Your Mouth is the Mirror of Health and Disease of the Gastrointestinal System: Oral Mucosal Manifestations of Gastrointestinal Disease
Keywords:
Oral mucosa, Gastrointestinal disease, Inflammatory bowel disease, Coeliac disease, Gastro-oesophageal reflux disease, Helicobacter pylori, Hepatobiliary systemAbstract
Introduction: Over the last few years, the importance placed on multi-disciplinary approach to patient care has been increasing. One such relationship is the between a dentist and medical practioner.
Methods: This narrative review examines the manifestations of gastrointestinal diseases in the oral mucosa. Understanding the interconnection between the oral cavity and gastrointestinal conditions can help with early diagnosis and can serve as an indicator of disease progression. The aim of this narrative review is to underscore the importance of recognising these suspicious oral mucosal signs and understand the bi-directional relationship between oral health and systemic well-being.
Results: The findings highlight the need to integrate oral examinations in patients at high risk of or with suspected or current gastrointestinal diseases. A holistic approach will help in better patient care and overall patient outcomes.
Discussion: There exists a gap in diagnostic approaches for oral manifestations of gastrointestinal diseases, which must be bridged to efficiently facilitate early diagnosis and treatment of these diseases. Understanding this inter-play between oral health and systemic well-being will significantly improve patie
Downloads
References
1. Oral Health [Internet]. World Health Organization. World Health Organization; [cited 2023 Apr 14]. Available from: https://www.who.int/Health-Topics/Oral-Health/#tab=tab_1
2. Varoni EM, Rimondini L. Oral microbiome, Oral Health and Systemic Health: A multidirectional link. Biomedicines. 2022 Jan 17;10(1):186.
3. Mantegazza C, Angiero F, Crippa R, Paglia M, Zuccotti GV. An overview on oral manifestations of gastrointestinal diseases. Ital J of Dent Med. 2019.
4. Wray D. Gastrointestinal and granulomatous diseases. Periodontol 2000. 1998 Oct;18(1):95–101.
5. Oral manifestations of GI diseases [Internet]. Canadian Society of Intestinal Research. 2021 [cited 2023 Apr 18]. Available from: https://badgut.org/information-centre/a-z-digestive-topics/oral-manifestations-of-gi-diseases/
6. Lankarani KB. Oral manifestation in inflammatory bowel disease: A Review. World J Gastroenterol. 2013 Dec 14;19(46):8571–9.
7. Harty S, Fleming P, Rowland M, Crushell E, McDermott M, Drumm B, et al. A prospective study of the oral manifestations of Crohn’s disease. Clin Gastroenterol Hepatol. 2005 Jul 22;3(9):886–91.
8. Saeid Seyedian S, Nokhostin F, Dargahi Malamir M. A review of the diagnosis, prevention, and treatment methods of inflammatory bowel disease. J Med Life. 2019 Apr;12(2):113–22.
9. Bertl K, Burisch J, Pandis N, Klinge B, Stavropoulos A. Patients with inflammatory bowel disease have more oral health problems and higher costs of professional dental care than healthy controls: The periodontitis prevalence in ulcerative colitis and Crohn disease (PPCC) case-control study. J Periodontol. 2023 Jul 19;50(12):1601–20.
10. Jajam M, Bozzolo P, Niklander S. Oral manifestations of gastrointestinal disorders. J Clin Exp Dent. 2017 Oct 1;9(10):1242–8.
11. Triantafillidis JK, Valvi FZ, Merikas E, Peros G, Galitis ON, Gikas A. Granulomatous cheilitis associated with exacerbations of Crohn's disease: A case report. J Med Case Rep. 2008 Feb 25;2(1).
12. Lazzerini M, Martelossi S, Cont G, Bersanini C, Ventura G, Fontana M, et al. Orofacial granulomatosis in children: Think about Crohn's disease. Dig Liver Dis. 2015 Jan 21;47(4):338–41.
13. Bogenrieder T, Rogler G, Vogt T, Landthaler M, Stolz W. Orofacial granulomatosis as the initial presentation of Crohn’s disease in an adolescent. Dermatology. 2003;206(3):273–8.
14. Ribaldone DG, Brigo S, Mangia M, Saracco GM, Astegiano M, Pellicano R. Oral manifestations of inflammatory bowel disease and the role of non-invasive surrogate markers of disease activity. Medicines (Basel). 2020 Jun 16;7(6):33.
15. Mejia LM. Oral manifestations of gastrointestinal disorders. Atlas Oral Maxillofac Surg Clin North Am. 2017;25(2):93–104.
16. Lauritano D, Boccalari E, Stasio DD, Vella FD, Carinci F, Lucchese A, et al. Prevalence of oral lesions and correlation with intestinal symptoms of inflammatory bowel disease: A systematic review. Diagnostics (Basel). 2019 Jul 15;9(3):77.
17. Daley TD, Armstrong JE. Oral manifestations of gastrointestinal diseases. Can J Gastroenterol. 2006 Jul 20;21(4):241–4.
18. Cheng J, Malahias T, Brar P, Minaya MT, Green PH. The association between celiac disease, dental enamel defects, and aphthous ulcers in a United States cohort. J Clin Gastroenterol. 2010 Mar;44(3):191–4.
19. Vetrano S, Zampaletta U, Anania MC, Di Tola M, Sabbatella L, Passarelli F, et al. Detection of anti-endomysial and anti-tissue transglutaminase autoantibodies in media following culture of oral biopsies from patients with untreated Coeliac disease. Dig Liver Dis. 2007 Oct;39(10):911–6.
20. Giorgi FD, Palmiero M, Esposito I, Mosca F, Cuomo R. Pathophysiology of gastro-oesophageal reflux disease. Acta Otorhinolaryngol Ital. 2006 Oct;26(5):241–6.
