Crohn's Disease Forum » General IBD Discussion » Tooth Problems and Crohns

04-08-2010, 03:37 PM   #1
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Tooth Problems and Crohns

I am 23 and wasn't diagnosed with Crohn's until 2 years ago. Ever since I was young I've had bad teeth. I've always taken care of my teeth by brushing twice a day and flossing after almost every meal. When I was 15 I started to get cavities and the dentist diagnosed me with "Dental caries". Now to elaborate Dental caries is a destructive process causing decalcification (loss of calcium) of the tooth enamel leading to cavitation of the tooth. He asked me if I was a sickly child and I answered yes. I had intestinal problems (bloating, gas, & diarrhea) as an infant, was heavily medicated, and was so lactose intolerant that I had to be fed soymilk (which wasn't calcium enriched in '86) instead of formula or breast milk. That caused my body to never gain the amount of calcium needed for healthy bone and tooth growth. He also told me that getting braces at the age of 13 had weakened the enamel on my teeth because of the glue used to hold the braces in place. I am now 85% sure that I have had crohn's since birth, but since the area I live in has a very small amount of crohn's patients (my GI doctor only has several crohn's patients and I live in an area with a population of over 1.1 million) I was never diagnosed correctly. I've done some research and I really do think the disease itself has something to do with it. Although now that I'm on medications for crohn's the decay has become very much accelerated, and my dentist says that by the time I'm 25 or 26 I'll either need dentures or need to get false teeth screwed into my skull and jaw.

Have any of you had any problems with your teeth because of Crohn's or the medication you take?
04-08-2010, 04:01 PM   #2
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Luckily no. Good teeth and hair are the two good things I was blessed with. I am 32 this year and have never had a cavity, braces, nothing. Just regular check ups every six months.

Sorry to hear you have had such a rough go of it. Scifi is great by the way!
Diagnosed in 1996
Currently on: Filgotinib clinical trial, Prednisone, Imuran
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04-08-2010, 07:38 PM   #3
Join Date: Mar 2010
Wow, OMG, that sounds just like me... And I though the Pred caused my teeth problems... Maybe I should have my calcium levels looked at?? I've always brushed and flossed and ate healthy yet my teeth were/are always bad, yet the rest of my family doesn't and they have wonderful teeth. The dentist I saw basically said to me my saliva is causing the decay due to something or other and all I need is a good scrape and polish... Doesn't sound very fun, and my bottom front teeth are slowly going, along with the gum, which is major painful. Thanks for putting this on here, I'm going to mention this to my doc next time I see him and see what they can do!
Diagnosed with Crohn's Colitis since '07. Eczema since '07. Arthiritis since '09.
Tried every medication, diet and natural therapies going. Nothing really working.

Currently on -

Humira - Fortnightly shot
Codeine Phosphate - 30mg 4 times daily
Pain medication as and when
Omeprazole - 1 capsule daily
Going through ANOTHER flare!!!! :@ ("Remission" lasted the whole of 4 weeks :/

Considering surgery as another route. AGAIN!!
04-08-2010, 08:03 PM   #4
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That's the thing, my teeth are pretty far gone but my gums are just fine. And the amazing thing is I don't feel any pain (even when eating ice cream). Either I have a very high tolerance to pain or the nerves in my teeth are all dead.
04-08-2010, 08:10 PM   #5
Join Date: Mar 2010
I don't feel pain from eating really, not through my teeth anyway, it's my gums, where it's sort of receeded and now the bottom of my tooth is showing. I'm going to have to look into this as, if it is my saliva doing this, then a scrape and polish isn't really going to do much is it? It will just come back?? I have some errotion in between the two bottom ones and they are sort of see through, have they said for you to try/take anything scifi? And can your nerves just die like that?? I'm getting quite frightened that mine may fall out... I hate going to the Dentist or anyone touching my teeth as I had a bad dentist when I was younger who went pull happy with my teeth when I had my brace. He ended up getting tried and sued... wish I sued him now!!
04-08-2010, 09:01 PM   #6
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Hi scifi! I'm 27 and haven't had tooth troubles - which is amazing because I was on pred a lot as a child, and I know pred messes with calcium and causes bone/tooth trouble.

Did you ask your dentist if there are things you can do to try to save your teeth? (and did your dentist do any tests on your teeth to see if the nerves are still alive?) I used to work as a dental assistant, and the office I worked at could make fluoride trays for people with advanced dental problems - they looked like retainers, and you fill them up with fluoride gel and wear them overnight. I don't know if something like this would be helpful to your situation, but it's worth asking about.

