Oral Health and Inflammatory Bowel Disease

Inflammatory bowel disease established risk factors are diet, sleep quality and smoking, among others. To that list, we need to now add dental disease. Although doctors often focus on new interventions and medications, evaluating a patient’s oral health is a must.

A recent study from researchers in South Korea analyzed more than 2.2 million individuals, which captured approximately 97% of the country’s population. Periodontitis was identified by dentists during oral health screenings. Individuals were followed for a median of 17 years.

Investigators found that the incidence of Crohn’s disease and inflammatory bowel disease were 11.6 and 32.4 cases per 100,000 persons. Among those with periodontitis, the risk for Crohn’s disease was nearly 30% higher and the risk for ulcerative colitis was approximately 20% higher.  

Investigators also looked at the influence of various oral hygiene methods on the incidence of Inflammatory bowel disease. Among those who reported frequent tooth brushing three times per day, the risk of developing Crohn’s disease was reduced by 12%; but there was no significant risk reduction for developing ulcerative colitis among these participants. 

The main finding is that the incidence of inflammatory bowel disease was significantly associated with the presence of periodontal disease. 

Periodontal disease is also linked with respiratory disease, rheumatoid arthritis, coronary artery disease, preterm birth and low birth weight, and problems controlling blood sugar in diabetes.

What is Periodontal Disease?

Periodontitis is the most severe form of gum disease, and the leading cause of tooth loss in adults.

The Centers for Disease Control and Prevention (CDC) estimates that 47.2 per cent of American adults are affected by periodontitis – that’s 64.7 million people aged 30 and over across the United States.

Symptoms of periodontitis can include:

• Swollen or puffy gums or bright red, dark red or dark purple gums.
• Gums that feel tender when touched and bleed easily.
• A toothbrush that looks pink after brushing your teeth.
• Spitting out blood when brushing or flossing your teeth.
• Bad breath that won’t go away.

Unlike the earlier stages of gum disease, periodontitis is not reversible. It’s important to act early to prevent it from developing.  

Factors that can increase your risk of periodontitis include smoking or chewing tobacco, hormonal changes, such as those related to pregnancy or menopause, recreational drug use, such as smoking or vaping, certain medicines that cause dry mouth or gum changes, conditions that lower immunity, such as leukemia, HIV/AIDS and cancer treatment, diabetes, rheumatoid arthritis and Crohn’s disease.

The Importance of Oral Hygiene

The key features of good oral hygiene include tooth brushing and flossing at least twice per day, as well as dental cleaning and dental evaluations at least twice a year.  Periodontal disease needs to be aggressively treated. Gastroenterologists now see the importance of dental health and are now evaluating their patient’s oral hygiene. If you are suffering from inflammatory bowel disease or other health problems, I highly recommend a dental evaluation from your dentist or oral & maxillofacial surgeon.

Dr. Pamela Alberto earned her DMD from the University of Pennsylvania School of Dental Medicine and her certificate in oral and maxillofacial surgery from the University of Medicine and Dentistry of New Jersey’s University Hospital. Dr. Alberto is the former assistant dean of predoctoral education at New Jersey Dental School. She is currently a clinical associate professor at Rutgers School of Dental Medicine. www.drpalberto.com