Although Crohn's disease—an inflammatory disorder—usually affects the walls and lining of the colon and small intestine (small bowel), it can affect any area of the gastrointestinal tract, including the mouth. Some individuals with Crohn's disease experience symptoms that affect the oral cavity before gastrointestinal problems present. In fact, oral symptoms often appear first and can aid doctors in making the diagnosis.
Common Crohn's Disease Symptoms
The various symptoms of Crohn's disease may be mild, severe or anything in between, depending on the individual. These symptoms may affect areas of the body other than the gastrointestinal tract as well. Sometimes individuals have periods of remission when they experience no symptoms of the disease and lesions in the GI tract are healing. However, if inflammation persists, the disease can become more severe over time.
When the disease is active, common orofacial symptoms include swollen and cracked lips, gingival (gum) swelling, and mucosal tags as well as nodules or papules on the face that can form a rash. Oral ulcers and the swelling or cobblestoned appearance of the soft tissue that lines the inside of the cheeks can also occur.
Other symptoms of Crohn's disease include nausea, frequent diarrhea, stomach cramps or abdominal pain, malnutrition, unexplained weight loss and bloody stool. You may also suffer anemia if the disease causes you to become deficient in iron or vitamin B-12 as nutrient deficiencies can affect both your general and oral health.
Risk Factors
If your dentist notes oral symptoms during a dental examination that may be signs of Crohn's disease, he or she may discuss whether you are at risk for the disease. Some of the risk factors include:
- Smoking
- Excess weight
- Diet high in sugar and saturated fat
- Family history of Crohn's or other inflammatory bowel diseases (IBD)—particularly if a parent or sibling has form of IBD
- Certain medications
While regular use of nonsteroidal anti-inflammatory medications is not a risk factor alone, these pain-relieving drugs can lead to inflammation of the bowel, which makes Crohn's disease worse. In addition to these and other factors that put you at higher risk of developing inflammatory bowel disease, Crohn's disease is an underlying medical condition that alone puts you at risk for gum disease.
If you have Crohn's disease, your body's lowered immunity makes it easier for inflammation of the gums to set in. Untreated gingivitis can then advance to periodontitis as the infection spreads below the gum line. Periodontitis itself is an inflammatory disease that breaks down the gum tissue and bone that hold your teeth in place.
Potential Oral Complications
The effect of Crohn's symptoms can lead to a number of oral complications if left untreated. Depleted levels of certain vitamins and minerals can affect mouth tissue even before causing symptoms elsewhere in the body.
Consequently, damage to the GI tract or adverse side effects of medications to treat Crohn's disease sometimes makes it difficult for the body to absorb nutrients such iron, calcium, zinc, B vitamins and vitamins A, C and D—all of which are nutrients that contribute to good oral health.
Oral side effects of medications you take to treat the symptoms of Crohn's disease can cause dry mouth, which increases the risk of cavities, enlarged gums, abnormal bleeding, mouth sores and oral yeast infections.
The medications that can cause these and other side effects may include corticosteroids and immunosuppressant drugs. Both of these drug types can make you more prone to infection, and when the balance of oral bacteria is disrupted it can be hard to control fungal growth, which can lead to fungal infections.
For more information on how Crohn's disease can affect your oral health, the dental professionals at
Rabel Family Dental General Dentistry
are happy to assist with these and other dental concerns you may have.
