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Haugbo HO, Klepp P, Verket A. Ulcerative colitis and periodontitis - a cross-sectional pilot study from a Norwegian cohort. Acta Odontol Scand 2023; 81:541-548. [PMID: 37171849 DOI: 10.1080/00016357.2023.2210660] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Accepted: 04/30/2023] [Indexed: 05/13/2023]
Abstract
BACKGROUND Inflammatory bowel disease, which includes ulcerative colitis (UC), is an inflammatory disorder with potential impact on periodontal disease, but evidence to date for this association is limited. The primary aim of this study was to investigate the prevalence of periodontitis according to the 2017-classification in a cohort of subjects with UC. The secondary aim was to assess a potential correlation of periodontal status with previous UC disease parameters and to assess oral health-related quality-of-life. METHOD A cohort from a community hospital in Norway with confirmed extensive UC was comprehensively examined. Periodontal parameters, OHIP-14 and demographic variables were collected. Previous UC data including colon activity index (CAI), Mayo score and years of UC diagnosis was used to explore a potential correlation with periodontal status. RESULTS A total of 50 out of 63 invited patients participated. According to the 2017-classification, 74% of the patients presented periodontitis. No correlation was found between periodontitis (stage, grade, bleeding on probing or probing pocket depth ≥6mm) and CAI, Mayo score, or years with UC diagnosis. CONCLUSIONS Within the limitations of this study, the prevalence of periodontitis among patients with mild UC for more than 12 years was in line with that reported from a Norwegian general population. No correlation between periodontitis and UC disease indices or years with UC diagnosis was observed. The study suggests that the susceptibility to periodontitis may be limited in patients with well treated or mild UD who regularly attend the dental office, despite a considerable UC disease duration.
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Affiliation(s)
- Helena O Haugbo
- Department of Hospital Dentistry, Lovisenberg Diaconal Hospital, Oslo, Norway
- Institute of Clinical Dentistry, Department of Periodontology, University of Oslo, Oslo, Norway
| | - Pasquale Klepp
- Department of Gastroenterology, Lovisenberg Diaconal Hospital, Oslo, Norway
| | - Anders Verket
- Institute of Clinical Dentistry, Department of Periodontology, University of Oslo, Oslo, Norway
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Wiriyakijja P, Niklander S, Santos-Silva AR, Shorrer MK, Simms ML, Villa A, Sankar V, Kerr AR, Riordain RN, Jensen SB, Delli K. World Workshop on Oral Medicine VIII: Development of a Core Outcome Set for Dry Mouth: A Systematic Review of Outcome Domains for Xerostomia. Oral Surg Oral Med Oral Pathol Oral Radiol 2023:S2212-4403(23)00068-8. [PMID: 37198047 DOI: 10.1016/j.oooo.2023.01.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Revised: 12/11/2022] [Accepted: 01/25/2023] [Indexed: 03/08/2023]
Abstract
OBJECTIVE The purpose of this study was to identify all outcome domains used in clinical studies of xerostomia, that is, subjective sensation of dry mouth. This study is part of the extended project "World Workshop on Oral Medicine Outcomes Initiative for the Direction of Research" to develop a core outcome set for dry mouth. STUDY DESIGN A systematic review was performed on MEDLINE, EMBASE, CINAHL, and Cochrane Central Register of Controlled Trials databases. All clinical and observational studies that assessed xerostomia in human participants from 2001 to 2021 were included. Information on outcome domains was extracted and mapped to the Core Outcome Measures in Effectiveness Trials taxonomy. Corresponding outcome measures were summarized. RESULTS From a total of 34,922 records retrieved, 688 articles involving 122,151 persons with xerostomia were included. There were 16 unique outcome domains and 166 outcome measures extracted. None of these domains or measures were consistently used across all the studies. The severity of xerostomia and physical functioning were the 2 most frequently assessed domains. CONCLUSION There is considerable heterogeneity in outcome domains and measures reported in clinical studies of xerostomia. This highlights the need for harmonization of dry mouth assessment to enhance comparability across studies and facilitate the synthesis of robust evidence for managing patients with xerostomia.
