OBJECTIVE: To assess and compare the salivary characteristics and oral health and to evaluate the impact of asthma and its medication on dental caries among adolescents with and without asthma. METHODS: A cross-sectional comparative study was conducted among 50 asthmatic and 50 nonasthmatic adolescents aged 12-15 years in Bangalore City. Data were acquired using a structured questionnaire. Salivary samples were collected to determine the flow rate, pH, buffering capacity, and Streptococcus mutans and Lactobacilli counts. Oral health assessment was performed using WHO 2013 proforma. Inferential statistics such as chi-square, student's t-test, spearman's correlation, multinomial logistic. and stepwise linear regression were applied with P < .05 considered as significant. RESULTS: Asthmatic participants had significantly higher mean number of teeth with dental caries, gingival bleeding, and dental erosion than nonasthmatics (P < .05). The prevalence of fluorosis, traumatic dental injuries, and oral mucosal lesions in asthmatics were 34.0%, 38.0%, and 28.0%, respectively. Most of the asthmatic participants required preventive or routine (18.0%) and prompt treatment (30.0%). Statistically significant difference was found in the flow rate, pH, buffering capacity, S. mutans and Lactobacilli counts, and Decayed, Missing, Filled Teeth (DMFT) index between asthmatic and nonasthmatic participants. Severity of asthma, medication use, and dental caries experience significantly correlated with low salivary flow rate, pH and buffering capacity, and higher levels of S. mutans and Lactobacilli (P < .001). Asthmatic participants had significantly higher odds of having very low unstimulated salivary flow rate (odds ratio [OR] = 3.2), buffering capacity (OR = 2.94), highly acidic pH (OR = 3.65), high risk of S. mutans (OR = 6.02), and DMFT ≥ 1 (OR = 2.06) than nonasthmatics (P < .05). CONCLUSION: Salivary characteristics and oral health were significantly poor in asthmatic adolescents. Asthma and its medications had significant impact on salivary characteristics and dental caries among asthmatic adolescents.