Why Crohn's disease can cause mouth problems
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.
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.