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Li C, Wu Y, Xie Y, Zhang Y, Jiang S, Wang J, Luo X, Chen Q. Oral manifestations serve as potential signs of ulcerative colitis: A review. Front Immunol 2022; 13:1013900. [PMID: 36248861 PMCID: PMC9559187 DOI: 10.3389/fimmu.2022.1013900] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Accepted: 09/14/2022] [Indexed: 11/23/2022] Open
Abstract
As an immune dysregulation-related disease, although ulcerative colitis (UC) primarily affects the intestinal tract, extraintestinal manifestations of the disease are evident, particularly in the oral cavity. Herein, we have reviewed the various oral presentations, potential pathogenesis, and treatment of oral lesions related to UC. The oral manifestations of UC include specific and nonspecific manifestations, with the former including pyostomatitis vegetans and the latter encompassing recurrent aphthous ulcers, atrophic glossitis, burning mouth syndrome, angular cheilitis, dry mouth, taste change, halitosis, and periodontitis. Although the aetiology of UC has not been fully determined, the factors leading to its development include immune system dysregulation, dysbiosis, and malnutrition. The principle of treating oral lesions in UC is to relieve pain, accelerate the healing of lesions, and prevent secondary infection, and the primary procedure is to control intestinal diseases. Systemic corticosteroids are the preferred treatment options, besides, topical and systemic administration combined with dietary guidance can also be applied. Oral manifestations of UC might accompany or precede the diagnosis of UC, albeit with the absence of intestinal symptoms; therefore, oral lesions, especially pyostomatitis vegetans, recurrent aphthous ulcer and periodontitis, could be used as good mucocutaneous signs to judge the occurrence and severity of UC, thus facilitating the early diagnosis and treatment of UC and avoiding severe consequences, such as colon cancer.
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Affiliation(s)
| | | | | | | | | | | | - Xiaobo Luo
- *Correspondence: Qianming Chen, ; Xiaobo Luo,
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Association of Preterm Birth with Inflammatory Bowel Disease and Salivary Gland Disease: Machine Learning Analysis Using National Health Insurance Data. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19053056. [PMID: 35270746 PMCID: PMC8910052 DOI: 10.3390/ijerph19053056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Revised: 03/02/2022] [Accepted: 03/03/2022] [Indexed: 11/17/2022]
Abstract
This study employs machine learning and population data for testing the associations of preterm birth with inflammatory bowel disease (IBD), salivary gland disease, socioeconomic status and medication history, including proton pump inhibitors. The source of population-based retrospective cohort data was the Korea National Health Insurance Service claims data for all women aged 25–40 years and who experience their first childbirths as singleton pregnancy during 2015 to 2017 (402,092 women). These participants were divided into the Ulcerative Colitis (UC) Group (1782 women), the Crohn Group (1954 women) and the Non-IBD Group (398,219 women). For each group, the dependent variable was preterm birth during 2015–2017, and 51 independent variables were included. Random forest variable importance was employed for investigating the main factors of preterm birth and testing its associations with salivary gland disease, socioeconomic status and medication history for each group. The proportion of preterm birth was higher for the UC Group and the Non-IBD Group than for the Crohn Group: 7.86%, 7.17% vs. 6.76%. Based on random forest variable importance, salivary gland disease was a top 10 determinant for the prediction of preterm birth for the UC Group, but this was not the case for the Crohn Group or the Non-IBD Group. The top 5 variables of preterm birth for the UC Group during 2015–2017 were socioeconomic status (8.58), age (8.00), proton pump inhibitors (2.35), progesterone (2.13) and salivary gland disease in 2014 (1.72). In conclusion, preterm birth has strong associations with ulcerative colitis, salivary gland disease, socioeconomic status and medication history including proton pump inhibitors.
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Imai J, Ichikawa H, Kitamoto S, Golob JL, Kaneko M, Nagata J, Takahashi M, Gillilland MG, Tanaka R, Nagao-Kitamoto H, Hayashi A, Sugihara K, Bishu S, Tsuda S, Ito H, Kojima S, Karakida K, Matsushima M, Suzuki T, Hozumi K, Watanabe N, Giannobile WV, Shirai T, Suzuki H, Kamada N. A potential pathogenic association between periodontal disease and Crohn's disease. JCI Insight 2021; 6:148543. [PMID: 34710061 PMCID: PMC8675195 DOI: 10.1172/jci.insight.148543] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Accepted: 10/27/2021] [Indexed: 11/17/2022] Open
Abstract
Oral conditions are relatively common in patients with inflammatory bowel disease (IBD). However, the contribution of oral maladies to gut inflammation remains unexplored. Here, we investigated the effect of periodontitis on disease phenotypes of patients with IBD. In all, 60 patients with IBD (42 with ulcerative colitis [UC] and 18 with Crohn’s disease [CD]) and 45 healthy controls (HCs) without IBD were recruited for this clinical investigation. The effects of incipient periodontitis on the oral and gut microbiome as well as IBD characteristics were examined. In addition, patients were prospectively monitored for up to 12 months after enrollment. We found that, in both patients with UC and those with CD, the gut microbiome was significantly more similar to the oral microbiome than in HCs, suggesting that ectopic gut colonization by oral bacteria is increased in patients with IBD. Incipient periodontitis did not further enhance gut colonization by oral bacteria. The presence of incipient periodontitis did not significantly affect the clinical outcomes of patients with UC and CD. However, the short CD activity index increased in patients with CD with incipient periodontitis but declined or was unchanged during the study period in patients without periodontitis. Thus, early periodontitis may associate with worse clinically symptoms in some patients with CD.