[At the risk of sounding like an infomerical.... The dentist I worked for really stressed that technique is just as important as frequency when cleaning your teeth/gums as bacteria gets trapped in the pocket btw your tooth/gums (point your soft tooth brush at an angle down/up to your gums - brushing your teeth should feel like a good gum massage; when flossing scrape up and down in your gum pocket 10-12 times until it's "squeaky" clean). There is a battery operated toothbrush called "Sonicare" that is amazing (it's about $30 at Walgreens). I have used it for 2yrs, and it's kept me trouble free even though I have braces on. I also use a waterpick - it's an alternative to flossing, you shoot a stream of water into your gum pocket to flush out the bacteria.]

Anyway, I'm sorry you are having tooth troubles!
IBD diagnosed 1990 @ 8yrs old (current dx: Crohn’s); Blood clots 12/2009 (DVT, bilateral PE)
6MP: 50mg/day

Ethel: “So, is everything okey-dokey?” Lucy: “No, it’s inky-stinky” ~ I Love Lucy

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04-09-2010, 07:24 AM   #7
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My front teeth are almost see-through, but it is more to do with so much vomiting than anything else. I only learned recently that I should have gargled with baking soda & water, instead of mouthwash. The mouthwash only helped to wear the enamel off my teeth at an accelerated rate.
04-09-2010, 11:11 AM   #8
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My teeth are ok for my age (46) but my dental hygienist said that my gums are receding cos of the Crohns! urgh
which could result in my teeth falling out, can't wait! NOT!
I've got to use a small thin brush to floss in between my teeth twice a day as a prevention.


Dx Crohn's in TI 2005 symptoms for 15 years prior

BEEN ON -Azathioprine, 6MP, Prednisolone, Pentasa, Budesonide, Metronidazole, Humira, Methotrexate,

NOW ON -Amitriptyline 25mg
21/02/14 Right hemicolectomy surgery!/profile.p...4208290&ref=ts

No-one should make you feel inferior without your consent!

04-09-2010, 12:40 PM   #9
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I had 8 cavities after my last bad flare. When I am healthy I have good teeth. I havent had a cavity in over 4 years.
04-09-2010, 06:16 PM   #10
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I had to have my teeth pulled 19 yrs ago because of the pred. I didn't realize how bad Pred was and that I should have been taking calcium. So now 19 yrs later I have no teeth and I have no dentures. Plays heck with the chewing part.
I'm the Captain of my own pirate ship. You'll find me on the POOP deck!

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Diagnosed w/ CD Febuary 1986
No surgeries
Current meds:REMICADE (CATS SCARE ME), Pentasa, Nexium, Probonics.
04-09-2010, 07:11 PM   #11
Join Date: Apr 2006
Didn't a doctor or dentist recommend that you should be taking calcium/vit D supplements? If not you may want to bring this up to your doctor. I read if your teeth are weak, then most likely your bones are weak as well? I wish someone told me to use calcium a long time ago and that may have avoided the osteoporosis that I have now.

For me, the major problem is receeding gums. I get my teeth cleaned every 6 months and I still have receeding gums. My doctor said he heard of colitis causing gum recession but he hasn't heard of crohn's causing it? Little does he understand about inflammatory bowel disease. I disagree with him since I take good care of my gums and teeth and I'm still having problems.
05-23-2010, 10:28 PM   #12
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It's very interesting (although unfortunate) to read these posts regarding crohns and problems with teeth and gums. I was diagnosed 4 years ago with crohns. Up until then, I had very few issues with my teeth--only a few cavities as a child, and one problem tooth as an adult. In the last two years, however, I've had lots of problems with my teeth. I've had two teeth crack, and then had to have caps put on. It seems that every time I'm on steroids a tooth cracks, gets infected, gets a cavity, or a cap pops off (like one did Today!!).
A month ago I had a great deal of tooth pain. After ex-rays I was told there was a cavity and decay under an old cap. After filing down the cap, the dentist kept drilling to remove the decay until there was no tooth left. Now I have to get an implant or a bridge! (I use a dental clinic due to no insurance. I don't know if I would have lost the tooth with a private doctor?). That was on Wednesday. And as I mentioned before, today, 4 days later, a cap fell out. I was just put back on steroids about two weeks ago, and right away I have problems with my teeth.
This is freaking me out!! Does anyone know how to prevent this? Is this from the Crohn's, the steroids, the medication (I'm on Asacol HD), or all of the above?
05-24-2010, 06:08 AM   #13
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Hi Everyone
I found this, very interesting!

(kindly reproduced from the NACC (UK Crohn’s & Colitis) newsletter).

