P218 Oral manifestations in inflammatory bowel disease patients under anti-tumour necrosis factor treatment
M. Barreiro-de Acosta*1, P. Rio2, R. Ferreiro1, M. J. Bouza1, M. d. C. Pombo1, A. Lorenzo1, M. Gallas2, J. E. Dominguez-Munoz1
1University Hospital Santiago de Compostela, Gastroenterology, Santiago, Spain, 2Odontology University, Santiago, Spain
Oral manifestations are common in inflammatory bowel disease (IBD) patients, but data regarding their prevalence in the group of more severe patients have not been evaluated. Data are also limited because of the absence of a complete dentist exploration. The aim of the study is to analyse the predominance of different oral pathologies in IBD patients under anti-tumour necrosis factor (TNF) treatment.
A prospective consecutive study was performed. Inclusion criteria included all IBD patients older than 17 years and in clinical remission under maintenance treatment with biological therapies. Patients in flare were excluded. Clinical and demographic data was also recorded. A basic clinical oral examination by a dentist was performed to identify any evidence of oral ulcers, dental erosions, dental abscesses, lip lesions, periodontitis, or gingivitis. In order to assess the dental condition of IBD patients the CAO index was applied. All participants completed a survey specifically designed to detect oral pathology. This study was approved by the local ethic committee. Results are expressed as percentages and the Chi-square test was used in the analysis or the t-student test if it was necessary.
Included consecutively were 68 IBD patients (42 Crohn’s disease [CD] and 26 ulcerative colitis [UC]) under biological treatment; 55% were female, and the mean age was 44 years old, ranging from 22 to 71 years of age. Oral lesions were observed in 73.5% of patients. Regarding types of disease, in CD oral manifestations were present in 66.6% and in 84.6% of patients with UC, but differences were not statistically significant (p = 0.26). The most common lesions observed were aphthae ulcers in 34 (50%) and lip lesions in 22 (33.3%). In both groups, distribution was similar between CD and UC. Change in normal colouration of teeth was observed in 15 patients, but in only 3, an oral lichen planus was confirmed. In oral exploration 26 (38.2%) patients presented gingivitis, being significantly more common in CD than in UC (p = 0.028). Periodontitis was observed in 26.4% of patients with similar distribution in CD and UC. Regarding extra-oral exploration, 21 patients (30.8%) presented a mandibular joint clicking, but only 5 (7.3%) temporomandibular joint dysfunction was confirmed (n = 21).
Oral manifestations are common in IBD patients under anti-TNF treatment, with aphtaes, lip lesions, gingivitis, and periodontitis being the most common. Distribution was similar between CD and UC, except that gingivitis was more characteristic in CD patients.