Why Crohn's disease can cause mouth problems

Kathleen Blanchard's picture
Taking care of your oral health is important for anyone with Crohn's disease or colitis.
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Crohn’s disease and ulcerative colitis can affect other parts of the body besides the colon. Unfortunately, the health of your teeth and gums can also suffer if you’ve been diagnosed with the inflammatory bowel disease (IBD). Unlike ulcerative colitis that is also a form of IBD, Crohn’s disease can affect any part of the gastrointestinal tract including the lips, mouth and even the esophagus, but either form of IBD can cause symptoms other than bowel disease. Some medications cause your mouth, tongue or throat to be sore or develop ulcers and other oral problems.

Reasons your oral health can suffer if you have IBD

Sometimes it is difficult to tell what is causing changes in the mouth such as ulcers, soreness, dry mouth or cavities. Sometimes medications taken to treat Crohn’s disease interfere with normal mouth bacteria that can cause problems. IBD can also lead to nutritional deficiencies that affect dental and oral health. In other instances, it is the disease itself causing the problems. Your doctor can identify whether Crohn’s or colitis is interfering with the health of your teeth and gums with testing.

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Mouth problems you might experience from Crohn’s disease or colitis include:

  • Stomatitis that is inflammation of the mouth. The tongue can also become inflamed if your are deficient in folic acid, and essential B vitamin, causing glossitis.
  • Mouth ulcers can also occur that are sometimes severe.
  • Pyodermatitis-pyostomatitis vegetans is also associated with Crohn’s disease, but just rarely. Symptoms include pustules (pimples) that can be yellow or whitish in appearance in the mouth. After the pustules rupture, they leave a superficial ulcer. The lymph glands under the chin can become swollen and there may be mild pain. The mouth condition also causes redness.
  • A yeast infection of the mouth is associated with zinc deficiency that can happen from malabsorption
  • White patches in the mouth might signal a deficiency of vitamin A that is important for immune function. The vitamin is found in orange, red and green leafy vegetables.
  • Flat red patches in the mouth and a reddened “beefy” tongue are signs of vitamin B12 deficiency
  • If your gums bleed you might be low on vitamin K that is essential for blood clotting.

Common medicines for Crohn's that affect the mouth

  • Steroids can make your mouth feel dry and cause the tongue to be inflamed and swollen.
  • Mesalazine can cause dry mouth, tongue inflammation and change the way foods taste.
  • Methotrexate can cause a sore throat, inflamed tongue and gingivitis.
  • Sulphasalazine can cause a side effect of stomatitis (tongue inflammation), dry mouth and thrush (oral candidiasis). It can also interfere with folic acid absorption.

Understanding that Crohn’s disease and colitis can affect your dental health to cause recurrent or sporadic mouth problems because of how the disease causes systemic inflammation can help explain why it's important to keep regular dental visits. You will also want to know if your medication is the cause and keep a check on your nutritional status.

Keeping up with your regular visits to the dentist can help prevent tooth loss and the need for costly painful dental procedures. Optimal health of the gums and teeth also makes it easier to eat and enjoy food that is so important for good nutrition for anyone dealing with Crohn's disease or ulcerative colitis. It’s also important to tell your dentist if you have been diagnosed or are being tested for IBD, in addition to providing a list of medications you are taking.

“Oral Manifestations of Crohn’s Disease”
Dermnetnz.org
“Dental management of patients with inflammatory bowel disease”
Medicina.org

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Comments

Your dentist most likely has no idea what Crohn's disease is, because many doctors and nurses are ignorant about the true nature of the illness. It will likely be up to you to communicate these problems to your dentist so they can monitor for oral conditions related to crohn's disease.
Oats, you are so right. If you tell your dentist you have Crohn's disease and even think they don't understand, you definitely want to make sure they have that documented and schedule your follow-ups accordingly. Remind them if you think you need to.
My dentist was great! Knew all about crohns and asked about my medications and changed me to a 3monthly check up and clean to keep on top of any problems :)
That's the way it should be. Glad you are getting good oral care. It is sooo important.
Hi, im GUN sham 21 year old .after my graduation last year n have been having issue with my throat , I could See little red dots in my throat n it's been effecting me from past 1 n half year . I had been to almost 8 ENT. Specialist n no one has been able to help me out and my reports are normal .doctors have told me that i have no issues it's just normal n rather advised me to meet psychologist. It's really depressing for me has I had lost 45 lbs of weight n my parents don't know about this and I don't wanna meet them in this condition of mine. I came to know a bit about crohn disease ..but I have know idea what next step should be taken? If any one has any idea kindly help me out thank u.
Please note that stomatitis means inflammation of mouth not inflammation of tongue. Inflammation of tongue is called glossitis. hope you will correct it soon. Regards.
Have Crohns disease.My teeth have problems all the time and can't afford dentist visits as I have 4 kids etc...Lately I've been getting lots of mouth ulcers,sore throats regularly,really tired.I've also hit menopause .Wondered any connection? Thanks
Betty, there definitely could be a connection. May I suggest a dental clinic that might help you by providing care based on what you can afford? They basically use a sliding scale. You can look them up in your area on the internet. AlsAls, Care Credit is a no interest payment option that many dentists use.I hope you can get the care you need and feel better.
I've suffered with ulcers from being small and they have got worse over the years to points where I couldn't speak properly and in a lot of pain. I ended up seeing a consultant who gave me steroids to wash around my mouth and they did work,however have found that staying away from dairy and using the progesterone only pill kept them at bay. When I mean ulcers let me explain: Ulcers in my mouth/tongue, down my throat and gullet so I could feel anything I drank or eat going half way down my back Ulcers in my nose Patches on my face (dry skin like) Beefy tongue that sticks to my teeth Dry Mouth Ridges running around my tongue - would imagine looks like Cryton's off Red Dwarf [if you have ever watched it]. A dentist said he thought I bit my mouth when sleeping - I don't! Swolen lips and mouth so no need for Botox ..again stick to teeth and painful to reposition.. eg opening mouth after not talking for 10 minutes. Ulcers on my lips My Mum had Chron's however I have never been diagnosed - I assume they're not going to bother to do this until I'm ill enough to look at! My usual dentist thought I had caught the Coldsore virus which kids usually get...nope wrong again! Hope some others have recognised the same sympthoms..... bloody painful and really has had an impact on my life ... from talking to my children to social events but hope it doesn't travel down my system!