Does ulcerative colitis, inflammatory bowel disease (IBD), or Crohn’s disease impact someone’s dental health? Yes, and vice versa. If you have a gastrointestinal (GI) condition, you may need to take extra steps to avoid issues like periodontal disease, tooth loss, cavities, and mouth sores. Similarly, addressing conditions like periodontitis could improve your GI health.
People with Crohn’s disease are more likely to experience amplified periodontal disease symptoms.
Ulcerative colitis can cause chronic dry mouth, raising the risk of tooth decay.
Oral bacteria can spread through the GI tract and alter the gut microbiome.
Improving oral wellness and hygiene habits can positively impact your GI health.
If you’re one of the 20 million Americans with a digestive disease, you may also be experiencing dental problems. That’s because gastrointestinal (GI) issues like Crohn’s disease, inflammatory bowel disease (IDB), and ulcerative colitis have been studied and shown to have a possible link back to certain types of dental health concerns. The research indicates that this may be the case specifically for periodontitis, or what most people call “gum disease.”
What does Crohn's affect most?
Crohn's disease is a type of inflammatory bowel disease that primarily affects the digestive system, specifically the small intestine, and colon. However, it can affect any part of the digestive tract from the mouth to the rectum. It can cause inflammation, pain, and various digestive symptoms such as diarrhea, abdominal cramps, and weight loss. Many people also experience oral symptoms like bleeding, swollen gums, and periodontitis-like conditions like gum stippling and loss of tissue attachment, which can lead to tooth mobility or loss.
Can Crohn's cause tooth loss?
In studies, patients who had Crohn’s disease had deeper “periodontal pockets” than patients without the condition. Pockets are the area around infected teeth where the soft gum tissues have pulled away from the tooth structure. As the gums detach, the underlying bone structures also become compromised. This leads to a “pocketing” effect around the tooth, which can harbor hard-to-clean areas of bacterial deposits.
Unfortunately, the deeper and more prevalent periodontal pockets become, the more at-risk the individual is for tooth mobility and loss. However, that does not necessarily mean Crohn’s causes tooth loss per se; it just raises the risk factors for individuals who may already have a developing gum infection.
Why does Crohn's affect the mouth?
The reason that Crohn’s disease can affect your mouth is that it’s a disorder of the digestive system, and your mouth is the first part of the digestive tract. The soft tissues lining the inside of the mouth are just as prone to ulcerations and inflammation as your overall GI tract. Additionally, poor nutrient absorption because of your GI condition could lead to specific nutritional deficiencies, leading to additional gum health problems.
How does Crohn's affect gums?
Some researchers believe that issues such as swollen gum tissues and “cobblestone” gum surfaces can precede the intestinal inflammation often seen in Crohn’s patients. These oral warning signs can help patients and their healthcare providers take steps to address intestinal inflammation as early as possible.
Effects of ulcerative colitis on teeth
Most of the relationships observed in people with GI conditions like ulcerative colitis experience more issues with their soft tissues than with their teeth or tooth enamel, such as mouth sores across their tongue, the roof of the mouth, or gums.
Researchers know that people with ulcerative colitis are more likely to experience changes in their saliva, potentially leading to dry mouth (xerostomia). Chronic dry mouth can significantly increase a person’s risk of developing tooth demineralization and decay because the lack of saliva allows bacteria and acids to set on the surface of the teeth for an extended amount of time.
Hypothetically speaking, given that ulcerative colitis can trigger xerostomia, it could be considered a risk factor for tooth decay or cavities. Therefore, people with this GI condition will want to take steps to improve their oral hygiene plan to include fluoride products in addition to daily flossing and proper brushing.
Oral hygiene with Crohn’s or ulcerative colitis
- Drink water frequently throughout the day.
- Plan regular dental exams and cleanings at least twice a year.
- Floss daily, either with traditional floss or a water flosser.
- Upgrade to a quality electric toothbrush for improved plaque removal and soft tissue stimulation.
- Use fluoridated toothpaste twice a day as directed.
- Rinse with a fluoride mouthwash before bed, or speak to your dentist about prescription fluoride gel.
- Address issues such as periodontal pocketing, tooth demineralization, and decay as early as possible.
Will gum disease affect the GI tract?
Researchers have found that people with active gum disease may have atypical gut health. More specifically, they experience changes in their intestinal bacteria. Those individuals are likely swallowing the “bad” bacteria inside their mouth, where it settles into their intestinal tract and increases their risk of an inflammatory response, specifically in patients with IDB.
Studies show that people with Crohn’s disease, IDB, and ulcerative colitis are more likely to experience periodontal disease. In addition, scientists have found that the more aggressive someone’s periodontal condition is, the more likely they struggle with GI issues.
The good news is that by limiting active periodontal infections in your mouth, you can reduce overall bacterial loads and the spread of bacteria into your GI system. In addition, treating gum disease just might help you better manage co-existing ulcerative colitis or Crohn’s flare-ups.
- BMC Oral Health. Periodontitis and inflammatory bowel disease: a meta-analysis.
- United European Gastroenterology Journal. Oral health and salivary function in ulcerative colitis patients.
- Acta Paediatrica. Crohn's disease should be considered in children with inflammatory oral lesions.
- World Journal of Gastroenterology. Periodontal and inflammatory bowel diseases: Is there evidence of complex pathogenic interactions?