Medication-Induced Xerostomia Caries — ORE Part 1 MCQ

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ModerateDental Public Health & EpidemiologyMedication-Induced Xerostomia CariesORE Part 1

A 55-year-old woman on long-term inhaled salbutamol and beclomethasone for COPD presents with extensive cervical caries. What is the most likely contributing dental factor from her medication?

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Correct answer: C — Reduced salivary flow from the beta-2 agonist

The correct answer is C. Beta-2 agonists (salbutamol) reduce salivary flow, which is the primary mechanism for increased caries risk in patients on long-term inhaled therapy for COPD. Cervical caries specifically reflect poor buffering and clearance of plaque acids in a xerostomic mouth. Both salbutamol and beclomethasone contribute to altered salivary function and composition. Option B is incorrect: propellant-related effects manifest as erosion (smooth, broad surfaces) rather than localised cervical caries. Option A is incorrect: inhaled corticosteroids' main oral effect is candidiasis risk, not direct cariogenicity. Option D is incorrect: gingival overgrowth is not an adverse effect of these drugs. Option E is incorrect: medication-induced discolouration does not explain caries pathology.

Reference: Oral health in asthmatic patients: a review. NCbi.nlm.nih.gov/pmc/articles/PMC7648282/, 2020. Highlights reduction of salivary flow as the main mechanism for caries in patients on beta-2 agonists and inhaled corticosteroids. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7648282/