Department of Stomatology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong, China.
Department of Gastroenterology, The Center for Inflammatory Bowel Disease, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong, China.
Int Dent J. 2020 Jun;70(3):227-236. doi: 10.1111/idj.12542. Epub 2020 Jan 30.
Inflammatory bowel disease (IBD) may be associated with oral diseases, but few relevant studies have been reported in China. This study aimed to compare the prevalence, severity and extent of dental caries and periodontal disease in Chinese IBD patients and healthy controls.
In this cross-sectional study, questionnaires and oral examinations were completed for 389 IBD patients [265 with Crohn's disease (CD) and 124 with ulcerative colitis (UC)] and 265 healthy controls based on the established criteria of the World Health Organization. Tobit regression, multiple linear regression and logistic regression were performed to analyse the data.
After adjusting for confounders, the decayed, missing and filled surfaces indices were significantly increased in the CD and UC patients compared with those in the controls (P < 0.001). Patients with CD [odds ratio (OR) = 4.27, 95% confidence interval (95% CI): 2.63-6.95, P < 0.001] and UC (OR = 2.21, 95% CI: 1.24-3.94, P = 0.007) had significantly higher risks of dental caries than controls. Significantly higher percentages of sites with probing pocket depth ≥ 5 mm and clinical attachment loss ≥ 4 mm were observed in CD and UC patients compared with controls (P < 0.001). A fully adjusted model revealed that CD and UC were risk indicators for periodontitis (OR = 4.46, 95% CI: 2.50-7.95, P < 0.001; OR = 4.66, 95% CI: 2.49-8.71, P < 0.001, respectively). No significant differences in dental caries and periodontal disease were observed between the CD and UC patients.
Chinese IBD patients have a higher prevalence, severity and extent of dental caries and/or periodontal disease than controls, and require oral health education and multidisciplinary treatment.
炎症性肠病(IBD)可能与口腔疾病有关,但在中国相关研究较少。本研究旨在比较中国 IBD 患者与健康对照者的龋齿和牙周病的患病率、严重程度和范围。
本横断面研究根据世界卫生组织的既定标准,对 389 例 IBD 患者[265 例克罗恩病(CD)和 124 例溃疡性结肠炎(UC)]和 265 名健康对照者完成了问卷调查和口腔检查。采用 Tobit 回归、多元线性回归和逻辑回归分析数据。
调整混杂因素后,与对照组相比,CD 和 UC 患者的龋失补面数显著增加(P<0.001)。CD(比值比[OR] = 4.27,95%置信区间[95%CI]:2.63-6.95,P<0.001)和 UC(OR = 2.21,95%CI:1.24-3.94,P=0.007)患者发生龋齿的风险显著更高。与对照组相比,CD 和 UC 患者的探诊深度≥5mm和临床附着丧失≥4mm的位点百分比显著更高(P<0.001)。完全调整模型显示,CD 和 UC 是牙周炎的危险因素(OR = 4.46,95%CI:2.50-7.95,P<0.001;OR = 4.66,95%CI:2.49-8.71,P<0.001)。CD 和 UC 患者的龋齿和牙周病患病率无显著差异。
中国 IBD 患者的龋齿和/或牙周病患病率、严重程度和范围均高于对照组,需要进行口腔健康教育和多学科治疗。