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Increased risk of periodontitis among patients with Crohn’s disease: a population-based matched-cohort study

Abstract

Background

Periodontitis is a frequently cited extraintestinal manifestation of Crohn’s disease (CD). Despite a plethora of investigations and a recent meta-analysis linking CD and periodontitis, no study has estimated the risk of periodontitis among CD patients with respect to a comparison group nor has any investigation analyzed the effect of CD-specific medications on the risk of periodontitis. The present cohort study compared CD patients and matched subjects without a history of inflammatory bowel disease (IBD) to estimate the effect of CD and CD-specific pharmaceutical prescriptions on the risk of developing periodontitis by leveraging a population-based dataset in Taiwan.

Methods

We sourced 6657 CD patients and 26,628 comparison subjects without a history of IBD from the Taiwan National Health Insurance Database. Cox proportional hazards regressions were used to estimate the risk of subsequent periodontitis by CD status and pharmaceutical prescription during the follow-up period.

Results

After adjusting for socioeconomic status (SES), urbanicity, selected medical co-morbidities, and CD-specific pharmaceutical prescriptions, the hazard ratio (HR) for subsequent periodontitis among patients with CD was 1.36 (95% CI = 1.25–1.48) that of comparison subjects. There was not a significant difference in risk between genders or across ages. Steroids (95% CI = 0.66–0.77) appeared to confer a protective effect and Aspirin, Plavix, and Licodin were marginally protective (95% CI = 0.76–0.95).

Conclusion

This is the first study to report an increased HR for subsequent periodontitis among CD patients when compared to matched comparison subjects without IBD. The protective effect of some pharmaceuticals may suggest that treatment of CD protects against periodontitis.

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Acknowledgments

This study is based in part on data from the National Health Insurance Research Database. The authors are grateful to the members of the Research Office for Health Data, Department of Education and Research, Taipei City Hospital, Taiwan for their valuable contributions in data management and statistical analysis.

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Correspondence to Joseph Jordan Keller.

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Chi, YC., Chen, JL., Wang, LH. et al. Increased risk of periodontitis among patients with Crohn’s disease: a population-based matched-cohort study. Int J Colorectal Dis 33, 1437–1444 (2018). https://doi.org/10.1007/s00384-018-3117-4

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Keywords

  • Crohn’s disease
  • Periodontitis
  • Epidemiology