Readers’ Medical Queries ~ Tooth decay

Question: Is there any medical evidence of a correlation between Crohn’s disease and gum/tooth decay?

Answer: A number of studies have shown an association between increased dental caries and Crohn’s disease. For example, a paper by Rooney in Oral Surgery, Oral Medicine, Oral Pathology, 57(6):623-4, 1984 showed a significantly greater number of decayed, missing or filled teeth compared to two separate age-matched control groups. The reasons are not clear but may include high sugar consumption, alterations in saliva due to Crohn’s, oral inflammation as part of Crohn’s and treatment with corticosteroids.

High sucrose consumption has been consistently associated with Crohn’s disease over the years. As recently as 1997, an Israeli group (Reif et al, Gut 40(6): 754-60, 1997 June) showed that pre-illness high consumption of sucrose appeared to increase the risk of IBD three-fold compared to population controls. It remains unknown to what extent the high intake is an effect of an already present condition (i.e. undiagnosed Crohn’s) or whether this is a genuine risk factor for developing the disease. However, it has been a consistent finding in studies over the years.

It is not known whether low-carbohydrate diets will help Crohn’s disease as there is little work in this area. There are reports of improvements on reduction in refined carbohydrate and this is something we observe anecdotally in clinical practice. As one factor, it will certainly help to lower the risk of tooth decay/dental caries. Corticosteroids, not just because of dental caries, must always be used for minimum periods possible. Whilst on steroids, patients should pay particular attention to dental hygiene using standard measures (brushing, flossing, mouthwashes) and, if possible (but difficult sometimes), try to avoid responding to the stimulatory effects on appetite by eating refined sugar.

Dr J Sanderson-Consultant Gastroenterologist, Guy’s and St Thomas’ Hospitals

Last edited by Astra; 05-24-2010 at 06:11 AM.
05-24-2010, 07:10 AM   #14
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Huh...... well that explains a lot!!

I've always had really strong healthy teeth and I've wondered why they've got so bad the last few years. I've chipped them all over the place, they're cracked, covered in holes and I need a TON of work done on them now.

Had no idea that it was related to Crohn's.. but then I was on Pred for 7 years!! If my bones are thin then must teeth must be affected too! Yet another thing from Crohn's. Yey. I have calcium and Vit. D, but it came a little late after years of Pred.
05-24-2010, 08:16 AM   #15
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Add me to the list of problem teeth. Starting as a child I had awful teeth which the doctors blamed on excessive vomiting and too many antibiotics. Now I am starting to have issues with my gums receeding. I can't eat meat without it getting stuck between my teeth and gums and causing inflammation.
05-24-2010, 12:26 PM   #16
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My Support Groups: hygenist would comment on how much my gums bled....and they are receeding......never thought myself it could be related.....

30 plus years and counting with UC/Crohn's!
on remicade since 11/05

While my experiences may not be what everyone has had- I feel it is worthwhile to share any and all experiences that may be beneficial to others.
05-24-2010, 06:48 PM   #17
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I too have dental problems, only appearing about 4 or 5 years ago which was about 1 or 2 years after i now know i started getting the symptoms of crohns. Started with 2 cavities requiring fillings, think i've 4 or 5 to date. Which from 17 years or so beforehand of no problems is a shock considering i hadn't changed habits. If anything since, i am using higher strength flouride toothpaste on prescription and have cut sugary drinks/sweets down to virtually zero. Yet still cavities have emerged. Only now in the last few months i have started taking vit d and calcium tablets.

I told my dentist i had just been diagnosed and the time period seemed to correspond as well as the fact that when i'm clearly not absorbing nutrients and iron etc surely i haven't been absorbing calcium and he said that it definately wasn't a factor. He said it would show in bones before teeth, which saying as they have never been tested doesn't exactly put my mind at ease. In fact i suffered 3 broken arms (not all at once -i'm not an octopuss! lol) in 4 years from fairly innocuous situations though that was long before the crohns became apparant. Only thing he did say would do damage was from vomiting which thankfully isn't too common.

Last edited by Liverpool FC; 05-24-2010 at 06:51 PM.
05-25-2010, 04:56 PM   #18
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Does anyone know how to prevent this? Is this from the Crohn's, the steroids, the medication (I'm on Asacol HD), or all of the above?
Yes. LOL!

All of the above. the steroids, meds and vomiting don't help, but also, our bodies do not easily or readily absorb the minerals and nutrients we need to have healthy bodies in general. What supplements do you need? Well that depends on what part of your intestine is affected, and what vitamins/minerals are absorbed in that part of the tract.

