Poor Oral Health Could Worsen Inflammatory Bowel Disease, Study Warns

The consequences of poor dental care could go beyond cavities and root canals. Inflammatory bowel disease (IBD) could be made worse by not maintaining good oral health, warns a new study.

Experts from the U-M Medical and Dental Schools have been studying the gut microbiome- the collection of bacteria that normally live in the intestines. They have now found a link between an overgrowth of foreign bacterial species in the guts of IBD patients. These bacteria are normally found in the mouth.

"I decided to approach the dental school to ask the question, does the oral disease affect the severity of gastrointestinal diseases?" MedicalXpress quoted Nobuhiko Kamada, Ph.D., assistant professor of internal medicine in the division of gastroenterology.

The study reveals two different pathways by which oral bacteria appear to worsen gut inflammation.

Pathway 1: Periodontitis (gum disease) causes an imbalance in the normal healthy microbiome found in the mouth and an increase of inflammation-causing bacteria. These infectious bacteria then travel down to the gut. Although this alone might not be causing the gut inflammation, the researchers demonstrated that oral bacteria might aggravate gut inflammation by noticing the microbiome changes in the inflamed colons of the mice models.

Pathway 2: Periodontitis activates the immune system’s T cells present in the mouth. Then, these T cells go down towards the gut where they get aggravate inflammation. The oral inflammation generates mostly inflammatory T cells that migrate to the intestines where they disrupt the normal environment and trigger the gut’s immune response and worsen IBD.

“This exacerbation of gut inflammation driven by oral organisms that migrate to the gut has important ramifications in emphasizing to patients the critical need to promote oral health as a part of total body health and wellbeing," MedicalXpress quoted the study’s co-author William Giannobile, DDS, the William K and Mary Anne Najjar Professor of Dentistry and chair of the department of periodontics and oral medicine at the U-M School of Dentistry.

The findings of this study also have implications for novel ways to treat inflammatory bowel diseases since too many medications still fail patients. The findings highlight that monitoring oral inflammation can dramatically improve the clinical outcomes in IBD.