Corticosteroid (Dental Route)

When used in dentistry, corticosteroids can help to alleviate pain and irritation caused by gum and mouth problems.

Overview

Although corticosteroids have various medicinal uses, dental corticosteroids can be prescribed in order to manage the symptoms of gum and mouth problems. Typically, corticosteroids have extremely effective anti-inflammatory properties. By repressing inflammatory mediators and activating anti-inflammatory mediators, corticosteroids can reduce inflammation in various areas of the body. In doing so, corticosteroids also help to reduce the pain and discomfort caused by the inflammation.

Often prescribed to patients who are suffering from post-surgery pain, dental corticosteroids can help to speed up the healing process and ensure patients do not endure pain unnecessarily. As corticosteroids work in conjunction with the body’s own anti-inflammatory response, they are usually only needed for a short amount of time.

While some conditions can require the long-term use of corticosteroids, this can increase the risk of side effects occurring. In most cases, dental corticosteroids are effective in managing short-term dental pain and resolving conditions affecting the mouth and gums.

Conditions Treated:

  • Oral pain and discomfort

Type of Medicine:

  • Corticosteroids

Side Effects:

When corticosteroids are taken orally, they contain much larger doses than dental corticosteroids. Due to this, traditional oral corticosteroids treatments are associated with a significant number of side effects.

As dental corticosteroids are typically used for a short time and, in low doses, they are not associated with any particular side effects. However, if patients notice any side effects occurring while using dental corticosteroids, they should consult their dentist immediately. Similarly, if symptoms are not improving despite the use of dental corticosteroids, patients should return to their dentist and obtain further medical advice.

On rare occasions, dental corticosteroids may cause signs of irritation or infections. If patient’s experience peeling, itching, blistering, burning or irritation which was not present before treatment, they should seek medical advice as quickly as possible.

If patients experience side effects following the use of dental corticosteroids, they can also report them to the Food and Drug Administration. The FDA welcomes feedback from patients as this helps them to collate data regarding medical side effects. If patients want to report side-effects to the FDA, they can contact them on 1-800-FDA-1088.

Dosage:

When dental corticosteroids are prescribed, the patient’s dose will depend on various factors. Dentists will take the patient’s medical history, age and weight into account, as well as their current condition. The type of dental corticosteroids prescribed will also affect what dose is used.

If patients are prescribed hydrocortisone, for example, adults may be advised to apply the medication to the affected area two or three times a day. In most cases, patients will be advised to apply the hydrocortisone after meals and before they go to bed so that it has an optimum amount of time to take effect.

Similarly, adult patients who are prescribed triamcinolone are usually advised to apply the medication two or three times per day. Once again, the medication should normally be applied after meals and before the patient goes to bed.

If children or teenagers are prescribed dental corticosteroids, they may be advised to use a smaller amount of paste or to apply the paste less frequently. Generally, younger patients are prescribed a lower dose of medicines, including dental corticosteroids, and an appropriate dose will be determined by their dentist.

When applying corticosteroids dental paste, patients should use a cotton swab. These are appropriate for single use only and should not be reused as this could increase the risk of infections occurring. Patients should be given an adequate supply of cotton swabs when they are prescribed corticosteroids for dental use.

Using the cotton swab, patients should simply press the dental paste over the affected area. Patients should not attempt to rub the paste into the affected area as it is likely to crumble. Alternatively, patients should simply press the corticosteroids paste on to the affected area until it sticks. The paste will then form a slippery, smooth film.

Although the above information provides information regarding standard dosing and treatment strategies, every patient will require specific instructions from their dentist. Patients should always adhere to the individual instructions set out by their dentist as they will reflect their current condition, as well as their medical history.

It’s extremely important that patients only use dental corticosteroids for as long as their dentist has advised them to. If patients use too much corticosteroid dental paste or use it for longer than they are instructed to, it will increase the levels of absorption and patients may experience adverse effects.

