Inhalers effectively manage respiratory conditions by delivering medication directly to the airways. While designed for targeted relief, proper usage extends beyond just inhaling. Following all recommended steps maximizes effectiveness and minimizes side effects.
Why Inhalers Leave Residue
When medication is delivered via an inhaler, it is released as a fine mist or powder intended to reach the lungs. However, not all medication travels directly into the lower respiratory tract. A portion of the inhaled dose inevitably deposits in the mouth and throat.
This deposition occurs when medication particles collide with the oral cavity and upper airway walls before reaching the lungs. Factors like breath speed, particle size, and coordination between activation and inhalation influence how much medication settles. This leaves residue in the mouth and throat after each use.
Preventing Common Oral Complications
Unremoved residue from inhaler use can cause several oral and throat complications. One primary concern is oral thrush, also known as oral candidiasis. Inhaled corticosteroids, often delivered via inhalers, can locally suppress the immune response in the mouth and throat. This suppression creates an environment conducive to the overgrowth of Candida albicans, a yeast naturally present in the mouth, leading to fungal infections.
Beyond fungal infections, residual medication can contribute to dysphonia, which manifests as hoarseness or changes in voice quality. This occurs due to irritation or inflammation of the vocal cords in the larynx. Throat irritation, like a scratchy sensation, is also possible. An unpleasant taste in the mouth can result from lingering medication particles. Rinsing the mouth and gargling helps physically remove these particles, reducing the risk of these adverse effects.
How to Properly Rinse
Rinsing your mouth and throat after inhaler use is a simple, effective step to mitigate side effects. Immediately after inhaling the medication, take a sip of plain water. Swish the water thoroughly around your entire mouth, ensuring it reaches all surfaces, including under the tongue and along the gums.
After swishing for about 10 to 15 seconds, gargle with the same water for an additional 5 to 10 seconds. Gargling helps clear any medication residue from the back of the throat and vocal cords. Always spit out the water completely to prevent systemic absorption of residual medication. The use of a spacer device with your inhaler can also help reduce the amount of medication deposited in the mouth, making the rinsing process even more effective.
Which Inhalers Require Rinsing
The recommendation to rinse your mouth after inhaler use primarily applies to inhalers that deliver inhaled corticosteroids (ICS). These medications, such as fluticasone, budesonide, or beclomethasone, work by reducing inflammation in the airways. Their localized anti-inflammatory action can suppress the immune system in the mouth and throat, increasing the likelihood of oral thrush and voice changes. Rinsing is an important measure to prevent these specific side effects.
Conversely, many bronchodilator inhalers, often called “rescue inhalers,” do not carry the same strong recommendation for rinsing. These medications, such as albuterol or levalbuterol, primarily work by relaxing the muscles around the airways to open them quickly. They do not have the same localized immunosuppressive effects as corticosteroids, consequently lowering the risk of oral thrush or dysphonia.