Inflammatory bowel diseases and the oral cavity

Abstract

The professions of dentistry and gastroenterology are linked, as both dentists and gastroenterologists have their primary focus within the alimentary canal. Consequently, diseases that initially express themselves in one portion of the alimentary canal can present signs and symptoms in other segments as well. Patients with inflammatory bowel disease (IBD) may present with oral findings that are a manifestation of the underlying disease process. Oral manifestations of IBD may precede the onset of intestinal radiographic lesions by as much as a year or more.1,2 Treatment modalities used to manage IBD can affect the delivery of routine dental care. GENERAL INFORMATION IBD is a general classification of inflammatory processes affecting the large and small intestines. Ulcerative colitis and regional enteritis (Crohn’s disease) are the most common forms of IBD. Ulcerative colitis is an idiopathic inflammatory disease causing ulceration of the lining mucosa and submucosa of the colon. Crohn’s disease is a chronic granulomatous inflammatory process that occurs throughout the bowel wall but primarily in the ileum. The cause of IBD is unknown, but genetic factors, infectious agents, and immunologic mechanisms appear to play a role in these disorders. Symptoms of IBD include the following: