• Oral Manifestations of Crohn’s Disease and its effect on Dental Treatment

      Rudduck, Alannah; Watkins, Meghan; Dental Hygiene (2020-02)
      OBJECTIVES: The purpose of this literature review is to inform dental health care professionals about CD, the oral manifestations that may be present, and what treatment modifications may be necessary. METHODS: To research information for this paper, we using the keywords: “Crohn’s Disease,” “oral manifestations,” and “dental treatment.” We gathered the majority of our articles through PubMed and EBSCO. We narrowed our search criteria by eliminating sources that were greater than five years old and articles that were not peer-reviewed. RESULTS: In order to understand CD, there is a lot that still remains unknown, and much more research needs to be conducted. However, understanding the biomarker in recent studies is the most important factor in any health care profession. The use of interprofessional communication with the patient's nutritionist, physician, and dental health team to determine key factors that are associated with CD is currently very important for further research. It’s theorized that IL12 cytokine stimulation in Th1 mediated upregulation results of IFNY may be the primary factors of CD.4 The reasons why it is significant to be conscious of the signs and symptoms of CD is due to oral inflammation may precede the intestinal manifestations.4 In addition, it’s hypothesized that the inflammatory response of IBD raises the basal cytokine response that induces periodontal disease. Several studies have been looking into this relationship further. Additional studies have recognized that CD patients have higher attribution of periodontal disease, deeper pocket depth, and clinical attachment loss.4 CONCLUSIONS: Treatment alterations to make the patient more comfortable include scheduling short appointments in the morning and allowing time for frequent restroom breaks. Despite having minimal biofilm accumulation, these patients tend to have bleeding on probing, deep periodontal pockets, decay, missing teeth and/or extensive previous dental treatment.3 Thus, clinicians need to regularly monitor caries and periodontal risks to optimize CD patient’s oral health status. Knowledgeable clinicians that recognize CD signs and symptoms should refer patients to their physicians for further diagnosis. It’s believed the more that is learned about CD and other IBD, the more overlap we will see in the oral cavity. Limitations to our research include inconsistent data and misrepresented populations. To best benefit the population, research will need to continue in order to learn more about the disease, development and management, and ways to prevent CD and other IBD, as well as less aggressive treatment options.