Dental Caries, Prevalence and Risk Factors in Patients with Crohn’s Disease

Abstract

ObjectiveThe present study tested the hypothesis that patients with Crohn’s disease (CD) have a higher prevalence and risk for caries compared to people without CD.Material and MethodsPatients with CD were divided into groups; 71 patients (50.7±13.9 years) who had gone through resective intestinal surgery and 79 patients (42.0±14.4 years) who had not. The patients were compared to 75 controls (48.6±13.4 years) regarding DMF-T and DMF-S, Lactobacilli (LB), Streptococcus mutans (SM), salivary flow and dental plaque. Statistical methods including ANOVA or Chi-square test for calculation of demographic differences between groups, analysis of covariance (ANCOVA) to compare the clinical variable and Post hoc analyses were done with Fischers Least Significant Difference test or Chi-square. Non-parametric Spearman’s correlation matrix coefficient was estimated between clinical variables and disease duration.ResultsCD patients who had been subjected to resective surgery had a higher DMF-S score (50.7 versus 36.5; p = 0.01) compared to the control group after adjusting for age, gender and smoking. These patients had higher counts of SM (1.5 versus 0.9; p = 0.04) and LB (10000.0 versus 1000.0; p = 0.01), and more dental plaque (53.7 versus 22.6; p = 0.001). CD patients reported a more frequent consumption of sweetened drinks between meals compared to controls (p = 0.001).ConclusionsThe present study shows that patients with CD who had undergone resective surgery had a higher DMFs score, and higher salivary counts of Lactobacilli and Streptococcus mutans compared to the control group.

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

“…However, the positive percentage of food intolerance in IBD patients (52.4%) in our study was lower than in a report from Spain, which found that 77% of patients avoided some foods to prevent disease relapse. In addition, surveys in other countries have found that IBD patients often adopt a diet of small, frequent meals and tend to consume more refined carbohydrates and sugary food, which was considered one of the causes of caries susceptibility in IBD patients. By contrast, in our study, the frequency of daily meals did not differ significantly among the three groups, and patients with CD and UC may consume fewer sugary foods than controls.…”

Inflammatory bowel disease and oral health

“…IBD patients also have increased rates of lactobacilli and streptococcus mutans found in their oral cavity contributing to caries. 50 The reasoning behind why these increased rates of caries and infections are not clear, however, proposed arguments include salivary components (increased bacterial concentrations), oral hygiene and diet. 51,52 As discussed above, a risk factor for patients developing IBD is the increased sugar intake that can be associated with further infection.…”

The relationship between the immune system and oral manifestations of inflammatory bowel disease: a review

“…Caries prevalence in patients with IBDs is significantly increased compared to healthy controls [53, 57]. Established risk factors for dental caries in IBDs patients include an increased number of Lactobacilli and Streptococcus mutans , reduced salivary secretion, poor oral hygiene, increased sugar consumption and malabsorption [53–58].…”

“…Established risk factors for dental caries in IBDs patients include an increased number of Lactobacilli and Streptococcus mutans , reduced salivary secretion, poor oral hygiene, increased sugar consumption and malabsorption [53–58]. The dietary habits of patients with IBDs include an increased intake of refined carbohydrates and sweetened drinks, especially for patients with acute exacerbations of the disease [57, 68, 69]. Patients with IBDs eat more frequently and take a smaller amount of food to avoid gastrointestinal difficulties [54].…”