Service evaluation of patients with orofacial granulomatosis and patients with oral Crohn’s disease attending a paediatric oral medicine clinic

Abstract

This service evaluation highlights the variety of presenting features of OFG and OCD. Despite only a moderate response to treatment, patient satisfaction with the service was high, emphasising the importance of good communication when managing children with chronic, debilitating conditions.

Crohn's disease should be considered in children with inflammatory oral lesions

“…1). The 28 original papers included in the review comprised nine observational studies, five retrospective studies and 14 case reportsfive case series and nine single cases (11)(12)(13)(14).…”

“…We evaluated oral manifestations in patients with Crohn's disease at the ages of 2-19.7 years (mean age 11.6 AE 3.1 years) (11)(12)(13)(14). We found that oral lesions were common in Crohn's disease and more prevalent in children.…”

“…Clinical examination often reveals nonspecific stomatitis or aphthous‐like ulcers, angular cheilitis, lip fissuring and gingivitis. Oral mucosa exhibits localised swelling with characteristic, specific mucosal tags, swelling of the lips, cheeks and gingiva, and areas of focal hyperplasia of the mucous membrane, which fractures and creates so‐called cobblestoning and granulomatous cheilitis . Patients might experience xerostomia as a common adverse drug reaction, dysgeusia, a metallic taste in mouth and difficulty in swallowing .…”

“…Systematic oral evaluation by paediatricians and experienced paediatric dentists played an important role in accurately identifying oral Crohn's disease lesions. Studies have shown that oral lesions, especially in children, may be an expression of the initial manifestation of Crohn's disease and may appear before gastrointestinal signs as a manifestation of the disease (12,15,21,25,29,30,32,33,(38)(39)(40). The higher prevalence of oral manifestation in the paediatric group is accounted for by severe phenotypes with more profound immunological activation (2).…”

“…Crohn's disease is a chronic transmural granulomatous inflammatory disorder, a type of inflammatory bowel disease (IBD) that may occur in any part of the gastrointestinal tract, including the mouth. The incidence of the childhood-onset disease is estimated to be 0.1-11.2 cases per 100 000 individuals per year, and an aetiopathogenesis role of immunological, genetic, infectious, environmental, psychosocial, dietary factors has been suggested (1,(3)(4)(5)(6)(7)(8)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19). The prevalence of oral manifestations in adults is 0.5-20% (20,21).…”