Salivary Function and Oral Health Problems in Crohn’s Disease Patients

Vries, Silvia A G de; Tan, Christopher X W; Bouma, Gerd; Forouzanfar, Tim; Brand, H.S.; Boer, Nanne K. H. de

doi:10.1093/ibd/izy017

Cited by 25 publications

(34 citation statements)

References 35 publications

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“…Previous studies have shown a higher prevalence of oral health problems in patients with IBD compared with the normal population. 9,10,13,14,20 The present study also showed that patients with CD have an increased risk for oral health problems, independent of surgical removal of (a part of) the inflamed intestine, suggesting a generally increased susceptibility of patients with CD for oral health problems.…”

Section: Discussionsupporting

confidence: 71%

“…Xerostomia is a subjective feeling of a dry mouth and is not necessarily associated with a reduced saliva secretion rate. 13,14 In this study, patients with CD had a significantly higher total XI score compared with those with UC or CC. This is in line with studies on xerostomia in patients with IBD, in which an increased prevalence of dry mouth was found in patients with IBD 27 and in those with active CD.…”

Section: Discussionmentioning

confidence: 50%

“…8 Oral diseases that have been reported in patients with IBD are, among others, mucosal ulceration, mucosal swelling and cobblestoning, orofacial granulomatosis, xerostomia, and an increased risk for dental caries, gingivitis, and periodontitis. [9][10][11][12] Patients with active CD suffer more from xerostomia 13 and have higher salivary levels of Streptococcus mutans, a microorganism that is highly associated with origin of dental caries. 14 In 2011, in a case report published in the patient magazine of the Stoma Federation of The Netherlands, the patient stated that she had fewer oral health problems after surgical removal of the inflamed part of her intestine.…”

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confidence: 99%

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A self-reported survey on oral health problems in patients with inflammatory bowel disease with a stoma

Tan

Brand

Iqbal

et al. 2020

Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology

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Objectives. Patients with inflammatory bowel disease have an increased risk of developing oral health problems. The aim of this study was to investigate whether oral diseases in these patients are related to inflammation of the intestine and if there is a correlation between inflammatory bowel diseaseÀspecific health-related quality of life (IBD-HR-QOL) and oral health problems. Study Design. The study was a cross-sectional survey and analysis of self-reported oral health of individuals with a stoma for Crohn's disease (CD), ulcerative colitis (UC), and treated colon cancer (CC). Validated international questionnaires were sent to members of the Stoma Federation of The Netherlands. Because there was an unequal distribution of male and female patients with CD and CC, data of 169 age-matched female patients with CD, UC, and CC with a stoma were analyzed. Results. Patients with CD had significantly more oral health problems compared with those with UC or CC. Patients with CD and UC both had significantly more gingival-related problems compared with patients with CC. There was a significant negative correlation between IBD-HR-QOL and oral health problems. Conclusions. In the 3 distinguishable groups of patients with a stoma, patients with CD had an increased risk for oral health problems, independently from surgical removal of (a part of) the inflamed intestine, suggesting a general increased susceptibility of patients with CD for oral health problems. (Oral Surg Oral Med Oral Pathol Oral Radiol 2020;130:e80Àe86) Statement of Clinical Relevance Patients with inflammatory bowel disease, particularly those with Crohn disease, have an increased risk for oral health problems, which remains after surgical removal of (a part of) the inflamed intestine, necessitating special attention to their oral health from gastroenterologists and dentists.

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Section: Discussionsupporting

confidence: 71%

Section: Discussionmentioning

confidence: 50%

mentioning

confidence: 99%

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A self-reported survey on oral health problems in patients with inflammatory bowel disease with a stoma

Tan

Brand

Iqbal

et al. 2020

Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology

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“…In addition, differences in salivary composition have also been implicated in the perception of dry mouth [ 19 – 21 ]; the salivary mucin MUC5B retains large amounts of water and contributes to the generation of a hydrophilic gel essential for lubrication of the oral epithelium [ 22 – 24 ]. Moreover, MUC5B is the main component that determines the viscoelasticity of saliva [ 24 ]. Local variations in the MUC5B concentration have been reported with higher intensity on the hard palate compared with other oral surfaces [ 18 ].…”

