Recent studies suggest that the mouth may be involved frequently in patients with Crohn's disease.
Dr Billy Bourke and colleagues from Ireland prospectively documented the proportion of children with oral lesions at diagnosis of Crohn's disease.
The researchers described the type of lesions found, and to examine the ability of gastroenterologists to identify correctly oral Crohn's manifestations.
In a prospective 3-year study, systematic dental examinations were performed on all children with suspected inflammatory bowel disease.
Each child underwent upper endoscopy, colonoscopy, and barium follow-through radiography.
|Noncaseating granulomas occurred in 8 specimens from oral Crohn's lesions|
|Clinical Gastroenterology & Hepatology|
The team reported that 48 of 49 children with Crohn's disease were examined by the dentist.
The researchers found oral Crohn's disease in 20 patients.
The team noted that oral findings included mucogingivitis in 12 patients, mucosal tags in 4 patients, and deep ulceration in 4.
The research team also observed cobblestoning in 3 patients, lip swelling in 3, and pyostomatitis vegetans in 1 patient.
Noncaseating granulomas were found in all 8 oral biopsy specimens from oral Crohn's disease lesions.
The researchers found that 2 patients with granulomas in oral biopsy specimens had no granulomas in any other biopsy specimens.
The presence of oral manifestations was associated with perianal disease.
The team also noted that in only 9 patients with oral Crohn's disease was the mouth found to be abnormal by the consultant gastroenterologists.
Only nonspecific oral changes were seen in children with ulcerative colitis and indeterminate colitis.
Dr Bourke's team commented, “More than one third of all children presenting with Crohn's disease had involvement of the mouth.”
“The ability of physicians to recognize oral lesions was poor.”
“Expert dental evaluation may be useful during the investigation of patients with suspected inflammatory bowel disease.”