Oral Manifestations of Inflammatory Bowel Diseases: Two Case Reports

Abstract

Inflammatory bowel diseases (IBD) are known as chronic inflammatory disorders of the digestive tract, represented mainly by Crohn's disease (CD) and ulcerative colitis (UC). Among the main oral manifestations of IBD are cobblestoning of the oral mucosa, labial swellings with vertical fissures, pyostomatitis vegetans, angular cheilitis, perioral erythema, and glossitis. In this sense, understanding these nosological entities by dentists would help reach early and differential diagnosis. Thus, two case reports are presented and discussed based on theoretical references obtained by a literature review. The first case report refers to an adult patient whose IBD diagnosis was established after stomatological assessment. The second case was a patient with CD diagnosed in childhood with characteristic oral lesions.

Keywords: Aphthous stomatitis; Crohn’s disease; Inflammatory bowel diseases; Oral lesions; Oral manifestations; Ulcerative colitis.

Figure 1

Left jugal mucosa with scars, erythematous areas, and loss of tissue elasticity.

Figure 2

(A) Scars on the right jugal mucosa and relevant painful ulceration near the lower right molar. (B) Scar fibrosis with ischemia of mucosa upon distention, making inspection of oral cavity more difficult.

Figure 3

(A) Gingival recession on the anterior lower teeth, with changed vestibule fold and scars on the lower labial mucosa. (B) Gingival recession on the anterior upper teeth, gingiva growing towards the vestibule fold, and presence of important scar fibrosis.

Figure 4

Erythematous fissures on lip commissures and skin desquamation compatible with angular cheilitis.

Figure 5

Bilaterally cobblestoned jugal mucosa (A and B), and subsidence after partial treatment of CD (C and D).