Understanding the link between IBD and periodontal disease

Understanding the link between IBD and periodontal disease

A new study has shown that inflammatory bowel disease (IBD) often coexists alongside periodontal disease.

IBD is frequently identified in periodontal disease patients. Evidence for this has been shown in two new publications from a European research project that explored the connection between the two diseases.

Previous research has established a link between periodontal disease and diabetes, and cardiovascular disease. However, the relationship between periodontal disease and inflammatory bowel disease has not been fully explored in the context of a large-scale European study.

Producing a large-scale study

Recently, two publications from a large research project involving Danish patients found a strong connection between the two diseases.

“The study shows that patients with IBD have more periodontal disease and fewer teeth compared to people without IBD. We also see that patients with IBD and periodontal disease have an aggravated intestinal disease with a higher activity than patients with IBD who have no oral health issues,” said Andreas Stavropoulos, a professor and senior dental officer at the Faculty of Odontology at Malmö University and one of the researchers behind the study.

“Both diseases can be described as a strong overreaction of the immune system against a theoretically relatively mild bacterial trigger. You can say that the immune system attacks one’s own body,” he added.

The researchers conducted an online survey which involved around 1,100 patients. Approximately half of these patients suffered from Crohn’s disease and the other half had ulcerative colitis. Around 3,400 patients who did not have IBD also participated in the study. These participants were randomly selected, but also matched for certain criteria to the patients with inflammatory bowel disease.

“The investigation not only showed that patients with intestinal disease had worse oral health than people without IBD, but also that the oral health of patients with Crohn’s disease was more affected. They lost more teeth than patients with ulcerative colitis,” explained lecturer and senior dental officer Kristina Bertl.

Improving care for periodontal disease

The researchers identified participants for the study through contacts with the patient association for Crohn’s disease and ulcerative colitis in Denmark. It was well established within the association that a vast number of patients had recurring problems with their teeth, infections, and ulcers in their mouths. At the same time however, many of these patients felt that this was not properly addressed during health checks.

“The association was very keen to help. The participants stated that they did not receive any information about the possible connection between the two diseases and that the problems with the teeth and the mouth were generally under-prioritised,” said Stavropoulos.

Periodontal disease initially causes relatively mild symptoms, such as bleeding gums when brushing the teeth, but can lead to tooth loss if it is not treated quickly and effectively.

“Similarly important, it may be that treatment of periodontal disease has a positive impact on the management of IBD,” concludes Stavropoulos.


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