Dental caries, oral hygiene and Streptococcus mutans serotypes in patients with inflammatory bowel disease

Introduction and Objective. Inflammatory bowel disease (IBD), comprising Crohn’s disease (CD) and ulcerative colitis (UC), is a chronic inflammatory condition with systemic and extra-intestinal manifestations. Clinical findings in the oral cavity include, among others, a higher caries burden and microbiome dysbiosis linked to the oral-gut axis with Streptococcus mutans playing an important role. Materials and Method. The study included 110 IBD patients in remission (73 CD, 37 UC) and 50 controls. Participants underwent oral cavity examination (DMFT, API) and completed a questionnaire on oral hygiene. Unstimulated saliva from IBD patients was analysed for S. mutans detection by PCR and serotyping by multiplex (c, e, f) and singleplex (k) PCR. Results. DMFT was higher in CD and UC patients (mean=19.08 and 19.51) than controls (mean=15.04; p=0.007), with elevated D (p<0.001) and M (p=0.011) components in CD group and no difference in F component. API was higher in CD group than in controls (mean=67.77 vs 53.03; p=0.020), with significant differences in API ranges for CD vs controls (p<0.001) and UC vs controls (p<0.05). Insufficient oral hygiene was noted in 49% of CD and 43% of UC patients, and average hygiene in 41% of CD and 46% of UC. Oral hygiene habits differed only in toothbrushing frequency, with CD patients brushing less frequently than controls (p=0.017). Higher D component counts and API were associated with increased IBD odds. CD and UC patients were 5.95-and 5.17-fold more likely to have insufficient or average oral hygiene. S. mutans was detected in 78% of IBD patients, with serotype k in 31%. In UC group, rural residence was linked to higher DMFT, with no such effect in CD patients. Conclusions. These findings underscore the importance of targeted oral hygiene education for IBD patients and support further research on the oral microbiome.