Dental steroids are not the muscle-building anabolic type but are corticosteroids, a class of synthetic hormones that replicate the effects of cortisol, a hormone naturally produced by the body. Their primary function in a dental setting is to manage inflammation and suppress the immune response. Dentists prescribe these medications to address the swelling, discomfort, and pain that can accompany specific dental procedures and inflammatory conditions, which helps facilitate a smoother recovery.
Conditions Treated with Dental Steroids
Corticosteroids are frequently used to manage inflammation following oral surgery. Procedures like the extraction of third molars (wisdom teeth) or the surgical placement of dental implants often cause considerable swelling and discomfort. Administering a steroid such as dexamethasone before or after the surgery helps to significantly reduce this inflammatory response, leading to less post-operative pain and a more comfortable recovery.
Certain painful, non-infectious oral lesions that cause chronic irritation are also managed with steroids. Conditions like severe aphthous ulcers (large, persistent canker sores) and erosive oral lichen planus, an inflammatory condition causing painful sores, respond well to corticosteroid treatment. The steroid’s anti-inflammatory action helps calm irritated tissues, reduce pain, and promote healing.
Disorders of the temporomandibular joint (TMJ), which connects the jawbone to the skull, can cause significant pain and limit mouth movement. When inflammation is a contributing factor to the pain and dysfunction, corticosteroids can be an effective treatment. By reducing inflammation within the joint capsule, steroids can help alleviate jaw pain, decrease tenderness, and improve the range of motion.
Endodontic treatments, such as root canals, can sometimes lead to inflammation within the tooth’s pulp chamber or in the tissues surrounding the root. This can result in post-operative pain and sensitivity. Steroids may be used to reduce this internal inflammation, providing relief from discomfort after the procedure and managing the inflammatory response that can occur after instrumentation.
Administration of Steroids in Dentistry
One common method of administration is systemic, which involves the patient taking medication orally in pill form. Drugs such as prednisone or methylprednisolone are prescribed as a short-term course to manage widespread or severe inflammation. This approach is often used following major oral surgeries where significant post-operative swelling is anticipated, as the medication circulates throughout the body.
Another targeted approach is the use of local injections. This method delivers the corticosteroid directly into the specific area of concern, such as an inflamed TMJ or a tender muscle in the jaw. Injecting a steroid like triamcinolone acetonide allows for a high concentration of the medication at the site of inflammation, which maximizes the therapeutic benefit while minimizing the body’s overall exposure to the drug.
For conditions affecting the surface tissues inside the mouth, topical application is a preferred method. This involves using pastes, gels, or rinses that contain a corticosteroid, such as triamcinolone acetonide in a dental paste. The patient applies the product directly onto oral lesions like aphthous ulcers or lichen planus, focusing the anti-inflammatory action on the tissue’s surface for relief without significant absorption into the bloodstream.
Side Effects and Patient Considerations
The use of steroids in dentistry is for a short duration, which reduces the likelihood of side effects associated with long-term therapy. However, patients may still experience temporary effects, including an increase in blood sugar levels, difficulty sleeping, an elevated appetite, and mood changes. In some cases, topical steroids can lead to oral thrush, a fungal infection, or a dry mouth.
Because corticosteroids can influence various bodily systems, it is important for patients to be thorough when discussing their medical history with their dentist. Full disclosure allows the practitioner to weigh the benefits against potential risks and ensure the appropriate use of the medication for their specific situation.
What to Disclose to Your Dentist
Before starting steroid treatment, inform your dentist of any pre-existing health conditions. It is particularly important to mention if you have:
- Diabetes, as corticosteroids can cause a rise in blood sugar levels that may require monitoring.
- A history of high blood pressure, glaucoma, or osteoporosis, as steroids can potentially worsen these conditions.
- Any active infections, whether bacterial or fungal, as corticosteroids suppress the immune system and can make it harder for the body to fight an infection.
- If you are pregnant, planning to become pregnant, or are currently breastfeeding to ensure the treatment is appropriate.