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The mucosa lining the oral cavity is affected by many inflammatory, atrophic and ulcerative conditions for which topical steroids are an appropriate treatment. The physical environment of the mouth creates unique problems in drug delivery, and many strategies have been proposed in an attempt to overcome the difficulties. The therapeutic benefit of corticosteroids lies in their anti-inflammatory and immunosuppressive properties which makes them highly effective in the management of oral mucosal lesions. Managing mtor-associated oral lesions with topical oral, intralesional, and/or systemic steroids can be beneficial, in contrast to the lack of evidence supporting steroid treatment of oral mucositis caused by high-dose chemotherapy or radiation. However, steroid management is not uniformly efficacious in all patients receiving mtor inhibitors. Steroids can irritate the lining of the stomach by inhibiting prostaglandins – these are substances that help protect the stomach lining. Excessive irritation can lead to stomach ulcers. Oral steroids should be taken with food and other medicines that also irritate the stomach, such as nonsteroidal anti-inflammatory drugs (nsaids), avoided. Exclusion criteria were predominant or exclusive mucosal involvement and treatment with oral or topical corticosteroids, dapsone, or immunosuppressive drugs during the previous six months. Hence oral mucosal systems exhibit a faster initiation and decline of delivery than do transdermal patches. Oral mucosal delivery occurs is less variable between patients, resulting in lower inter-subject variability as compared to transdermal patches. The large contact surface of the oral cavity contributes to rapid and extensive drug absorption. With topical corticosteroids, the main side-effects were oral candida (yeast) infection and pain or discomfort in the upper abdomen. Temporary burning was a common side-effect reported with tacrolimus 0. 1% ointment and pimecrolimus 0. About 50% of patients who have oral lesions also present with skin lesions. 13 the tongue and buccal mucosa are the most frequent sites. Among the different forms of lichen planus, the reticular form is the most common and appears as slightly elevated, fine, white lines called wickham's striae , which have a lace-like pattern. The introduction of corticosteroids into oral medicine heralded a therapeutic advance, and substantial benefits have occurred from their use. Three topical steroids are being used currently in oral diseases, i. Steroid medicines (known as corticosteroids) are man-made versions of natural steroids. There are several different forms of steroid medicines. The form discussed in this leaflet is the tablet form, taken by mouth, called oral steroids. Topical corticosteroids in dental practice nw savage,* mj mccullough† abstract topical corticosteroids represent an important therapeutic aid in the management of a range of oral mucosal disease conditions. Like all medications, their successful use depends upon an understanding of the disease process. This includes an appropriate
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