Dental corticosteroids should only be used if they have been prescribed for a specific complaint, by a dentist. Numerous viral, fungal and bacterial mouth conditions cannot be treated with dental corticosteroids and patients should not attempt to self-treat any medical condition. Using dental corticosteroids on certain conditions may exacerbate them and using the wrong type of medication will not resolve the patient’s pain or discomfort.

If patients miss a dose when they are using dental corticosteroids, they should apply the medication as soon as they remember to do so. However, if the next application of dental corticosteroids is almost due, patients should skip the missed dose and simply revert to their normal treatment schedule. Patients should not attempt to apply a double dose of dental corticosteroids, even if they have missed a dose.

If patients are unsure when to use the dental paste or if they are unsure how to apply dental corticosteroids, they should seek advice from their dentist.

Warnings:

If patients are taking any other medication, they should inform their dentist before using dental corticosteroids. This includes, prescription medications, topical medicines, over-the-counter medicines, vitamins and/or supplements. Once patients are using dental corticosteroids, they should seek medical advice before using any other medicines, supplements and/or vitamins.

Patients should discuss their medical history with their dentist before undergoing any treatment or using dental corticosteroids. Some conditions may prevent dental corticosteroids from being prescribed so it’s vital that patients disclose anything which may be relevant. The following conditions may affect the use of dental corticosteroids:

• Tuberculosis
• Diabetes
• Sores or infections of the throat or mouth
• Herpes

Although specific studies have not been carried out on the use of dental corticosteroids in pregnant patients, topical corticosteroids have been linked to birth defects in some cases. As dental corticosteroids are generally used for a shorter time than other topical corticosteroids, they may not present the same risk. If patients are pregnant, they should discuss the risks of using dental corticosteroids with their dentist before accepting the medication.

If patients become pregnant when using dental corticosteroids, they should contact their dentist or physician for medical advice.

Currently, dental corticosteroids are not thought to pose a risk to infants if they are used by breastfeeding mothers. Patients should discuss the risks with their dentist before breastfeeding whilst using dental corticosteroids.

If children or teenagers are prescribed dental corticosteroids, they may need to undergo check-ups with their physician. As dental corticosteroids are absorbed by the lining of the mouth, they easily enter the patient’s system. If corticosteroids are used too often or too much is used, it could affect a child’s growth. Patients or their parents and guardians should discuss this risk with their dentist or doctor before using dental corticosteroids.

If patients do not notice an improvement within 1 week of using dental corticosteroids, they should contact their dentist for further medical advice. Similarly, if symptoms worsen when using dental corticosteroids, patients will need to visit their dentist for another consultation.

Patients should disclose any allergies to their dentist before undergoing any treatment. If patients develop any symptoms of an allergic reaction when using dental corticosteroids, they should seek immediate medical treatment.

Storage

As patients will normally need to apply dental corticosteroids at home, they will need to find a safe and secure location to store the medicine. Patients should consider using a locked cupboard or medicine box so that corticosteroids can be stored safely, without posing a risk to others.

If children and/or pets are present in the home, dental corticosteroids must be kept out of their reach.

When prescribed dental corticosteroids, patients will be given specific storage instructions as well. In most cases, however, dental corticosteroids should be stored at room temperature and away from moisture, heat and direct light.

If patients are advised to stop using the medicine, they will need to dispose of the medication safely. As medications should not be thrown out with normal household waste, patients can contact their dentist’s office in order to access an appropriate disposal method for medical waste.

Summary

There are many gum and mouth problems which can cause significant pain and discomfort. Even regular dental work can result in irritation occurring, particularly if the patient has undergone a relatively invasive or complication procedure.

Reducing irritation and inflammation is vital to a successful recovery and dental corticosteroids can help to achieve this. As much of the discomfort associated with gum conditions is caused by inflammation, it can be relieved by applying anti-inflammatory medication.

When used appropriately, dental corticosteroids can be used to manage gum and mouth inflammation and can provide relief from a variety of oral conditions.