ABSTRACT
OBJECTIVES: The aim of this study was to determine if salivary hypofunction increases the incidence of oral fungal infections (OFIs) after topical steroid use for the management of oral lichen planus (OLP). STUDY DESIGN: Patients with a diagnosis of OLP, treated for at least 2 weeks with topical steroids, had baseline salivary flow evaluations completed, and had a follow-up visit within 5 weeks of steroids being prescribed were assessed. Patients were evaluated for clinical signs of fungal infection at follow-up visits. RESULTS: Forty-Seven patients (91% female) met the inclusion criteria, with 21.3% developing an OFI after topical steroid use. Demographic characteristics, type of OLP, steroid used, and antifungal used did not impact the development of an OFI. The mean stimulated salivary flow was significantly lower in the group that developed an OFI compared with the group that did not develop an OFI (8.31 mL/15 min vs 15.4 mL/15 min, respectively; Pâ¯=â¯0.0006). A higher incidence of OFIs occurred in the low stimulated flow group versus the normal flow group (39% vs 4%, respectively). Most patients in the OFI group received a preventative antifungal (90%). CONCLUSIONS: OFIs increased after steroid treatment in patients with OLP who had low stimulated salivary flows. Antifungals (90%) were not effective in preventing OFIs in patients with OLP who had salivary hypofunction and were treated with topical steroids.
Subject(s)
Lichen Planus, Oral/drug therapy , Mouth Diseases/epidemiology , Mouth Diseases/microbiology , Mycoses/epidemiology , Mycoses/microbiology , Steroids/administration & dosage , Xerostomia/drug therapy , Xerostomia/physiopathology , Administration, Topical , Aged , Antifungal Agents/therapeutic use , Female , Humans , Incidence , Male , Middle Aged , Mouth Diseases/drug therapy , Mycoses/drug therapy , Retrospective StudiesABSTRACT
Those experiencing intraoral pain associated with dental and oral diseases are likely to pursue treatment from medical and dental providers. The causes for intraoral pain include odontogenic, periodontal, oral mucosal, or contiguous hard and soft tissue structures to the oral cavity. Providers should be vigilant when diagnosing these, as they should be among the first in their differential diagnoses to be ruled out. This review provides brief overviews of frequently encountered oral/dental diseases that cause intraoral pain, originating from the teeth, the surrounding mucosa and gingivae, tongue, bone, and salivary glands and their causes, features, diagnosis, and management strategies.
