Rodrigues Eduardo, Laranjeira Nuno, Nunes Gonçalo, Roque-Ramos Lídia, Vieira Ana, Fonseca Jorge
CiiEM, Centro de Investigação Interdisciplinar Egas Moniz, Monte da Caparica, Portugal.
Hospital Garcia de Orta, Departamento de Gastroenterologia, Almada, Portugal.
Arq Gastroenterol. 2019 Aug 13;56(2):118-123. doi: 10.1590/S0004-2803.201900000-25.
High prevalence of dental caries in ulcerative colitis (UC) has been attributed to diet and changes in salivary environment.
We aimed to characterize the prevalence of dental caries, salivary flow rates, salivary buffering capacity and cariogenic bacteria counts of Mutans streptococci and Lactobacillus spp and to evaluate their relationship with drug therapy, disease activity and duration.
A cross-sectional study was performed with UC patients followed in a tertiary center. Participants were submitted to a questionnaire (including demographic data, oral hygiene, eating habits) and a clinical observation with assessment of plaque index and Decayed, Missing and Filled Teeth index. Unstimulated/stimulated saliva was collected. Medical records, disease activity (Partial Mayo Score) and disease duration were collected. Laboratory data included salivary flow rates, salivary buffering capacity (CRT® buffer) and cariogenic bacteria count (Mutans streptococci and Lactobacillus spp) in saliva using the CRT® bacteria test (results: high or low counts).
Thirty UC patients were recruited. Oral hygiene routines were daily teeth brushing once or more (96.7%) and fluoride toothpaste (73.3%). Decayed, Missing and Filled Teeth index (mean 16.17±6.428) was not affected by the frequency of soft drinks, cakes, sweets and sugars between meals (P>0.2). Long-term disease showed a trend towards higher prevalence of caries (P=0.06). Most presented normal salivary flow rates, unstimulated (73.3%) and stimulated (60.0%), and high salivary buffering capacity (66.7%). Any association was found with age, gender, disease activity, disease duration and drug therapy. High Mutans streptococci and low Lactobacillus spp count were observed in 73.3% and 60% of patients, respectively. Patients with active disease (100%) and longer duration (88.9%) displayed higher Mutans streptococci count.
The prevalence of dental caries observed in UC patients was significant and did not seem to be influenced by their eating habits. The high prevalence of Mutans streptococci count may be a major risk factor for dental caries and may be looked as part of the UC dysbiosis. Dental care of UC patients should be planned according with this microbiota variation.
溃疡性结肠炎（UC）患者中龋齿的高患病率归因于饮食和唾液环境的变化。
我们旨在描述UC患者龋齿的患病率、唾液流速、唾液缓冲能力以及变形链球菌和乳酸杆菌属致龋菌的数量，并评估它们与药物治疗、疾病活动度和病程的关系。
在一家三级中心对随访的UC患者进行了一项横断面研究。参与者填写了一份问卷（包括人口统计学数据、口腔卫生、饮食习惯），并接受了临床观察，评估菌斑指数和龋失补牙指数。收集了非刺激性/刺激性唾液。收集了病历、疾病活动度（部分梅奥评分）和病程。实验室数据包括唾液流速、唾液缓冲能力（CRT®缓冲液）以及使用CRT®细菌检测法检测唾液中致龋菌的数量（变形链球菌和乳酸杆菌属，结果为高计数或低计数）。
招募了30例UC患者。日常口腔卫生习惯为每天刷牙一次或多次（96.7%），并使用含氟牙膏（73.3%）。龋失补牙指数（平均16.17±6.428）不受餐间软饮料、蛋糕、糖果和糖的食用频率影响（P>0.2）。病程较长者龋齿患病率有升高趋势（P=0.06）。大多数患者非刺激性唾液流速（73.3%）和刺激性唾液流速（60.0%）正常，唾液缓冲能力高（66.7%）。未发现与年龄、性别、疾病活动度、病程和药物治疗有任何关联。分别在73.3%和60%的患者中观察到变形链球菌计数高和乳酸杆菌属计数低。疾病活动期患者（100%）和病程较长者（88.9%）变形链球菌计数较高。
UC患者中观察到的龋齿患病率较高，且似乎不受其饮食习惯的影响。变形链球菌计数高可能是龋齿的主要危险因素，可视为UC生态失调的一部分。应根据这种微生物群变化为UC患者制定口腔护理计划。