21. Ranjitkar S, Smales RJ, Kaidonis JA. Oral manifestations of gastroesophageal reflux disease. J Gastroenterol Hepatol. 2011 Jan 17;27(1):21–7.
22. Di Fede O, Di Liberto C, Occhipinti G, Vigneri S, Lo Russo L, Fedele S, et al. Oral manifestations in patients with gastro-oesophageal reflux disease: A single-center case-control study. J Oral Pathol Med. 2008 Feb 17;37(6):336–40.
23. Silva MA, Damante JH, Stipp AC, Tolentino MM, Carlotto PR, Fleury RN. Gastroesophageal reflux disease: New oral findings. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2001 Mar;91(3):301–10.
24. Warsi I, Ahmed J, Younus A, Rasheed A, Akhtar TS, Ain QU, et al. Risk factors associated with oral manifestations and oral health impact of gastro-oesophageal reflux disease: A multicentre, cross-sectional study in Pakistan. BMJ Open. 2019 Mar 30;9(3).
25. Bıcak DA, Akyuz S. Oral diseases associated with gastrointestinal disorders. Gastroenterol Hepatol Digest Dis. 2018 Mar;1(1):1–5.
26. Al-Zahrani MS, Alhassani AA, Zawawi KH. Clinical manifestations of gastrointestinal diseases in the oral cavity. Saudi Dent J. 2021 Sep 13;33(8):835–41.
27. Krasteva A, Panov V, Krasteva A, Kisselova A. Oral Cavity and Systemic Diseases—Helicobacter Pylori and Dentistry. Biotechnol Biotechnol Equip. 2014 Apr;25(3):2447–51.
28. Yee JKC. Helicobacter pylori colonization of the oral cavity: A milestone discovery. World J Gastroenterol. 2016 Jan 14;22(2):641–8.
29. Birek C, Grandhi R, McNeill K, Singer D, Ficarra G, Bowden G. Detection of helicobacter pylori in oral aphthous ulcers. J Oral Pathol Med. 2007 Feb 27;28(5):197–203.
30. Kilmartin CM. Dental implications of Helicobacter pylori. J Can Dent Assoc. 2002 Sep;68(8):489–93.
31. Napeñas JJ, Brennan MT, Elad S. Oral manifestations of systemic diseases. Dermatol Clin. 2020 Sep 3;38(4):495–505.
32. Amitrano L, Guardascione MA, Brancaccio V, Balzano A. Coagulation disorders in liver disease. Semin Liver Dis. 2002 Feb;22(1):83–96.
33. Samant H, Kothadia JP. Spider Angioma [Internet]. National Center for Biotechnology Information. U.S. National Library of Medicine; 2023 [cited 2023 Apr 18]. Available from: https://pubmed.ncbi.nlm.nih.gov/29939595/
34. Giuca MR, Lardani L, Ligori S, Carli E, Giuca G, Miceli M. Oral manifestations in paediatric patients with hepatobiliary diseases: a review. J Biol Regul Homeost Agents. 2021;35:117–25.
35. Olczak-Kowalczyk D, Kowalczyk W, Krasuska-Sławińska E, Dądalski M, Kostewicz K, Pawłowska J. Oral health and liver function in children and adolescents with cirrhosis of the liver. Prz Gastroenterol. 2014 Mar 1;9(1):24–31.
36. Shapiro BM, Gallagher FE, Needleman HL. Dental management of the patient with biliary atresia. Oral Surg Oral Med Oral Pathol. 1975 Dec;40(6):742–7.
37. Roopashree MR, Gondhalekar RV, Shashikanth MC, George J, Thippeswamy SH, Shukla A. Pathogenesis of oral Lichen Planus - a review. J Oral Pathol Med. 2010 Oct 4;39(10):729–34.
38. Panov VE. Oral manifestations of hepatitis C virus. J IMAB. 2013 Oct 1;19(4):377–9.
39. Raj G, Raj M. Oral Lichen Planus [Internet]. National Center for Biotechnology Information. U.S. National Library of Medicine; 2023 [cited 2023 Apr 18]. Available from: https://www.ncbi.nlm.nih.gov/books/NBK578201/#_NBK578201_pubdet_
40. Cassol-Spanemberg J, Rodriguez-de Rivera-Campillo ME, Otero-Rey EM, Estrugo-Devesa A, Jane-Salas E, Lopez-Lopez J. Oral Lichen Planus and its relationship with systemic diseases a review of evidence. J Clin Exp Dent. 2018 Sep 1;10(9):938–44.
41. Gill KS, Frattali MA. Colorectal adenocarcinoma metastasis to the tongue. Case Rep Otolaryngol. 2015 Dec 2;1–5.
42. van der Waal RIF, Buter J, van der Waal I. Oral metastases: Report of 24 cases. Br J Oral Maxillofac Surg. 2003 Feb;41(1):3–6.
43. de Almeida Lança ML, Carvalho YR, Almeida JD, Kaminagakura E. Hidden colon adenocarcinoma diagnosed from Mouth Metastasis:
Downloads
Published
How to Cite
License
Copyright (c) 2025 Anya Dingley
This work is licensed under a Creative Commons Attribution 4.0 International License.
Authors retain copyright and grant the journal the right of first publication with the work simultaneously licensed under a Creative Commons Attribution (CC-BY) 4.0 License that allows others to share the work with an acknowledgement of the work’s authorship and initial publication in this journal.
Provided they are the owners of the copyright to their work, authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal’s published version of the work (e.g., post it to an institutional repository, in a journal or publish it in a book), with an acknowledgement of its initial publication in this journal.
