Periodontitis prevalence in patients with ulcerative colitis and Crohn's disease ‐ PPCC: A case–control study

Abstract

Aim: The aim of this questionnaire-based case-control study was to assess whether self-reported oral health and periodontitis in patients with ulcerative colitis (UC) and Crohn's disease (CD) differ from those in matched controls without inflammatory bowel disease (IBD). Materials and Methods:A survey including questions on general anamnestic information, IBD diagnosis, and oral health was distributed online. Self-perceived overall health of teeth and gums, severe periodontitis, and tooth loss were defined as outcome parameters.Results: Analyses were based on answers from 1108 patients with IBD and 3429 controls. Patients with IBD reported significantly worse oral health and more periodontal problems compared to controls. Regression analyses corrected for relevant confounders showed significantly increased odds for fair or poor self-perceived overall health of teeth and gums (odds ratio [OR] 2.147 and 2.736, respectively) and for severe periodontitis (OR 1.739 and 2.574, respectively) for patients with UC and CD compared to controls; patients with CD presented additionally 91% higher odds for having <20 remaining teeth. Conclusion:Patients with UC and CD have significantly increased odds for worse self-perceived oral health and severe periodontitis compared to controls, with the former being more severely affected and losing more teeth. It is strongly recommended that patients with IBD are kept under close surveillance to prevent periodontitis development and/or mitigate its progression.

Association between inflammatory bowel disease and periodontitis: A bidirectional two‐sample Mendelian randomization study

“…For example, recent observational studies on the association between IBD and periodontitis had some unmeasured or unknown potential confounding factors, such as socio-economic factors, prescription policies, and reverse causation, which were included in the limitations of their respective study (Bertl et al, 2022;Madsen et al, 2022). In this MR study, we confirmed a positive causal effect between IBD and periodontitis and a suggestive causal association between periodontitis and IBD based on large-scale GWAS summary statistics through the use of genetic instruments, which are not affected by confounders or reverse causation.…”

“…However, when confounders are not observed because they are unmeasured or unknown or when the number of confounders is too large, regression methods may not provide unbiased estimates of the real association between an exposure and outcome, which may lead to some biases when interpreting the results (Sekula et al, 2016). For example, recent observational studies on the association between IBD and periodontitis had some unmeasured or unknown potential confounding factors, such as socio‐economic factors, prescription policies, and reverse causation, which were included in the limitations of their respective study (Bertl et al, 2022; Madsen et al, 2022). In this MR study, we confirmed a positive causal effect between IBD and periodontitis and a suggestive causal association between periodontitis and IBD based on large‐scale GWAS summary statistics through the use of genetic instruments, which are not affected by confounders or reverse causation.…”

Susceptibility of periodontitis and its impact on patients with inflammatory bowel disease

“…24 In a large matched case-control study involving 1108 cases and 3429 matched controls, patients with IBD had higher odds of having worse self-perceived oral health and severe periodontitis compared to controls. 25 Another matched case-control study revealed that significantly more patients with IBD had moderate or severe periodontitis (85.6% versus 65.6%) and severe periodontitis (36.7% versus 25.6%) compared to controls. Differences were more pronounced in the 35-to 50-year-old and 51-to 65-yearold age groups, but there were no significant differences between CD and UC.…”

Oral Health in Patients with Inflammatory Bowel Diseases Qualified for Biologic Treatment

“…In contrast, other researchers observed higher values of plaque indices in IBD patients but no significant differences in caries and periodontal status between the study and control groups [ 20 ]. However, in the most recent studies from 2022, the authors found that the progression of periodontitis is closely associated with a worsening of the course of IBD [ 21 , 22 ]. Therefore, preventive and therapeutic strategies concerning the oral–gut axis should be imposed in IBD patients.…”