An asthmatic patient using a corticosteroid inhaler presents with a white plaque on the palate. What preventive advice should you give to reduce recurrence?

Inhaled corticosteroids can deposit on oral and pharyngeal mucosa, suppressing local immunity and promoting oral candidiasis. Patients should be instructed to rinse their mouth with water and spit after each use of a corticosteroid inhaler to remove residual steroid from the oral mucosa. The use of a spacer device with the inhaler also reduces oropharyngeal deposition. Antifungal treatment (nystatin) is required to treat the active candidal infection. This simple and inexpensive preventive measure is a key patient education point in dentistry.