Impact of Salivary Hypofunction on Incidence of Orofungal Infections with use of Topical Steroids for Management of Patients with Oral Lichen Planus and Xerostomia

Publication date: Available online 20 July 2018

Source: Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology

Author(s): Mary Hil Edens, Michael D. Carpenter, Joel J. Napeñas, Michael T. Brennan

Abstract

Objectives

To determine if salivary hypofunction increases the incidence of oral fungal infections (OFI) after topical steroid use for the management of oral lichen planus (OLP).

Study Design

Patients with a diagnosis of OLP, treatment for at least 2 weeks with topical steroids, baseline salivary flows completed and had a follow-up visit within 5 weeks of steroids being prescribed were assessed. Patients were evaluated for clinical signs of fungal infection at follow-up visits.

Results

Forty-Seven patients (91% female) met the inclusion criteria with 21.3% developing an OFI following topical steroid use. Demographics, type of OLP, steroid used, and antifungal used did not impact the development of an OFI. The mean stimulated salivary flow was significantly lower in the group that developed an OFI compared to the group that did not develop an OFI (8.31 ml/15min vs 15.4 ml/15min, respectively; p=0.0006). A higher incidence of OFI occurred in the low stimulated flow group vs. the normal flow group (39% vs 4%, respectively). Most patients in the OFI group received a preventative antifungal (90%).

Conclusions

OFIs increased following steroid treatment in OLP patients with low stimulated salivary flows. Preventative antifungals (90%) were not effective to prevent OFIs in OLP patients with salivary hypofunction treated with topical steroids.

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