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Affiliation(s)
- Jin Imai
- Department of Internal Medicine, Tokai University School of Medicine, Kanagawa, Japan
| | - Hitoshi Ichikawa
- Center for Preventive Medicine, Keio University School of Medicine, Tokyo, Japan
| | - Sho Kitamoto
- Department of Internal Medicine, University of Michigan, Ann Arbor, United States of America
| | - Jonathan L Golob
- Division of Infectious Diseases, University of Michigan, Ann Arbor, United States of America
| | - Motoki Kaneko
- Department of Internal Medicine, Tokai University School of Medicine, Kanagawa, Japan
| | - Junko Nagata
- Department of Internal Medicine, Tokai University School of Medicine Hachioji Hospital, Tokyo, Japan
| | - Miho Takahashi
- Department of Oral and Maxillofacial Surgery, Tokai University School of Medicine Hachioji Hospital, Tokyo, Japan
| | - Merritt G Gillilland
- Department of Internal Medicine, University of Michigan, Ann Arbor, United States of America
| | - Rika Tanaka
- Department of Immunology, Tokai University School of Medicine, Kanagawa, Japan
| | - Hiroko Nagao-Kitamoto
- Department of Internal Medicine, University of Michigan, Ann Arbor, United States of America
| | - Atsushi Hayashi
- Department of Internal Medicine, University of Michigan, Ann Arbor, United States of America
| | - Kohei Sugihara
- Department of Internal Medicine, University of Michigan, Ann Arbor, United States of America
| | - Shrinivas Bishu
- Department of Internal Medicine, University of Michigan, Ann Arbor, United States of America
| | - Shingo Tsuda
- Department of Internal Medicine, Tokai University School of Medicine Hachioji Hospital, Tokyo, Japan
| | - Hiroyuki Ito
- Department of Internal Medicine, Tokai University School of Medicine Hachioji Hospital, Tokyo, Japan
| | - Seiichiro Kojima
- Department of Internal Medicine, Tokai University School of Medicine Hachioji Hospital, Tokyo, Japan
| | - Kazunari Karakida
- Department of Oral and Maxillofacial Surgery, Tokai University School of Medicine Hachioji Hospital, Tokyo, Japan
| | - Masashi Matsushima
- Department of Internal Medicine, Tokai University School of Medicine, Kanagawa, Japan
| | - Takayoshi Suzuki
- Department of Internal Medicine, Tokai University School of Medicine Hachioji Hospital, Tokyo, Japan
| | - Katsuto Hozumi
- Department of Immunology, Tokai University School of Medicine, Kanagawa, Japan
| | - Norihito Watanabe
- Department of Internal Medicine, Tokai University School of Medicine Hachioji Hospital, Tokyo, Japan
| | - William V Giannobile
- Department of Oral Medicine, Infection, and Immunity, Harvard School of Dental Medicine, Boston, United States of America
| | - Takayuki Shirai
- Department of Internal Medicine, Tokai University School of Medicine Hachioji Hospital, Tokyo, Japan
| | - Hidekazu Suzuki
- Department of Internal Medicine, Tokai University School of Medicine, Kanagawa, Japan
| | - Nobuhiko Kamada
- Department of Internal Medicine, University of Michigan, Ann Arbor, United States of America
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Imai J, Kitamoto S, Kamada N. The pathogenic oral-gut-liver axis: new understandings and clinical implications. Expert Rev Clin Immunol 2021; 17:727-736. [PMID: 34057877 DOI: 10.1080/1744666x.2021.1935877] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
INTRODUCTION Oral health is closely related to extra-oral disease status, as may be represented by the manifestations of gastrointestinal and liver diseases. AREAS COVERED This review focuses on the roles that the oral-gut or the oral-gut-liver axis play in the pathogenesis of inflammatory bowel disease, colorectal cancer, metabolic fatty liver disease, and nonalcoholic steatohepatitis. The discussion will begin with clinical data, including data from preclinical animal models, to elucidate mechanisms. We will also discuss ways to target oral dysbiosis and oral inflammation to treat gastrointestinal and liver diseases. EXPERT OPINION Several studies have demonstrated that oral pathobionts can translocate to the gastrointestinal tract where they contribute to inflammation and tumorigenesis. Furthermore, oral bacteria that migrate to the gastrointestinal tract can disseminate to the liver and cause hepatic disease. Thus, oral bacteria that ectopically colonize the intestine may serve as biomarkers for gastrointestinal and liver diseases. Also, understanding the characteristics of the oral-gut and oral-gut-liver microbial and immune axes will provide new insights into the pathogenesis of these diseases.
