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Oral signs and symptoms in relation to disease activity and site of involvement in patients with inflammatory bowel disease


Joseph Katz, Department of Oral Maxillofacial Surgery and Diagnostic Sciences, College of Dentistry, University of Florida, Gainesville, FL 32610-0416, USA. Tel: 352 392 6797, Fax: 352 846 0588, E-mail:


OBJECTIVE: An assessment of oral symptoms and signs in patients with inflammatory bowel disease (IBD).

METHODS: Fifty-four patients with IBD, 34 with Crohn's disease (CD) and 20 with ulcerative colitis (UC) participated in the study. Forty-two patients without gastrointestinal disease or complaints attending the orthopedic clinic served as controls. Each patient completed a written questionnaire and was subjected to an oral examination.

RESULTS: The main findings of this study were the higher prevalence of halitosis (50%vs 10%P < 0.0008), nausea (30%vs 7%, P < 0.017) and reflux (regurgitation) (45%vs 17%, P < 0.017) in patients with UC, and nausea (50%vs 7%, P < 0.026), dry mouth and halitosis (29%vs 10%, P < 0.026) and vomiting (41%vs 5%, P = 0.01) in patients with CD, compared with controls. Patients with active CD had a higher prevalence of dry mouth, nausea and vomiting compared with controls (46, 69 and 54%vs 10, 7 and 5%, respectively, P < 0.001) and of reflux compared with non-active CD (46%vs 5%, P < 0.001). Patients with active UC had a higher prevalence of halitosis and regurgitation (50 and 60%vs 10 and 17%, P < 0.001) compared with controls.

CONCLUSIONS: The present study demonstrates increased frequency of oral signs and symptoms in patients with IBD. Patients with active CD had more oral signs compared with non-active CD patients. Manifestations such as nausea, vomiting, regurgitation and dry mouth may have detrimental effects on teeth and soft tissues of the oral cavity. Communication between gastroenterologists and dentists is imperative for success of the overall treatment of their patients.

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