Increased risks of dental caries and periodontal disease in Chinese patients with inflammatory bowel disease

Abstract

Objectives: Inflammatory bowel disease (IBD) may be associated with oral diseases, but few relevant studies have been reported in China. This study aimed to compare the prevalence, severity and extent of dental caries and periodontal disease in Chinese IBD patients and healthy controls. Materials and methods: In this cross-sectional study, questionnaires and oral examinations were completed for 389 IBD patients [265 with Crohn's disease (CD) and 124 with ulcerative colitis (UC)] and 265 healthy controls based on the established criteria of the World Health Organization. Tobit regression, multiple linear regression and logistic regression were performed to analyse the data. Results: After adjusting for confounders, the decayed, missing and filled surfaces indices were significantly increased in the CD and UC patients compared with those in the controls (P < 0.001). Patients with CD [odds ratio (OR) = 4.27, 95% confidence interval (95% CI): 2.63-6.95, P < 0.001] and UC (OR = 2.21, 95% CI: 1.24-3.94, P = 0.007) had significantly higher risks of dental caries than controls. Significantly higher percentages of sites with probing pocket depth ≥ 5 mm and clinical attachment loss ≥ 4 mm were observed in CD and UC patients compared with controls (P < 0.001). A fully adjusted model revealed that CD and UC were risk indicators for periodontitis (OR = 4.46, 95% CI: 2.50-7.95, P < 0.001; OR = 4.66, 95% CI: 2.49-8.71, P < 0.001, respectively). No significant differences in dental caries and periodontal disease were observed between the CD and UC patients. Conclusions: Chinese IBD patients have a higher prevalence, severity and extent of dental caries and/or periodontal disease than controls, and require oral health education and multidisciplinary treatment.

Dental and periodontal disease in patients with inflammatory bowel disease

“…This is in accordance with findings in the present study. Several studies have reported an increased DMFT index for CD patients [16][17][18][19]. It has been suggested that patients with CD may have a higher incidence of dental caries because of nutritional deficiencies, changes in salivary conditions, and oral microflora [20].…”

“…Only three previous studies reported a significantly higher DMFT index in UC patients [ 17 – 19 ]. These studies were performed in China, Brazil, and Greece, so dissimilarities in comparison to a western European population cannot be excluded.…”

“…Periodontitis and IBD are both considered to be a disproportionate mucosal inflammatory response to micro-organisms in susceptible patients. Recent reviews of epidemiological studies conclude that there seems to be increasing evidence for a correlation between IBD and periodontal disease [ 19 , 26 – 28 ]. The present study failed to produce evidence for a correlation between IBD and periodontal disease.…”

“…Statistical significance depends on sample size and expected effect. Recent studies reported statistically significant differences for DMFS and periodontal disease in patients with UC compared to healthy controls [ 19 , 28 ]. The fact that no significant differences were observed for patients with UC in the present study might be related to the relatively small size of this subgroup of IBD patients.…”

Associations between dental caries and systemic diseases: a scoping review

“…Limited clinical studies were found assessing a connection between caries and gastrointestinal diseases, including studies of inflammatory gastrointestinal diseases [ 76 – 78 ]. A human clinical study (case-control) showed that pediatric participants with inflammatory bowel disease had significantly more caries and periodontal inflammation than healthy participants [ 76 , 77 ]. Similar results in an adult cohort has been shown previously [ 119 ].…”