The severity of psoriasis and dental health issues share a correlation where people with severe psoriasis also report problems with their oral health.
Psoriasis is a chronic autoimmune condition that causes the body to make new skin cells rapidly, resulting in scaling on the skin’s surface.
While scientists do not know the exact causes, several studies conducted in recent years have examined the relationship between psoriasis and dental health. They have repeatedly shown that the worse a person’s psoriasis symptoms, the worse their overall dental health tends to be.
This article reviews some of the current views from researchers about the link between dental health and psoriasis.
In a 2019 study, researchers created a questionnaire for 265 patients seen at the Ohio State University’s dermatology clinics. Their goal was to examine the relationship between psoriasis and patient-reported oral health.
In their analysis, they found that those who rated their oral health as poor or very poor also had the most severe psoriasis symptoms. Conversely, they noted that people who reported eating at least one piece of fruit a day reported better overall dental health.
Oral factors that they found correlated with more severe psoriasis included:
- poor gum health
- trouble speaking
- higher body mass index (BMI)
Another study published in 2019 acknowledged that previous studies have identified that psoriasis is associated with periodontitis or chronic inflammation of the gingival tissue. They also stated that data regarding people with psoriasis and oral health is limited.
In their study, researchers used three indexes to assess oral health in people with psoriasis. The findings of their preliminary study showed that psoriasis severity correlated with higher scores on Bleeding on Probe and Community Periodontal Index. These indexes help assess a person’s overall oral health and risk for developing oral health complications.
The researchers also found that those assessed had higher inflammation scores but did not have higher incidence of tooth loss.
The last set of findings about tooth loss appear to contradict the findings from another meta-analysis in 2019. In that analysis, researchers noted that people with psoriasis have worse dental health compared to those not living with psoriasis. They noted worse symptoms as:
- increased inflammation
- greater loss of alveolar bone (structure that holds the roots of teeth in place)
- fewer remaining teeth
- more missing teeth
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They found that people with periodontitis had a much greater chance of developing psoriasis compared with others. They also noted that smoking increased the risk even further.
Other reported findings included:
- periodontal bone loss in biological women increased risk of psoriasis
- people with psoriasis often have frequent Streptococcus infections
- correlation between more severe lesions and streptococcal tonsillitis and periodontitis
- people who underwent tonsillectomies showed significant improvement in psoriasis symptoms
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Some common symptoms include:
- trouble swallowing food
- burning
- difficulty chewing
- bleeding
- redness
They noted, as other researchers have, that a close cooperation between people living with psoriasis and dental healthcare workers can play an important role in their overall care.
People living with psoriasis should be mindful of their oral health. The American Dental Association provides several recommendations for general oral care, including:
- receive regular dental cleanings and exams
- use fluoride toothpaste and brush
- brush at least two times a day
- clean between teeth (floss) at least once a day
- eat a healthy diet and limit sugary foods and drinks
- avoid oral piercings and use of tobacco products
A person should see a dentist if they experience:
- excessive or regular bleeding when brushing teeth
- unexpected loss of one or more teeth
- moderate to severe pain or chronic pain that does not go away
- other oral symptoms or issues that may indicate an underlying issue
Recent studies have begun to look at the link between oral health and psoriasis. They have shown that, in general, the severity of psoriasis often correlates with worse overall dental health.
On rare occasions, psoriasis can appear in the mouth. When this occurs, it can cause redness, swelling, bleeding, and trouble chewing or swallowing.
Many studies note that people with psoriasis should consider adding a dentist to their care team to help address potential oral health concerns. A person should talk with a dentist if they experience symptoms that could indicate an underlying dental health issue, such as excessive or chronic bleeding or teeth loss.