Which question best assesses prevention of oral candidiasis in a patient using an inhaled corticosteroid?

• A. Are you rinsing your mouth with water and gargling each time you use the inhaler?
• B. When you rinse and gargle after using the inhaler, are you swallowing the water?
• C. Do you use an inhaler without a spacer to save costs?
• D. Do you rinse your mouth only if you feel irritation?

Answer: (A)

Preventing oral candidiasis from inhaled corticosteroids hinges on removing residual medication from the mouth to limit local immune suppression and fungal growth. Rinsing the mouth with water and gargling after each use directly achieves this by clearing medication from the oropharynx, making it the best question to assess preventive practice. Swallowing the rinse doesn’t reflect cleaning of the mouth and doesn’t address local deposition. Using a spacer can reduce oropharyngeal deposition overall, but the question focuses on preventive behavior, and rinsing after every dose best demonstrates adherence to the preventive measure. Rinsing only when irritation occurs misses the routine you want to evaluate for prevention.