Autoimmune Series Part 2: Impact of Psoriasis on Oral Health

July 18, 2019

This month we’re looking at psoriasis for our autoimmune series. Psoriasis affects 8 million Americans and more than 125 million people around the world, making it a fairly well known disease. The disease process is a result of skin cells reproducing too rapidly and the body is not able to shed these cells quickly enough. The immune response becomes triggered and initiates this process. The result is scaly patchy lesions ranging from slight to severe.

Image detailing Psoriasis as apart of skin layers.

Illustration showing where Psoriasis affects skin cells.

Many factors are implicated in this disease. Stress, alcohol and illness can all exacerbate psoriasis, but it is classified as a genetic autoimmune disease so we know genetics plays a role as well. Oral lesions are particularly rare but can occur if overly active cells end up in the mouth. If you’ve not been diagnosed with psoriasis yet and notice patchy lesions on the lips, this can be a first sign. If you’ve already been diagnosed and notice lesions beginning in your mouth, speak with your dermatologist and dentist.

There are 5 different types of psoriasis.

-Plaque Psoriasis: Characterized by the scaly patches of skin mentioned above.This is the most common type most people think of when they hear the term psoriasis. Lesions can often be itchy and may also crack and bleed.

-Guttate: Appears with small round lesions. Typically begins in childhood and may be triggered by a strep infection, which are common among children.

-Inverse: Presents as shiny lesions often in skin folds, behind the knees, in the armpits, etc. Inverse psoriasis is frequently found in combination with other types of the disease.

-Pustular: Found on the hands and feet. As the name implies white pustules form on the skin. Although it may look like an infection, it is not. The pustules are actually filled with white blood cells as a result of the immune response.

Erythrodermic: Very rare but also extremely severe. This form of psoriasis can be life threatening. It presents as an extreme redness all over the body. It can cause the skin to peel and is usually itchy and painful. You should see a doctor immediately if it appears. Erythrodermic psoriasis is often found in individuals with uncontrolled plaque psoriasis.

Gum disease may affect autoimmune disease and vice versa.

Any autoimmune disease can increase bleeding and inflammation of the gums.

To determine exactly how this particular disease affects oral health much more research needs to be completed. Other than a rare symptom that occasionally presents in the mouth there are no other known links. A study from Norway, it was found that 24% of participants with psoriasis had moderate to severe periodontitis. In contrast, only 10% of the control group without psoriasis suffered from moderate to severe periodontal disease. At the end of the study, the assumption is made that the link between the two diseases is likely involved in the immune response. No definitive link has been found, so more research is needed to further understand what if any impact periodontal disease and psoriasis have on each other.

All 5 types of psoriasis can be very difficult to control. It is our hope that as research continues further understanding will arise. If a link is found between psoriasis and periodontal disease we will do our best to provide treatment that can ease the symptoms of both diseases if possible. In the meantime, if you suffer from psoriasis or any autoimmune disease it seems that good oral health can often improve symptoms by decreasing overall inflammation in the body. At Hadlock Dental Center we strive to provide patients with the best care possible, and that means looking at how we can improve any diseases you may suffer from. Good oral health is always good for overall health! If you suffer from psoriasis and would like to discuss at your next visit how we can help you, don’t hesitate to ask

Psoriasis lesions covering the hands.

Psoriasis affecting the hands.

 

References

Colgate: https://www.colgate.com/en-us/oral-health/conditions/immune-disorders/how-to-treat-your-psoriasis-mouth-symptoms-0715

National Psoriasis Foundation

https://www.psoriasis.org/advance/gum-disease-more-likely-in-people-with-psoriasis

NCBI

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4280688/

Mayo Clinic

https://www.mayoclinic.org/diseases-conditions/psoriasis/symptoms-causes/syc-20355840

 


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