Autoimmune Series Part 3: Inflammatory Bowel Disease Effects on Oral Health

September 12, 2019

 

Do you or someone you know suffer from Crohn’s Disease? Maybe ulcerative colitis? These two diseases fall under the umbrella of  Inflammatory bowel diseases (IBD). IBD are autoimmune diseases that result in chronic inflammation in the gastrointestinal (GI) tract. The chronic inflammation ultimately leads to damage of the GI tract which results in painful symptoms. 

Image of the GI tract

IBD can affect any portion of the GI tract

Often mistaken for one another in a self diagnosis, both diseases must be diagnosed by your physician or gastroenterologist. Crohn’s disease can take place anywhere along the GI tract, from the mouth to the anus. The most common area targeted is in the small intestine, just before the colon (ileum). These areas affected show up as patches of irritation next to healthy tissue and the inflammation may reach through multiple wall layers within the intestine. Conversely, Ulcerative Colitis is localized to the colon and rectum. Unlike the patchy areas seen in Crohn’s, the damaged areas in Colitis are seen in a continuous pattern, typically moving upward from the rectum to the colon. Colitis is also only found in the innermost wall  of the colon as opposed to affecting multiple layers. 

Like most autoimmune diseases the etiology of IBD are not well known. Research points to environmental and genetic factors as the likely causes. The result is an immune response that when triggered by environmental factors attacks the cells in the GI tract. The symptoms are often uncomfortable and are similar between both diseases. 

Symptoms:

-Persistent diarrhea

-Abdominal pain
-Rectal bleeding/bloody stools
-Weight loss
-Fatigue

IBD are different from IBS and  Celiac disease. The similarity in symptoms can cause misdiagnosis which is why it’s important to seek a physician for a correct diagnosis and treatment. 

IBD may cause aphthous ulcers in mouth.

Painful aphthous ulcer on inner lip. These can be a result of IBD.

Now that we know how IBD can present itself, how can it affect our oral health? IBD can have several oral manifestations:

-Xerostomia (Dry Mouth): The salivary glands don’t produce enough saliva to keep the mouth moist and the pH of the oral cavity balanced. This can result in rampant decay.

-Aphthous Ulcers: Also known as canker sores. Individuals with IBD may present with frequent or multiple ulcers. These lesions can make oral care more uncomfortable.

Mucosal Tags: Similar to skin tags, these can be seen as a result of Crohn’s Disease. They may appear on the inner cheek, and can be visualized by your dentist or hygienist. 

-Gingivitis: Reversible form of periodontal disease, is treated with good home care and professional hygiene visits. 

Depending on which manifestations you’re experiencing your doctor and hygienist will tailor a treatment plan that best suits your needs. For example, if you’re frequently experience aphthous ulcers you may be prescribed a steroid cream to decrease length and frequency. Or if you suffer from xerostomia, we’ll discuss options to balance pH and decrease your risk for decay. As with all autoimmune diseases, the healthier we can keep your mouth the less effect it will have on your immune response. If you would like to discuss the impact your IBD may be having on your oral health, please ask us any questions at your next visit!

Image of GI tract affected by Crohn's Disease

Crohn’s Disease most commonly affects the end of the small intestine and the beginning of the colon.

 

References

 

CDC: 

https://www.cdc.gov/ibd/what-is-IBD.htm

 

Today’s RDH:

https://www.todaysrdh.com/crohns-disease-and-its-effects-on-the-oral-cavity/

 


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