For years, Lenette Sparacino struggled with persistent dental issues, from multiple cavities to frequent mouth ulcers and gum inflammation. “I’ve probably had at least 30 cavities over my lifetime,” she recalls. But it wasn’t until Sparacino was diagnosed with Crohn’s disease in 2014 that she began to understand the link between her digestive health and her oral problems. After researching her condition, she realized that years of untreated inflammation were at the root of both her digestive and dental issues.
The connection between the mouth and the gut may not be immediately obvious, but they are closely linked anatomically and chemically. Crohn’s disease, an inflammatory bowel disease (IBD), affects any part of the gastrointestinal (GI) tract, from the oral cavity down to the colon. “The mouth and intestines aren’t just linked physically, but also chemically,” explains Dr. Earl Campbell, a gastroenterologist at Wellstar Health System. The phenomenon, referred to as the “oral-gut axis,” highlights how inflammation can spread between these areas, especially in people with IBD.
Research shows that individuals with IBD, including Crohn’s disease and ulcerative colitis, are more likely to experience oral health problems, such as canker sores, gum disease, and cavities. In fact, up to 35% of IBD patients experience some oral manifestation of their condition, with Crohn’s patients particularly prone to mouth lesions. Oral symptoms can appear before, during, or after gut symptoms, with some Crohn’s patients noticing oral lesions first.
Sparacino, now an advocate for IBD awareness on social media, shares her journey of discovery about the link between Crohn’s disease and dental health. She found that neither her gastroenterologist nor her dentist explained this connection, leaving her to connect the dots herself over several years. “There’s a big gap in communication,” she says, highlighting the need for better education for both doctors and patients.
Dentists and gastroenterologists alike agree that raising awareness about this connection is crucial for IBD patients. “Canker sores are a common manifestation of Crohn’s disease, especially during flare-ups,” says Dr. Shirley Cohen-Mekelburg, a gastroenterologist and spokesperson for the American Gastroenterological Association. “Understanding this link empowers patients to manage their oral health alongside their digestive health.”
The relationship between oral and gut health is complex and still being studied. Experts are investigating how imbalances in bacteria in the mouth and gut may influence each other and contribute to inflammation. However, factors like smoking, poor nutrient absorption, and vitamin deficiencies are known to exacerbate both oral and GI health problems in people with IBD.
For those with Crohn’s disease, regular dental check-ups and good oral hygiene practices are essential. Sparacino, who now uses extra-strength toothpaste recommended by her dentist, has noticed fewer dental issues since taking better care of her oral health. Her treatment for Crohn’s disease, which includes biologic medications to reduce inflammation, has also helped alleviate her gum and mouth symptoms. “Now, my gums are just normal,” she says, reflecting on the positive impact of managing both her oral and gut health.
As research continues to uncover the intricacies of the oral-gut axis, experts hope that better understanding and treatment of oral symptoms could improve the management of IBD.