Section: Introductionmentioning

confidence: 99%

Regional differences in perceived oral dryness as determined with a newly developed questionnaire, the Regional Oral Dryness Inventory

et al. 2020

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Objectives Several questionnaires, such as the internationally validated and frequently used Xerostomia Inventory (XI), have been developed to quantify the subjective feeling of a dry mouth. These questionnaires quantify the overall perception of dry mouth but lack the possibility to differentiate between various intra-oral regions. In this light, a novel questionnaire, the Regional Oral Dryness Inventory (RODI), which quantifies the severity of dryness at various locations in the mouth, was evaluated. Materials and methods A retrospective case report study was designed. Data were collected from patients who visited the saliva clinic for Special Care Dentistry in Amsterdam. Data, including the saliva secretion rates, RODI scores, the Xerostomia Inventory (XI) score, and Clinical Oral Dryness Score (CODS), were extracted from the electronic health record system Oase Dental. Results A total of 337 patients participated in this study with an average age of 54 ± 17 years. The majority of the patients were female (68.5%). The perceived dryness as determined by the RODI was the highest for the posterior palate and the lowest for the floor of the mouth. The highest correlations were found between the corresponding regions in the RODI and regionally related individual items of the XI and CODS. Conclusion There is a significant difference in dry-mouth feeling at different intra-oral locations. Clinical relevance Regional evaluation of xerostomia with RODI might improve diagnosis of xerostomia by helping to discriminate between different potential causes of oral dryness in patients and for evaluating the efficacy of mouth-moistening products. RODI is highly accessible and easy to perform in dental practices during routine clinical assessment.

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“…This indicates a difference in salivary composition in patients with active disease. 15 The aim of this study was to evaluate oral health problems and salivary function and composition in UC patients and its correlation with disease activity. Secondary, we wanted to evaluate the correlation between quality of life and oral health problems in UC patients with active and inactive disease activity.…”

Section: Introductionmentioning

confidence: 99%

Oral health and salivary function in ulcerative colitis patients

et al. 2020

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Background Although ulcerative colitis primarily involves the colon, extra-intestinal manifestations are common and oral and dental complaints are no exception. Objective This study aims at evaluating oral and dental health problems and salivary function and composition in ulcerative colitis patients and its correlation with disease activity. Methods Xerostomia Inventory score, (unstimulated/stimulated) salivary flow rates, salivary amylase and mucin/ Mucin 5B levels, self-reported oral and dental complaints, the oral health related quality of life, Simple Clinical Colitis Activity Index and inflammatory bowel disease-specific health related quality of life were determined. Results The cohort consisted of 51 ulcerative colitis patients. Hyposalivation was experienced by 16% of patients under resting conditions and 24% under chewing-stimulated conditions. Xerostomia was not correlated with salivary flow rates. Disease activity did not influence salivary amylase and Mucin 5B concentrations. The Xerostomia Inventory score was correlated with the Simple Clinical Colitis Activity Index ( p = 0.042) and inflammatory bowel disease-specific health related quality of life ( p = 0.001). Most reported oral health problems were halitosis (29%) and aphthae (28%). Frequently reported dental problems were cavities (35%) and gum problems (31%). Patients with active disease experienced significantly more oral and dental complaints. The number of oral problems was positively correlated with the Simple Clinical Colitis Activity Index ( p = 0.045) and negatively correlated with the inflammatory bowel disease-specific health related quality of life ( p = 0.005). Conclusion The subjective feeling of a dry mouth (xerostomia) is related to disease activity and disease activity-associated quality of life in ulcerative colitis patients, whereas the objective saliva secretion rate is not. Oral and dental health problems are frequently observed in patients with ulcerative colitis, especially during active disease.

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Salivary Function and Oral Health Problems in Crohn’s Disease Patients

Cited by 25 publications

References 35 publications

A self-reported survey on oral health problems in patients with inflammatory bowel disease with a stoma

A self-reported survey on oral health problems in patients with inflammatory bowel disease with a stoma

Regional differences in perceived oral dryness as determined with a newly developed questionnaire, the Regional Oral Dryness Inventory

Oral health and salivary function in ulcerative colitis patients

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