Mind, Body, Mouth, it’s all connected. Dental Health Week 2023 – Inflammatory Bowel Conditions

Early evidence indicates that there is a link between periodontitis and inflammatory bowel diseases in that they both share a common pathological make up and the disease outcomes are worse when both conditions are present in an individual.

Inflammatory bowel disease (IBD) is the broad term used to encompass conditions affecting the gastrointestinal tract including Crohn’s Disease and ulcerative colitis. It is estimated that one in 200 Australians suffer from inflammatory bowel conditions.

In inflammatory bowel conditions, genetically susceptible individuals have increased chronic inflammation due to an aberrant immune response to gut bacteria. Manifestations of the disease can be seen in the joints, eyes, skin, liver and mouth. Signs in the mouth are usually seen at the onset of gastrointestinal inflammation or follow it. The presentation of signs outside of the gut, vary between individuals.

The link between periodontitis and IBD is thought to occur due to both conditions involving an aberrant immune response to bacteria and those patients with IBD are at increased risk of developing periodontitis.

This abnormal inflammatory and immune response in both diseases leads to tissue destruction. Some studies have hypothesised a two way link between periodontitis and IBD. Some studies have shown that pathogenic T-cells (immune cells) that proliferate during periodontitis may migrate to the gut and are activated by these misplaced oral pathogens and worsen IBD outcomes.

Systemically, both diseases have been shown to contribute to alter the neutrophil (type of white blood cell) function to exacerbate the damage of tissue and abscesses specifically found in IBD. This suggests both diseases may increase the severity lesions of one another.

In summary, is that coexistence of both diseases show greater risks for more severe outcomes, than for each disease on its own.

The beneficial effect of good oral hygiene and treatment of periodontitis, will reduce inflammation in the body and thereby not add to any other inflammation present systemically.