What advice should be given to an asthmatic patient using a corticosteroid inhaler to prevent oral candidiasis?

Rinsing the mouth with water and gargling after each use of a corticosteroid inhaler is the most effective preventive measure against inhaler-induced oral candidiasis. This removes residual steroid particles that have deposited on the oral mucosa and oropharynx before they can suppress local immune defenses. Using a spacer device also reduces oropharyngeal deposition. Brushing teeth before using the inhaler does not prevent candidiasis. Switching to systemic corticosteroids would cause systemic immunosuppression. Reducing inhaler frequency would compromise asthma management. Patient education about post-inhaler rinsing is a critical component of the dental management of patients on inhaled corticosteroids.