Crohn’s Disease, Colitis and Oral Health
About 5 million people worldwide are living with Crohn’s Disease or ulcerative colitis, also known as inflammatory bowel disease (IBD). These chronic diseases affect the digestive system and cause intestinal tissue to become inflamed, form sores and bleed easily. Crohn’s specifically can affect any part of the gastrointestinal tract including the lips, mouth and even the esophagus. And in addition to the physical and emotional toll IBD has on the well-being of its patients such as weight loss, fever, nausea, diarrhea and anemia, it can also have a number of negative effects on oral health.
Sometimes it is difficult to tell what is causing changes in the mouth such as ulcers, soreness, dry mouth or cavities. Sometimes medications taken to treat Crohn’s disease interfere with normal mouth bacteria that can cause problems. IBD can also lead to nutritional deficiencies that affect dental and oral health. In other instances, it is the disease itself causing the problems. Your doctor can identify whether Crohn’s or colitis is interfering with the health of your teeth and gums with testing.
Cavities & Tooth Decay
For 8-29% of patients with Crohn’s Disease, cavities can appear before any intestinal complications. Many patients have reported an increase in tooth decay and higher incidence of cavities as they have undergone treatment for Crohn’s. And studies have shown that changes caused by colitis in the mucus that lines the gastrointestinal tract have led to tooth decay in some patients. Patients who are using Prednisone for their symptoms might want to consult their physician and dentist as some patients have reported a link between the medication and cavities. In our research, this was a very common side effect of medical treatment and the connection should not be taken lightly.
Mouth Ulcers & Vitamin Deficiencies
Inflammatory Bowel Disease is known to cause legions throughout the intestine, colon, esophagus as well as in and around patients’ mouths. Poor vitamin consumption, particularly of vitamin D, can lead to complications that range from small, painless lesions inside the mouth to ulcerations and swelling of the lips. This can lead to more serious issues like Melkersson-Rosenthal syndrome, oral tuberculosis, cheilitis granulomatosa, sarcoidosis, or even contact allergic reactions. Pyodermatitis-pyostomatitis vegetans is also associated with Crohn’s disease, but only rarely. Symptoms include pustules (pimples) that can be yellow or whitish in appearance in the mouth. After the pustules rupture, they leave a superficial ulcer. The lymph glands under the chin can become swollen and there may be mild pain. Yeast infections and deficiencies in Vitamin A, Vitamin B12, zinc and Vitamin K are common.
Gum Inflammation & Gingivitis
Gum problems, such as swollen or bleeding gums, can be another complication of Crohn’s and may be the result of poor nutrition. Getting the right vitamins and minerals in your diet is crucial to good overall health and oral health, but the combination of Crohn’s and mouth problems can leave you with little appetite or interest in eating. You might need to work harder on the quality of your diet because the consequences of Crohn’s can prevent your body from taking advantage of all the nutrients in the foods you eat; instead, food is moved through your system without being fully digested. Some medicines can contribute to inflammation and gingivitis, so if you are using the following medications, you might want to talk with your doctor about possible alternatives: Steroids, Mesalazine and Methotrexate.
As always, we encourage you to discuss your symptoms and treatment options with your doctor or dentist. But the following tips will not only help your overall health, they might also prevent dental complications associated with IBD:
- Avoid sweetened drinks like soda, juice and energy drinks
- Limit the amount of dairy (milk, cheese, yogurt) you eat
- Get plenty of sunlight or take a vitamin D supplement
- Eat 5 or 6 small meals each day that are low in saturated fat, with lots of fruit and antioxidant-rich foods (beans, berries, apples)
- Stop smoking!