Most of us, though, do need a good calcium supp., along with vit D (to aid the absorption of calcium) and B12 (to aid the absorption of iron, whcih also helps with bone/tooth health).

Receding of the gums COULD be caused by a deficiency in Vit C absorption, but could also be a side effect of some meds.

I have learned that I have had to become a nutritionist as well as a doctor to take care of my own body! LOL! Being in the health profession helps a bit, as some of this stuff you learn by helping other clients.
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06-11-2010, 07:10 PM   #19
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Does anyone else have sensitive teeth as well? The past couple weeks mine have really started to be sensitive to hot and especially to cold! Ouch!
09-09-2010, 01:20 PM   #20
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Hello Everyone..

I had an abscessed tooth(which had already had the root canal/crown years ago) that carried over into the tooth in front of it, causing that tooth to have a serious abscess. This was May 2010. The tooth (and surrounding area) was in so much pain! Was referred to a specialist d/t the root being curved. Was put on antibiotics, (which helped keep the other CD abscess relatively small - which i thought was a swollen lymph node at the time). The infection spread to my jaw bone (PAINFULL!) and was on antibiotics for a few months, and finally finished the 2 part root canal. Basically on meds in May, June, July.. also had the mouth ulcers.. when the meds were over the lump grew.. which led to the mass growing large and internally rupturing sending me to the ER... which led to me finding out I had Crohns.. but, anyways.. just had surgery for the mass/lump/fistula on Aug 24th. I had been worried about the whole IBD thing that I had put off on getting the tooth i just had the root canal on crowned. So, my 1st day back at work on Sept 7th from surgery leave.. I go home after work, chewing gum, my tooth broke in half and my mouth was bleeding..

Had no idea that teeth would be a problem for CD. But it's quite frightening to realize that some of the dental work i've had done has been related to CD! I have had a number of Root Canals, and crowns over the years.. (only in the back teeth).

However, if this is related to an illness, wouldn't it be covered under regular Health Insurance? I'm wondering if anyone has queried this before. I have limited dental ins now, and they only pay out a small portion annually. If this was to fall under my health insurance i would have benefits allowing me to be treated, and not put it off until its affordable.

any thoughts?

2010:IBD, CD, Thyroid Nodules, Polyarthralgia; 2015:Gallstones, SBO
Meds: Apriso, Buproprion, B12, Levothyroxine, Lasix, Toprol, Duloxetine, etc
Prev: Traimcinolone, Nystatin, Promethazine, Omeprazole, VIT D, Folic acid, Sulfasalazine, Xifaxin, Zolpidem, Ranitidine, Cipro, Vasculera, Erythromycin, Hydrochlorothiazide, Prednisone, Naproxen, Levocetirizine, Flexeril, Methotrexate, Levaquin, Metronidazole, Tizanidine
Surgery: Abscess/Fistula - Aug2010; GB 2015
04-13-2011, 04:49 PM   #21
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My 2 back teeth hurt all the time, it hurts around the gum, ive been to the dentist and he said everything was fine. I think it has something to do with inflammation on my mouth n crohns???
11-30-2011, 08:24 AM   #22
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Apparently the teeth problems can be caused even in the absence of medication through malabsorption; your body might not be taking up the calcium like it should; so you would need to add daily doses of Vitamin D And Calcium; if I had been told this and followed the advice most likely the chances of me having the problems I do now would have been nipped in the bud.
11-30-2011, 09:28 PM   #23
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I've got some really bad recession in my gums near my molars - going to lose a couple of them. I had some gum surgery done about a decade ago for it. They take tissue from the roof of your mouth and insert it into the gum line with sutures. Yes, it hurts. LOTS. It's expensive, and it is all happening again. This time, no dental insurance. Teeth are going to lose this battle.
11-30-2011, 10:41 PM   #24
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After weeks of intractable vomiting they told me my gums had started to recede at 24, they haven't gone through too much recession since, but I'm rather surprised (as I had good insurance at the time), that they didn't offer that to me as over the years one of the teeth has gotten slightly loose, not enough to lose it yet; but there is the possibility I'll be in the same boat of either losing the lower front ones or needing surgery (If I can afford it by then) in the future. One of the things doctor's never really cover and I've never really seen anywhere but only have learned through talking to other Crohn's patients on boards like these is how many of us suffer from dental/gum issues due to medications and the disease itself/malabsorption issues (The gums is probably from issues with Vitamin C, so when diagnosed, we should be on a range of supplements from Vitamin B's, to Vitamin C, Zinc, Calcium, and Vitamin D); our guts just don't absorb everything necessary like they should, and soluble supplements seems to be the main way of making it so we don't have to face these battles down the road. In all actuality it should be a doctor's/specialists suggestion from the get go. The trouble comes because most dentist's don't understand the disease, and most doctor's don't talk specifically to your dentist, so there is a communication gap in all the treatments.
12-01-2011, 02:12 AM   #25
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Shamrock, had the gum graft last year. It was bearable with Tylenol with codeine (over the counter, so less potent than a T3), but far from pleasant.

