Dental and periodontal disease in patients with inflammatory bowel disease

Abstract

Objectives Although bowel symptoms are often predominant, inflammatory bowel disease (IBD) patients can have several oral manifestations. The aim of this study was to investigate the prevalence of dental caries and periodontal disease in patients with Crohn’s disease (CD) and ulcerative colitis (UC) compared to an age and gender-matched control group of patients without IBD. Material and methods The DMFT (Decayed, Missing, Filled Teeth) scores and the DPSI (Dutch Periodontal Screening Index) of 229 IBD patients were retrieved from the electronic health record patient database axiUm at the Academic Centre for Dentistry Amsterdam (ACTA) and were compared to the DMFT scores and DPSI from age and gender-matched non-IBD patients from the same database. Results The total DMFT index was significantly higher in the IBD group compared to the control group. When CD and UC were analyzed separately, a statistically significant increased DMFT index was observed in CD patients but not in UC patients. The DPSI did not differ significantly between the IBD and non-IBD groups for each of the sextants. However, in every sextant, IBD patients were more frequently edentulous compared to the control patients. Conclusion CD patients have significantly more dental health problems compared to a control group. Periodontal disease did not differ significantly between IBD and non-IBD groups as determined by the DPSI. Clinical relevance It is important that IBD patients and physicians are instructed about the correlation between their disease and oral health problems. Strict oral hygiene and preventive dental care such as more frequent checkups should be emphasized by dental clinicians.

Oral Health Status in Patients with Inflammatory Bowel Diseases: A Systematic Review

“…In contrast, Schütz et al [29] noticed that in CD patients, caries prevalence was increased by a longer disease duration but depended on insufficient oral hygiene and intensified sugar consumption. Tan et al [32] observed a significant increase in the DMF-t index only in the CD group but not in the UC group, while the periodontal status did not differ between IBD patients and healthy subjects.…”

Expression of inflammatory mediators in biofilm samples and clinical association in inflammatory bowel disease patients—a preliminary study

“…In a retrospective study, 229 IBD patients were compared with 135 healthy subjects regarding DPSI (Dutch PSI) and DMFT. While DMFT was significantly higher in IBD patients than in healthy subjects, DPSI did not differ between the groups regarding specific IBD medications (30). Other studies compared 99 CD patients and 80 UC patients with 74 periodontitis patients according to the DMFT, BOP, PD and plaque index parameters.…”

“…We know from the previous literature that some of the same cytokines are involved in IBD and P pathogenesis and that these cytokines are detectable outside the gut, namely, in the oral cavity (14)(15)(16)(17). In this context, many studies have already described altered parameters in the periodontium, in particular, elevated periodontal parameters in IBD patients (4,13,30).…”

Periapical and endodontic status of patients with inflammatory bowel disease: Age‐ and sex‐matched case–control study

“…The results of the present study show a significantly higher prevalence of RFT in patients with IBD (3.2 ± 2.6) compared to healthy control patients (0.9 ± 1.3; p < .01). This finding could be explained, at least in part, by the higher incident of caries, the main cause of AP, in patients with IBD (Koutsochristou et al, 2015; Nijakowski et al, 2021; Tan et al, 2021; Zhang et al, 2020). A recent systematic review has highlighted a remarkably increased past and present occurrence of dental caries in subjects with IBD, compared to healthy controls (Marruganti et al, 2021).…”