Crohn’s disease is a type of inflammatory bowel disease (IBD) that mostly affects your digestive tract, but it can have a surprising impact on your oral health as well. While the hallmark symptoms of Crohn’s disease are well-known, like abdominal pain, diarrhea, weight loss, anemia, and fatigue, there are other, lesser-known symptoms that can actually be found in your mouth.
That’s why telling your dentist if you have Crohn’s disease is super important, because it can help both you and your treating physician keep an eye on any related dental and oral concerns. Plus, you may need to up your dental treatment to keep your mouth healthy, which is why being open and honest with your dentist can go a long way in effectively managing the condition.
If you’ve been diagnosed with Crohn’s disease, here’s everything you should brush up on (no pun intended) about the connection between this chronic condition and its impact on oral health.
Research shows a strong connection between inflammatory bowel disease, or IBD, and dental conditions like dental caries, infections, and periodontitis. That’s because these conditions may share the same pathogens, or microorganisms, that play a key role in their existence.
In fact, studies show that up to 35 percent of people diagnosed with IBD will also experience the illness outside their digestive tract in a phenomenon known as “extra-intestinal manifestation.”
Anywhere from 5 percent to 50 percent of those individuals will see Crohn’s disease in their oral cavity, and some theories believe that the disease could first show up as oral inflammation before presenting itself in the intestines. In a research review, one study found that out of 113 people diagnosed with IBD, 54.9 percent had increased oral symptoms when compared to a control group without IBD.
Oral and dental manifestations of Crohn’s disease, sometimes known as oral Crohn’s disease, can show up in several ways. Here are key signs and symptoms to look out for:
- canker sores in the mouth or on the lips
- inflammation or cracks in one or both corners of the mouth
- throat irritation with visible bumps and lumps at the back
- swollen lips
- skin tags inside the mouth or behind teeth
- thickened mucus inside the mouth
- abscess or swelling with discharge
Oral Crohn’s disease is a less common form of Crohn’s disease that causes ulceration in and around the mouth. This generally includes some appearance of Crohn’s disease in the bowel. But 60 percent of oral Crohn’s disease can initially show up without any gut disease. Over time, though, 30 percent of those individuals will go on to develop gut symptoms.
If you have Crohn’s disease, it’s a good idea to keep track of canker sores, since they’re one of the most common oral manifestations of the condition.
While oral Crohn’s disease may be painful, there are numerous ways to treat it that begin with first identifying the cause of canker sores. Since medication can cause canker sores to flare up, it’s important for your dentist to rule out that possibility before beginning a treatment plan. If you take medication for Crohn’s disease or other conditions, be sure to let your dentist know.
Once medication has been ruled out as a cause, or adjusted as needed, these treatments can also be considered to treat canker sores or other oral symptoms of Crohn’s disease:
- exclusion diet to identify and reduce intake of food(s) which may make swelling worse
- special mouthwash or paste for mouth ulcers
- injections into swollen lips or cheeks for a cosmetic improvement
In more serious cases of oral Crohn’s or for individuals with extreme swelling, surgery may be necessary, though this approach isn’t common and is generally only considered if other noninvasive treatments don’t work.
People diagnosed with Crohn’s disease may seek out more dental treatment than those who aren’t diagnosed with the condition. Studies show that people who have Crohn’s disease have more dental procedures, including 65 percent more removable dentures, 52 percent more filling in front teeth, and 46 percent more endodontic treatment, or treatments of tissues and pulps like root canals.
Crohn’s disease can also cause gum inflammation, gingivitis, and your breath to smell, which may also lead to increased dental treatment. If you have Crohn’s disease, it’s important to keep up with dental cleanings and make it a point to contact your dentist at least twice a year.
Creating a handy list of questions to ask your dentist about the connection between Crohn’s disease and oral health, or about any concerns you may have, can help you get the right treatment and prevention plan.
Here are questions to consider asking your dentist:
- How does Crohn’s disease affect oral health?
- Do I have any oral signs or symptoms of Crohn’s disease?
- What signs or symptoms should I keep an eye out for?
- How often should I get dental cleanings?
- What else might prompt me to make an appointment?
- What mouthwash, toothpaste, floss, or toothbrush should I use?
- How can I keep my breath smelling fresh?
- Should I avoid any specific foods or dental products?
Crohn’s disease isn’t always just in your gut. Sometimes, it can show up in your mouth, teeth, and overall oral health. That doesn’t mean there’s no solution, though.
With the right information and by keeping up with your dental care, you can manage and even prevent some oral symptoms of Crohn’s disease. Talk with your dentist to develop a care plan that’s right for you.