Conclusion
The findings of this study underscore the importance of considering inhaler type as a potential factor influencing saliva microbiome composition in children with moderate-to-severe asthma. Further research is needed to elucidate the underlying mechanisms driving these differences and to determine the clinical implications of altered microbiome composition on asthma outcomes and oral health. Understanding the impact of inhaler devices on microbiome composition and microbial dysbiosis may ultimately inform personalized asthma management strategies tailored to individual microbial profiles.