Periodontitis is associated with increased disease activity in a Swedish cohort of patients with inflammatory bowel disease.

Background: Periodontitis and inflammatory bowel disease (IBD) are chronic, progressive inflammatory diseases with shared aetiopathogenetic mechanisms. Research suggests that IBD patients are at increased risk of developing periodontitis, which may, in turn, exacerbate IBD activity and disability. This study examines whether periodontitis is associated with increased IBD activity, severity, disability and reduced quality of life.

Methods: An online survey was distributed to Swedish IBD patients, covering demographics, oral health, and IBD characteristics. Validated tools were used where possible, and data were combined with a similar Danish study.

Results: A total of 786 IBD patients (371 Crohn's disease [CD] and 415 ulcerative colitis [UC]) completed the survey. Self-reported severe periodontitis was significantly associated with poorer IBD disability scores [coef. 5.07 (1.86; 8.27)], more self-reported active disease [OR 1.72 (1.19; 2.49)], higher self-reported disease activity in the preceding 12 months [OR 1.44 (1.05; 1.98)], and reduced quality of life [Coef. -1.45 (-3.01; 0.10)]. Self-reported tooth loss also correlated with poorer disability scores [Coef. 4.47 (0.71; 8.22)] and showed a trend toward greater self-reported disease severity [OR 1.57 (0.97; 2.52)]. Combined Danish-Swedish analysis confirmed these findings.

Conclusions: This study, although based purely on self-reported data at a single timepoint, reinforces associations between periodontitis, tooth loss and worse IBD outcomes, emphasizing the need for greater focus on oral health in IBD management.