Study finds IBD patients highly susceptible to severe periodontitis

A new study by Kristina Bertl and team found that patients with ulcerative colitis (UC) and Crohn's disease (CD) had considerably higher probabilities of having severe periodontitis, a condition that causes greater tooth loss in the former and lower self-perceived oral health in the latter. The findings of this study were published in the Journal of Clinical Periodontology.

In many ways, the aetiopathogenesis of periodontitis and inflammatory bowel disorders are comparable. Both disorders entail an overly inflammatory reaction in the intestinal or oral mucosa in a vulnerable host in response to a microbial stimulus. As a first-line defense mechanism, neutrophils infiltrate large amounts of tissue during this reaction, causing tissue damage in the process. This questionnaire-based case-control study sought to determine if patients with ulcerative colitis and Crohn's disease self-reported oral health and periodontitis differently from matched controls without inflammatory bowel disease (IBD).

An online survey was given that asked about general anamnestic details, the diagnosis of IBD, and dental health. As outcome criteria, tooth loss, severe periodontitis, and self-perceived overall dental and gum health were listed.

The key findings of this study were:

1. Analysis was based on responses from 3429 control subjects and 1108 IBD patients.

2. In comparison to controls, patients with IBD reported considerably lower oral health and more periodontal issues.

3. Regression analyses adjusted for relevant confounders revealed significantly higher odds for patients with UC and CD compared to controls for fair or poor self-perceived overall dental and gum health and for severe periodontitis; patients with CD also showed 91% higher odds for having fewer than 20 remaining teeth.

The current findings are consistent with the idea that UC and CD patients have much higher probabilities of having severe periodontitis, as well as fair or poor self-perceived overall dental and gum health. CD patients also appear to be more seriously impacted and to experience greater tooth loss. Therefore, it is highly advised that IBD patients be kept under careful observation in order to stop the development of periodontitis and/or slow down its progression and tooth loss.

Reference:

Bertl, K., Burisch, J., Pandis, N., Bruckmann, C., Klinge, B., & Stavropoulos, A. (2022). Periodontitis prevalence in patients with ulcerative colitis and Crohn’s disease ‐ PPCC: A case–control study. In Journal of Clinical Periodontology (Vol. 49, Issue 12, pp. 1262–1274). Wiley. https://doi.org/10.1111/jcpe.13615