Oral Symptoms of Crohn’s Disease

Crohn’s Disease is the second most-common inflammatory bowel disease (after ulcerative colitis). Crohn’s Disease affects approximately 700,000 people in the U.S. It can affect any part of the gastrointestinal system. Most symptoms affect the digestive tract. What many people do not know is that other symptoms are also possible.

Some symptoms of Crohn’s Disease outside the digestive tract affect the mouth and the lower part of the face. Mouth Woman with aphthous stomatitis - paid - Depositphotos 52168033 m-2015ulcers are the most common of these symptoms. The canker sores (mouth ulcers) tend to arise at the base of the gums, inside the mouth. Characteristics of these canker sores include: small size, oval or round shape, yellow or gray in color with a red border or “halo,” appearing in groups. These sores are typically painful.

Crohn’s canker sores may be the first symptom of the disease to appear. They can precede digestive symptoms by a number of years. In many cases, the mouth ulcers will become worse when there is a Crohn’s Disease flare-up. These mouth ulcers are typically caused by inflammation related to the disease, vitamin and mineral deficiencies, or as side effects of some of the medications prescribed to treat Crohn’s Disease.

Incidences of Crohn’s Disease are more common among women than men. Yet, it is men and children with Crohn’s Disease who are most likely to develop mouth ulcers. Some vitamin and mineral deficiencies that are common in those with Crohn’s Disease include vitamin B-12 and zinc, both of which can cause glossitis, or vitamin K, which can cause the gums to bleed.

Among the medications that can have oral side effects are:

  • Budenoside, which can cause redness or swelling of the tongue
  • Ciclosporin, which can cause the gums to swell
  • Loperamide, which can cause dry mouth
  • Methotrexate, which can cause mouth ulcers and gingivitis
  • Tacrolimus, which can cause oral thrush or mouth ulcers.

If you have Crohn’s Disease, be sure to tell your dentist, especially if you are experiencing any of the oral symptoms of the disease.

Other oral symptoms of Crohn’s Disease may include:

  • Bad breath
  • Edema/Swelling of the lips
  • Dry mouth
  • Oral granulomatosis/granulomatous cheilitis
  • Salivary duct inflammation or abscess
  • Erythema
  • Gingivitis
  • Cobblestone appearance
  • Mucosal tags
  • Deeply corrugated buccal mucosa
  • Tooth decay due to vomiting or acid reflux
  • Glossitis (inflamed or red tongue)
  • Redness and scaling around the lips.

Oral symptoms of Crohn’s Disease may be treated with topical medications, steroids to reduce inflammation, adjustment of primary medications, or vitamin or mineral supplements. Your doctor or your dentist may suggest rinsing with warm salt water, maintaining excellent oral hygiene, drinking plenty of water, and more.

The oral symptoms of Crohn’s Disease are painful and aggravating, but they can be controlled and will subside in time. Keep your dentist informed about your symptoms of Crohn’s Disease and any oral manifestations of the disease. Together, your doctor and dentist can help you manage these oral symptoms.

Fight Cavities with Coffee

You can prevent and fight off cavities with the coffee you love so much. Worldwide, we consume 10.5822 pounds of coffee per person per year, on average.

Dentists tell you daily that coffee can stain the enamel of your teeth. Now we know that drinking coffee can be good forroasting coffee - pixabay cco -758161 640 your teeth and your overall dental health.

Studies show that drinking coffee without additives in moderation inhibits some cavity-causing “bacteria from adhering to your teeth at a rate as high as 98%!”

While you drink your next cup of coffee, let me explain.


How Coffee Benefits Your Teeth

First, it is important to emphasize that we are talking about coffee without additives. This means black coffee, without sugar or sweetener and without milk or cream.

Second, these benefits are derived from roasted coffee. Most of us drink roasted coffee, both at home and in coffee shops. Specifically, medium-roasted coffee has the greatest benefit for your teeth. Medium-roasted coffee has the maximum level of antioxidant activity and an antibacterial activity that prevents even Streptococcus mutans from attaching to your teeth. This is a primary bacterium in causing cavities.

