Large-scale study links periodontitis and inflammatory bowel disease

MALMÖ, Sweden: Even though previous research has suggested a link between periodontitis and inflammatory bowel disease (IBD), the relationship and its impacts have not been fully explored. In a large-scale study—the first of its kind in a European population—researchers from Malmö University, in collaboration with other Europe-based researchers, have found evidence for a strong connection between the two diseases.

IBD is a group of inflammatory disorders of the gastrointestinal tract, principally Crohn’s disease and ulcerative colitis. The incidence of IBD is increasing worldwide, and more than 1.3 million people in Europe suffer from it. Its cause remains unknown, but an inappropriate immune response is considered to be involved.

Periodontitis and IBD are chronic inflammatory diseases with similarly complex pathogeneses. “Both diseases can be described as a strong overreaction of the immune system against a theoretically relatively mild bacterial trigger. You can say that the immune system attacks one’s own body,” explained co-author Prof. Andreas Stavropoulos from the Faculty of Odontology in a university press release.

The study was conducted in Denmark and the data collected via an online questionnaire answered by around 1,100 patients with IBD (of whom approximately half had Crohn’s disease and the rest ulcerative colitis) and around 3,400 matched controls without it.

The evaluation of the survey responses showed that patients with IBD had a higher probability of perceiving the overall health of their teeth and gingivae as worse and of having severe periodontitis. Those patients diagnosed with Crohn’s disease reported worse oral health than those diagnosed with ulcerative colitis and had higher odds of having lost more teeth than the control group.

“The study shows that patients with IBD have more periodontitis and fewer teeth compared to people without IBD. We also see that patients with IBD and periodontitis have an aggravated intestinal disease with a higher activity than patients with IBD who have no oral health issues,” commented Prof. Stavropoulos.

Based on the study results, the research team concluded that patients with IBD should be kept under close surveillance in order to prevent the development of periodontitis and/or to slow down its progression. “Similarly important, it may be that treatment of periodontitis has a positive impact on the management of IBD,” emphasised Prof. Stavropoulos.

The study, titled “Periodontitis prevalence in patients with ulcerative colitis and Crohn’s disease—PPCC: A case–control study”, was published in the December 2022 issue of the Journal of Clinical Periodontology.

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