The oral effect of inflammatory bowel disease

Inflammatory bowel disease (IBD) includes several disorders that cause the intestines to become irritated. There are two main types: Crohn’s disease and ulcerative colitis. Crohn’s disease causes inflammation of the wall and lining of the large and/or small intestine, while ulcerative colitis primarily affects the lining of the large intestine. IBD causes symptoms such as diarrhea, abdominal cramps, rectal bleeding, and weight loss.

If you have IBD, you may also experience ulcers in your mouth. These are usually firm and pink. They may be painless or they may hurt when eating acidic, spicy, or hot foods. One type, called an aphthous ulcer, is similar in appearance to a cold sore and is common in people with Crohn’s disease. Aphthous ulcers are usually shallow, oval shaped, and off-white surrounded by a red zone of inflamed tissue. They typically heal in one to two weeks.

Oral sores may be caused by IBD itself, or they may occur due to medications you take to treat IBD. For instance, a healthy immune system keeps levels of a certain kind of fungus in the mouth—called Candida—in check. However, people with IBD may take medications that suppress the immune system, which can cause an overgrowth of Candida. This results in whitish, velvety lesions in your mouth and on your tongue that may bleed—a condition called thrush. In addition, taking antibiotics or steroids, which are also used to treat IBD, can lead to thrush.

If you know that you have IBD, be sure to tell your dentist. In particular, let your dentist know what medications you take because they may have side effects that your dentist should consider. Steroids, for example, can increase your susceptibility to infection.

“Crohn’s Disease.” National Digestive Diseases Information Clearinghouse, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health. http://digestive.niddk.nih.gov/ddiseases/pubs/crohns/#treatment. Accessed 2013.

“Inflammatory Bowel Disease.” FamilyDoctor.org, American Academy of Family Physicians. http://familydoctor.org/online/famdocen/home/common/digestive/disorders/252.printerview.html. Accessed 2013.

“Inflammatory Bowel Disease.” American Gastroenterological Association. http://www.gastro.org/patient-center/digestive-conditions/inflammatory-bowel-disease. Accessed 2013. 

“Oral Manifestations of Gastrointestinal Diseases.” T. Daley et al. The Canadian Journal of Gastroenterology. Vol. 21, No. 4, pp. 241-4, April 2007. www.ncbi.nlm.nih.gov:80/pmc/articles/PMC2657699/pdf/cjg21241.pdf. Accessed 2013.

“Thrush.” Medline Plus, U.S. National Library of Medicine, National Institutes of Health. www.nlm.nih.gov/medlineplus/ency/article/000626.htm. Accessed 2013. 

“Ulcerative Colitis.” National Digestive Diseases Information Clearinghouse, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health. http://digestive.niddk.nih.gov/ddiseases/pubs/colitis/. Accessed 2013.