When coffee is roasted, some compounds are formed that do not form under other circumstances. Those compounds include melanoidins (polymers that form in food only at high temperatures). When you drink coffee (without additives) these characteristics prevent the bacteria that cause cavities from attaching to your teeth and causing damage.

What is the Down Side

Many people are surprised to learn that coffee drinkers typically have whiter teeth than others. This is true despite the tannins in coffee that can stain teeth (like cola drinks or wine). These stains, though not removed by additives in toothpaste, can be addressed by your dentist.

What about people who use additives in their coffee? Milk alone will not interfere with the positive effects of coffee for teeth. However, a mixture of milk and sugar or artificial sweetener will reduce the effect of these characteristics of the coffee and allow cavity-causing bacteria to form on tooth surfaces.

Drinking a moderate amount of coffee with no additives can have a positive effect on your dental health. The coffee prevents certain cavity-causing bacteria from attaching to your teeth.

How do you drink your coffee? Will you continue to use additives, or will you switch to black coffee?


Are Plaque and Tartar the Same Thing?

Most people hear dentists talk about plaque ad tartar. Many people use the two words interchangeably. There are some important differences between plaque and plaque

Plaque is the transparent to translucent sticky film that covers your teeth during the day. It is made up of particles of food, sugars from foods and beverages, any bacteria in your saliva and the saliva itself. Plaque begins to form on the surface of your teeth within hours after your last brushed your teeth. This points to the importance of brushing twice each day to interrupt the growth of harmful bacteria in your mouth. It is the plaque that is forming that makes you teeth feel rough, sticky and dirty.

Tartar is a hard substance that forms on your teeth from plaque when it is not removed regularly. One important difference between plaque and tartar (calculus) is that tartar cannot be removed from the surface of your teeth simply by brushing. Once tartar is formed, you will need to see your dentist or dental hygienist to remove it professionally.

When tartar is not removed from tooth surfaces regularly, it tends to become thicker and more difficult to remove from your teeth. The amount of tooth surface covered by tartar increases, and it continues to harden. When teeth are covered with tartar both brushing and flossing become increasingly ineffective.

Instead of thinking about how to remove tartar after it forms, it is more helpful to think about how to prevent plaque and tartar from forming. You do this by brushing thoroughly for at least two minutes twice every day, flossing at least once every day, and seeing your dentist and/or hygienist regularly (usually twice each year). Eating foods that naturally flight plaque and tartar formation is another step you can take. These foods include cheese, apples, celery, and carrots.

If you have crooked or overlapping teeth, you may find it difficult to brush and floss as thoroughly as others. In this case, some people turn to orthodontic treatment to straighten and space the teeth better.

The secret to strong teeth and overall oral health is, again, in your hands. Brush thoroughly twice daily and floss at least once daily. See your dentist as recommended (twice to four times per year). Preventing harm to your teeth from plaque and tartar is far more important than learning how it can be treated after it forms.

