Pharmacology · single question
A patient using a steroid inhaler (beclomethasone dipropionate) presents with white plaques on the buccal mucosa and dorsal tongue with erythematous lesions underneath. Which is the most appropriate recommendation?
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Correct answer: C. Rinse with water after use of inhaler
Corticosteroid inhalers can cause oral candidiasis (thrush) because inhaled steroids deposit in the mouth and suppress local immunity. The primary prevention measure is rinsing the mouth with water and spitting immediately after each use of the inhaler. This removes residual steroid from the oral mucosa. Stopping the inhaler or switching is inappropriate without medical consultation. An antifungal may be needed to treat EXISTING infection but is not the first recommendation.
- A. INCORRECT. Switching the inhaler type is a medical decision that should be made by the physician, not the dentist. It is not the first-line dental recommendation.
- B. INCORRECT. Stopping the inhaler without medical consultation could be dangerous for the patient's asthma control.
- C. CORRECT. Rinsing with water after every use of a corticosteroid inhaler removes residual steroid from the oral mucosa, preventing local immunosuppression and candida overgrowth. This is the standard recommendation for steroid inhaler users.
- D. INCORRECT. An antifungal may be appropriate to treat the current infection but is NOT the primary recommendation to prevent recurrence. The key prevention is proper inhaler technique (rinse after use).