Dental management of patients with inflammatory bowel disease

Abstract

Ulcerative colitis and Crohn's disease are the most common forms of inflammatory bowel disease (IBD), both of unknown aetiology. These conditions are characterised by the chronic and recurrent inflammation of different parts of the gastrointestinal tract, but while in CD, chronic inflammation may affect any part of the gastrointestinal tract, in UC, mucosal inflammatory changes are confined to the colon. IBD is currently on the increase, and it is important for the dental professional to be familiar with the condition as patients with IBD may present oral manifestations of the underlying disease. Such manifestations of IBD may precede the onset of intestinal radiographic lesions by as much as a year, or even more. Treatments used to manage IBD can affect the delivery of routine dental care.

The condition of the oral cavity at the time of diagnosis of inflammatory bowel disease in pediatric patients

“…Severe IBD has a less diverse microbiota with fewer commensal microbiota communities and more opportunistic pathogenic bacteria originating from the oral cavity or respiratory tract 14 , 15 . The image of specific and unspecific manifestations of inflammatory lesions within the oral cavity in inflammatory bowel diseases is described as oral mucosa hypertrophy, often with erosions, swelling and ulceration of the lips, inflammation of the corner of the mouth, as well as an overgrowth of the cheek mucosa with its characteristic "paving" 8 , 16 . Angular cheilitis is characterized by erythema at the corners of the mouth with or without painful fissures and sores.…”

Minireview on the Connections between the Neuropsychiatric and Dental Disorders: Current Perspectives and the Possible Relevance of Oxidative Stress and Other Factors

“…There are some initial studies stating that these mechanistic connections that we are suggesting here could be feasible, as shown quite clearly in the Esmaillzadeh et al [ 100 ] study regarding a correlation between tooth loss and irritable bowel syndrome, as well as other studies, such as the conclusive review of Kazemi et al group [ 101 ] looking on the “oral health,” “masticatory performance,” “dental status,” and “eating” or “food intake” correlations or further work on the relevance microbiome of the oral mucosa in irritable bowel syndrome [ 102 ], but also on other gastro-intestinal manifestations such as the inflammatory bowel disease (e.g., Crohn's disease) in studies focusing mainly on the dental management of patients with inflammatory bowel disease [ 103 ], a disorder where oxidative stress and inflammation modification are much clearer, as we also showed previously [ 85 ].…”