Effect of Long-term Use of Steroidal Anti-inflammatory Drugs on the Periodontal State: A Review

Abstract

Corticosteroids are chemically similar to endogenous cortisol and mostly prescribed for their antiinflammatory
and immunosuppressive properties, which are due to the inhibition of phospholipase A2
activity. These drugs are extensively used in the treatment of a plethora of autoimmune disorders such
as rheumatoid arthritis, various breathing disorders and also disorders of connective tissue. In the field
of dentistry these drugs are prescribed in most of the mucocutaneous disorders such as they are mostly
used in inflammatory diseases such as oral lichen planus, pemphigus, and oral stomatitis to alleviate postoperative
discomfort and swelling. These drugs can be administered systemically,topically or asinhalational
therapy. Evidence concludes that short term corticosteroids possess antiresorptive properties and its local
application shows a favourable effect on the periodontal ligament, but when administered systemically for
a long period could lead to periodontal diseases as it has shown to increase attachment with alveolar bone
and destruction of transseptalfibers. Oral manifestations are dependent on duration,dose and frequency of
use. It is commonly associated withmoniliasis, dental caries,altered taste sensation, ulceration of the tongue,
buccal mucosa, and gingiva due to xerostomia,gingival inflammation, periodontal inflammation,and immune
suppression. They can either cause dramatic improvement or dramatic adverse reactions which can lead to
a considerable increase in the distributionof periodontal disorders. In patients on long-term corticosteroid
therapy, oral health is generally not given importance during management. Hence this review explains about
various effects of different types of corticosteroids on periodontium used in dentistry.