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Affiliation(s)
- Jin Imai
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, University of Michigan, Ann Arbor, MI, United States.,Division of Gastroenterology and Hepatology, Department of Internal Medicine, Tokai University School of Medicine, Isehara, Japan
| | - Sho Kitamoto
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, University of Michigan, Ann Arbor, MI, United States
| | - Nobuhiko Kamada
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, University of Michigan, Ann Arbor, MI, United States
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Tan CXW, Brand HS, Kalender B, De Boer NKH, Forouzanfar T, de Visscher JGAM. Dental and periodontal disease in patients with inflammatory bowel disease. Clin Oral Investig 2021; 25:5273-5280. [PMID: 33619633 PMCID: PMC8370899 DOI: 10.1007/s00784-021-03835-6] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2020] [Accepted: 02/08/2021] [Indexed: 02/07/2023]
Abstract
Objectives Although bowel symptoms are often predominant, inflammatory bowel disease (IBD) patients can have several oral manifestations. The aim of this study was to investigate the prevalence of dental caries and periodontal disease in patients with Crohn’s disease (CD) and ulcerative colitis (UC) compared to an age and gender-matched control group of patients without IBD. Material and methods The DMFT (Decayed, Missing, Filled Teeth) scores and the DPSI (Dutch Periodontal Screening Index) of 229 IBD patients were retrieved from the electronic health record patient database axiUm at the Academic Centre for Dentistry Amsterdam (ACTA) and were compared to the DMFT scores and DPSI from age and gender-matched non-IBD patients from the same database. Results The total DMFT index was significantly higher in the IBD group compared to the control group. When CD and UC were analyzed separately, a statistically significant increased DMFT index was observed in CD patients but not in UC patients. The DPSI did not differ significantly between the IBD and non-IBD groups for each of the sextants. However, in every sextant, IBD patients were more frequently edentulous compared to the control patients. Conclusion CD patients have significantly more dental health problems compared to a control group. Periodontal disease did not differ significantly between IBD and non-IBD groups as determined by the DPSI. Clinical relevance It is important that IBD patients and physicians are instructed about the correlation between their disease and oral health problems. Strict oral hygiene and preventive dental care such as more frequent checkups should be emphasized by dental clinicians.
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Affiliation(s)
- Christopher X W Tan
- Department of Oral and Maxillofacial Surgery/Oral Pathology, Amsterdam University Medical Centre/Academic Centre for Dentistry Amsterdam (ACTA), PO Box 7057, 1007 MB, Amsterdam, The Netherlands.
| | - Henk S Brand
- Department of Oral Biochemistry, Academic Centre for Dentistry Amsterdam (ACTA), Amsterdam, The Netherlands
| | - Bilgin Kalender
- Department of Oral Biochemistry, Academic Centre for Dentistry Amsterdam (ACTA), Amsterdam, The Netherlands
| | - Nanne K H De Boer
- Department of Gastroenterology and Hepatology, Amsterdam University Medical Centre, VU University, AGEM Research Institute, Amsterdam, The Netherlands
| | - Tymour Forouzanfar
- Department of Oral and Maxillofacial Surgery/Oral Pathology, Amsterdam University Medical Centre/Academic Centre for Dentistry Amsterdam (ACTA), PO Box 7057, 1007 MB, Amsterdam, The Netherlands
| | - Jan G A M de Visscher
- Department of Oral and Maxillofacial Surgery/Oral Pathology, Amsterdam University Medical Centre/Academic Centre for Dentistry Amsterdam (ACTA), PO Box 7057, 1007 MB, Amsterdam, The Netherlands
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Salivary Stress/Immunological Markers in Crohn's Disease and Ulcerative Colitis. Int J Mol Sci 2020; 21:ijms21228562. [PMID: 33202858 PMCID: PMC7698267 DOI: 10.3390/ijms21228562] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2020] [Revised: 11/09/2020] [Accepted: 11/11/2020] [Indexed: 02/08/2023] Open
Abstract
There is continuous and growing interest in research into new alternatives to standard biomarkers to detect and follow-up disease, reducing physical and psychological stress in patients needing regular and invasive medical examinations for the evaluation of pathologies, including inflammatory bowel diseases (IBD). Saliva is one of the most promising body fluids in the research of new biomarkers, thanks to the large number of molecules it contains. Many molecules present in saliva are often directly correlated to their concentration in the blood but may be affected by the condition of the oral cavity. This means that a careful selection of a specific biomarker is required for each pathology, especially pathologies such as IBD, which may induce inflammation in the oral cavity. Here, we analyze the currently used and the proposed new salivary biomarkers (i.e., calprotectin, cytokines, IgA, cortisol, and oxidative stress markers) for the detection and follow-up of the main subtypes of IBD, known as ulcerative colitis and Crohn's disease.
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