This coming year it looks like I get to experience a root canal. In a period of months one tooth has just about rotted itself out. I went in for a filling in this tooth...and they did the one next to it, too. Unbelievable. I'm on soft foods until we decide whether it's going to stop hurting or whether the root canal is needed sooner rather than later.
Dx: Moderate Crohn's in 3 locations
Doctor's orders: 200 mg Imuran
Have used: 4500 mg Pentasa, 4500 mg Salofalk, Flagyl, Cipro, 50 mg Prednisone, 9 mg Entocort.
Turned my Crohn's life around: ginger for nausea.
Claim to fame: "loopy and floppy" colon
01-19-2012, 04:09 PM   #26
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Registered just to post in here. I'm very relieved to find this thread. I was diagnosed a few years ago and and I went from 1 filling falling out to every tooth having pieces cracked off and holes in them. A few have gone completely, I also have anxiety issues and have been too embarrassed to go to the dentist. It seems like yesterday that I had a perfect smile, now I find myself trying not to smile. It seemed to happen so fast. After seeing this thread I think I may have the courage to go get it taken care of.
By the way I've been on Pred/Meth injections/Imuran/pentasa/Asacol/codeine/lomotil. Currently taking pred/lomotil/codeine
This thread has lifted a huge weight off my shoulders, thanks.
03-12-2012, 11:17 AM   #27
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I too have registered just to post on here! I've been on anti biotics for an infection several times and the dentist has indicated that he is extracting the tooth tomorrow. Not sure if I am made up to be rid of the pain or devastated to lose a tooth!

It is interesting to hear how others cope with tooth pain and that it is apparent that decay is due to either the crohns disease and/or medication. I am currently on methotrexate weekly injections amongst other things.

Wish me luck for tomorrow!!
03-12-2012, 01:39 PM   #28
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I used to develop cavities often. Not every tooth has a filling, but it's pretty close to that. Additionally I've had a few root canals done. My dentist used to make a nice living off me, as I used to joke.

Everything changed around 5 years ago. I began eating a different diet where I avoided grains and other carbs, plus also took the vitamins D3 and K2. (I take 5000ius a day of D3 in order to reach a testing value between 60 to 70ng/ml) Since doing that I haven't had a cavity since. My dentist was greatly surprised at the quick change, to say the least.

I've learned since that it is possible to re-minerize teeth. It is possible for dentin to regrow. And what I did with the diet change plus taking the supplements of D3 and k2 is what has worked for others when re mineralizing teeth.

Dr. Guyenet has written a few interesting articles on improving dental health, and healing teeth, similar to what I mention.

And thought to add if needing to take a steroid like prednisone or similar medication, my understanding is chances are there is little that can be done to help teeth and bones strengthen till the medication is stopped.

"Dr. Mellanby's Tooth Decay Reversal Diet"


"Images of Tooth Decay Healing due to an Improved Diet"
03-12-2012, 02:54 PM   #29
Join Date: Mar 2012
Location: Arnold, Missouri
I had perfect teeth all of my life. Never had a cavity until I was 19. I was not diagnosed with CD at that point. I did have a few minor cavities for the few years after that. Once I was diagnosed and started on prednisone regularly off and on my teeth went really down hill. So I feel like the CD does have something to do with it but the medication helped the process along. I had to have 2 bridges on the front top and now there is damage on all of my bottom teeth. I just am not willing to get dentures and don't have the money to get implants. But here is a thought I have all the time. With no good teeth I am sure my food is not getting chewed up properly and that is not helping my crohns I am sure! I have really changed my diet due to that alone. Not because of pain or anything because like many of you I really don't have that much pain from it. I think we are all used to so much pain we just don't notice it. But I don't want my poor stomach to work any harder then it has to.
03-12-2012, 03:26 PM   #30
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I understand perfectly about not digesting food properly, I, too tend to not chew too much and then suffer afterwards just lately although I am eating a lot of cornflakes with milk at the moment because they are soft!

A part of me is relieved they are extracting this tooth as it is costing so much in dental treatment and prescription charges, to have root canal work and crowns over in the UK is a couple of hundred pounds whereas taking the tooth out is a lot less. Isn't it sad when we have to think about the pennies just because we have a chronic illness?!

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