, allergies, and autoimmune diseases. Their use, especially long-term or in inhaled forms, can lead to several oral health issues. A common concern is oral candidiasis, a fungal infection (thrush) that appears as white patches in the mouth and can cause discomfort. This infection occurs because corticosteroids suppress the local immune response, allowing the Candida albicans fungus, normally present in the mouth, to overgrow.
Dry mouth is another frequent side effect of corticosteroid use, particularly with inhaled or oral forms. Saliva plays a crucial role in neutralizing acids, washing away food particles, and protecting against decay and gum disease. A reduction in saliva flow can increase the risk of cavities and gum inflammation. Long-term corticosteroid therapy can also increase the risk of gum diseases, such as gingivitis (gum inflammation) and periodontitis (a more severe gum infection that affects the bone supporting teeth). This increased susceptibility is partly due to their immune-suppressing effects.
Beyond soft tissue issues, corticosteroids can affect bone density. Prolonged use may decrease jawbone mineral density, potentially impacting tooth stability and increasing tooth loss risk. This occurs due to their influence on calcium absorption and bone metabolism. Additionally, corticosteroids can delay wound healing, which can be a consideration for oral surgeries or injuries.
Anabolic Steroids and Dental Concerns
Anabolic steroids, often used for muscle enhancement, carry a distinct set of oral health risks. One notable effect is gingival hypertrophy, where gum tissue swells and grows excessively. This overgrowth can create spaces that harbor bacteria, potentially leading to gum disease and periodontitis. The hormonal imbalance caused by anabolic steroid use may contribute to these gum changes.
Users may also experience increased bruxism (teeth grinding and clenching). This can be a result of heightened aggression or stress linked to steroid use, leading to jaw pain, temporomandibular joint (TMJ) disorders, and damage to tooth enamel. The increased muscle mass, including masticatory muscles, from anabolic steroids may contribute to more intense grinding. Anabolic steroids may also alter bone density, potentially leading to bone loss in the jaw, which could increase the risk of tooth loss.
Protecting Your Teeth While Using Steroids
Maintaining good oral health practices is essential for individuals using steroids to mitigate dental problems. Brushing teeth twice daily with fluoride toothpaste and flossing at least once a day helps remove plaque and reduce the risk of cavities and gum disease. Regular dental check-ups, ideally every six months, allow dentists to identify and address any issues early. It is important to inform your dental professional about all steroid medications you are taking, including dosage and duration, as this information is relevant for comprehensive care and treatment planning.
For those using inhaled corticosteroids, rinsing the mouth thoroughly with water and spitting it out immediately after each use is an effective step to prevent oral candidiasis and dry mouth. Some healthcare providers also suggest brushing teeth after using an inhaler if possible. Staying well-hydrated by sipping water frequently can help combat dry mouth, and chewing sugar-free gum can stimulate saliva flow. Avoiding sugary and acidic beverages is advisable, as they can exacerbate dental issues, especially with reduced saliva.