Clinical decision-support only. For use by licensed dental professionals. Not a substitute for professional judgment or a complete drug reference. Always verify with primary sources.
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Medication

Fluticasone (inhaled corticosteroid)

Inhaled corticosteroid

Brand names: Flovent, Flixotide

Oral health effects

  • Oropharyngeal candidiasis (thrush)

    Local immunosuppression and steroid deposition predispose to candidal overgrowth.

    Mechanism: Topical corticosteroid effect on oral mucosal immunity.

    Clinical management: Advise rinsing/gargling and spitting after each use and using a spacer; treat candidiasis with antifungals.

  • Hoarseness (dysphonia)

    Hoarseness or dysphonia occurred in 2-6% of trial patients (dose-related, vs under 1% on placebo), caused by steroid deposited on the larynx.

    Clinical management: Reinforce spacer use, plus rinsing, gargling and spitting after each dose. Report persistent hoarseness to the prescriber; persistent hoarseness without an explanation also needs a laryngeal exam.

Sources

  1. Asthma and oral health: a review. Thomas MS, Parolia A, Kundabala M, Vikram M. Australian Dental Journal, 2010.
  2. Fluticasone propionate inhalation aerosol (Flovent HFA) prescribing information (FDA label) A-S Medication Solutions / DailyMed, 2023.
  3. Practical considerations for dysphonia caused by inhaled corticosteroids. Galván CA, Guarderas JC. Mayo Clinic proceedings, 2012.