PERCEIVED ORAL HEALTH AND SELF-REPORT OF THE EXTRAINTESTINAL ORAL MANIFESTATIONS IN PATIENTS WITH CROHN'S DISEASE

Aim: Systemic autoimmune andinflammatory diseasesoften manifestoral lesionsin their earliest stages, and early diagnosis, which may be spurred by a dental examination, is key for improved outcomes. After systemic diagnosis, oral lesions benefit from specialized care by dentists in collaboration with the medical team. Recent studies suggest that the mouth may be involved frequently in patients with Crohn’s disease (CD). The presence of oral manifestations is hardly detected by general practitioners and gastroenterologists in patients with Crohn’s disease. According to the evidences published, the aim of this study is to evaluate the perception of oral health in patients with Crohn’s disease and to investigate with a self-report the extraintestinal oral manifestation during the disease evolution. Methods: In January 2020 an on-line questionnaire was set up and published on “Google Form”. The study starts in February 2020. The population comprised 114patientswith Crohn’s disease recruited from the inflammatory chronic boweldiseaseassociation (A.M.I.C.I. Onlus). All participants received a direct link to the on-line questionnaire “Morbo di Crohn e Cavo Orale” (Crohn’s disease and oral cavity). The questionnaire had 3 sections: the first section asked for personal data, place of residence and education, the second section asked questions about Crohn’s disease (onset, evolution, therapy, familiarity, extraintestinal manifestations) and tobacco use, the third section asked about the perception of oral health, the presence of oral lesions or pain and the relation between the evolution of the oral pathologies and the dentist. Results: The answers arrived from 17 Italian regions and the patients were 78.1% F (89 female) and 21.9% M (25 male), of all ages with a higher percentage between 19 and 29 y. Lots of patients (54%), during their clinical story, waited lots of time before the diagnosis. 66.7% of patients have gone to the dentist in the past 12 months and 1,8 % have never been to a dentist. 76,3% of patients have had sore points in their mouth during their life. Regarding extra-intestinal manifestations of Crohn’s disease, we investigate both specific or nonspecific, 38.6% of patients reported one or more: 66.7% suffered from oral aphthae, 16.7% found red lesions, 9.6% found white lesions, 10.5% reported mucosal tags, 23.7% had lip swelling and fissurations, 3.5% reported cobblestoning and 21.9% didn’t find any lesions. 54.8% of patients had lesions before the diagnosis and 69,1% after the diagnosis. Only 10,5 % of patients say that these lesions were the first sign to investigate on a chronic pathology and 58.8% didn’t know that these manifestations are related to their disease. Conclusion: The results of the present study show that patients with Crohn’s disease have different perception of their oral health: 73,7% evaluate the general status of their mouth tolerable, 14.9% excellent, 11.4% terrible. Oral manifestations are diverse and common in Crohn’s disease, even if lots of them are not specific for this pathology, like aphthae. The dental practitioner is in the best position to detect them before the diagnosis and also lead to early diagnosis for a better outcome in affected patients.