We all know that we are supposed to brush, floss, and visit the dentist regularly for healthy teeth and gums. But these actions may be even more important for people with IBD. From increased risk of tooth decay and gingivitis to mouth sores and receding gums, oral hygiene is no joke for IBD patients. We are almost one and a half times more likely to need dental work compared to a healthy counterpart, according to a study in this article.
There is still more research to be done to identify exactly why this increased risk happens. However, there are a number of reasons known to contribute. These include medications like prednisone and immune therapies, increased acidity in the mouth, a cytokine immune response, the inflammatory nature of poor dental hygiene and IBD, as well as increased risk for oral infection.
Let’s explore some of these reasons for increased risk, and what we can do to help diminish them. One contributing factor for potential poor dental health is from commonly prescribed medications for both Chron’s and Colitis; prednisone and immune therapies like Azathioprine and Infliximab. Prednisone is known to weaken bones by pulling calcium from them, and teeth are no exception. If you have to take prednisone, be sure to also take a calcium supplement to counteract the loss. As far as immune therapies go, they can cause mouth ulcers and sores. For these, talk to your Dental health professional, and they can connect you with several options like corticosteroid injections or steroid mouthwashes.
Another reason for possible increased risk of cavities and tooth decay could be linked to increased acidity of the mouth for people with IBD. It is thought that bile and increased bacteria through saliva makes the mouth more acidic which breaks down the protective layer of enamel on the outside of the teeth, allowing for greater risk of tooth decay and receding gums.
What is thought to be the main reason for dental complications in people with IBD is the cytokine immune response. This triggers periodontal disease and the IBD inflammatory response. Many Crohn’s and UC patients, myself included, notice bad breath, a white covered tongue, and even mouth ulcers and sores before a flare. This is because the immune response in the mouth is the same as that in the gut. As such, active IBD can trigger the same response in the mouth and vice versa. Here, it is important to take a good probiotic to help balance the overgrowth of bad bacteria and practice good oral hygiene habits to keep plaque and bacteria at bay. There is still more research to be done in understanding this immune response completely, but here is an article to help you understand the details from the University of Michigan.
The last important factor is diet. Many people with IBD have a hard time finding foods that don’t bother them and end up eating foods high in simple sugars like soda and sherbet because they can be easily broken down by the body. However, these foods actually add excess plaque in the mouth and bad bacteria growth in the gut. This is where the SCD diet can help! When you replace those refined sugars with naturally occurring sugars, like those from fruit and honey, you can satisfy your sugar craving without putting your dental health at risk. So next time you think about skipping the dentist or flossing, don’t! Hopefully now you can see how closely related these two things are, and realize that ignoring one of them is really ignoring both of them. Make a commitment to your gut health by taking care of your dental health!