New Oral Cancer Risk Factor Identified

Scientists have identified a new oral cancer risk factor. Many people are surprised to learn that this risk factor is from breathing particulate matter in the air we breathe!
In several areas of the world oral cancer incidence has risen. In the UK, for example, rates of oral cancer development have increased by 68 percent during the las decades. On the other hand, in the US, oral cancer and mortality rates have declined across the country. But the picture painted by the numbers does not show the complexities of thepolluted city -  paid - Depositphotos 78453624 m-2015 presence of this risk factor in some parts of the nation. The incidence of oral cancer and the number of deaths attributed to it have risen significantly in Nevada, North Carolina, Iowa, Ohio, Maine, Idaho, North Dakota, and Wyoming.
Some risk factors for oral cancer are well known: smoking tobacco, drinking alcohol, human papillomavirus (HPV). Among the lesser known risk factors (to Americans) are air pollution and chewing betel quid (a mix of natural ingredients wrapped in a betel leaf). The latter is popular in some parts of Southeast Asia. In India, oral cancer is the most common cause of cancer-related deaths in men aged 30-69. Many scientists believe the betel quid may be responsible for those deaths.
Yet, there is still much to learn about how and why oral cancer affects some individuals but does not affect others.
A recent study conducted in Taiwan (funded by the Ministry of Science and Technology) examined another possible risk factor for oral cancer: air pollution. We are aware of the connection between air pollution and heart disease and respiratory disease. This research, however, focused on "fine particulate matter, also called PM2.5. These are particles of liquid or solid matter in the air that measure 2.5 micrometers in diameter or less. The test included 482,659 men aged 40 or over. Data was collected from 66 air quality monitoring stations throughout Taiwan. By comparing each person's health records, they then estimated each person's exposure to PM2.5.
After considering a number of influencing factors, the scientists found that PM2.5 exposure also increased risk of developing oral cancer. Higher levels of PM2.5 were associated with a 43 percent higher risk of developing oral cancer. The scientists noted that the size of the particles allows the body to absorb them relatively easily, potentially causing damage as they travel through the body.
It is important to understand that this study was observational and preliminary. Further study is needed.
At this time, the recognition of PM2.5 as a risk factor for oral cancer should be a factor you need to discuss with your dentist. If you have experienced higher than average exposure to these particles, your dentist needs to know and will be attentive to the risk, examining you carefully for early signs of oral cancer.

Oral Cancer is Not Rare

The most commonly held myth about oral health might be that oral cancer is rare. The truth is that oral cancer is common.

According to the American Cancer Society, nearly 50,000 Americans were diagnosed with oral/oropharyngeal cancer last year. Worldwide, the problem is exponentially greater. Squamous cell carcinoma is the most common type of oral cancer and accounts for roughly 90 percent of all cancers of the head and neck. Of those diagnosed, only half will be maxillofacial cancer - paid - Depositphotos 13282076 m-2015alive in five years.

Oral cancers related to the HPV virus continue to increase, but these cancers are more receptive to treatment protocols. It is frustrating that we do not have the same kind of success with prevention and diagnosis that we have achieved with other types of oral cancer. The treatment of oral cancer is especially brutal, often leaving scars that will remain for the rest of a patient’s life.

Consider, if you will, these statistics about oral cancer:

  • There are 240 billion people over the age of 16 in the US.
  • In 2017, 49,670 new cases of oral/oropharyngeal cancer were diagnosed.
  • One in every 4,831 people will be diagnosed every year with oral/oropharyngeal cancer.

HPV related cancers are difficult to diagnose because of the challenges in visual and tactile examination. HPV appears most often in the lymphoid tissues (tonsillar areas, posterior base of the tongue, and the oropharyngeal area. Thus, a critical part of diagnosis relies upon patient interviews.

The most common symptoms of HPV-related cancers are:

  • A sore or ulcer that does not heal within 14 days.
  • Red, white, or black discoloration of soft tissues in the mouth.
  • An abnormality that bleeds easily when touched.
  • A lump or hard spot in the tissue – usually on the border of the tongue.
  • Tissue that protrudes higher than the surrounding tissue.
  • A sore under a denture that does not heal after adjustment of the denture.
  • A developing lump or thickening in the mouth.
  • A painless fixated lump that is firm on the outside of the neck that has persisted for at least 2 weeks.

In some cases, less common symptoms will be present:

  • Sore throat or hoarseness that does not resolve within a few weeks.
  • Constant coughing that does not stop after some days.
  • Difficulty swallowing, with the feeling that food is unable to pass through the throat.
  • Ear ache on one side that lasts for more than 14 days.

No cancer or pre-cancerous condition should be ignored. Nor should you delay in seeing your dentist. Dentists and hygienists check for signs of cancer when you are in our office. You should also be aware of these symptoms and notify your dentist immediately if you identify any of them. Together, we have a greater opportunity to catch these cancers earlier and to prevent further development.


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