Studies Link Oral Health to Psoriasis Severity
Links between oral health and systemic health are indisputable. In periodontal inflammation, dental hygienists may find indication of autoimmune disorders such as psoriasis—and vice versa.
Psoriasis affects more than 8 million Americans and 125 million people worldwide, according to the National Psoriasis Foundation. It’s an autoimmune disease characterized by rough, red skin with thick, silvery scaly patches that can itch intensely. The etiology of the disease process, which involves accelerated turnover of skin cells, is not completely understood, though it is thought, in some cases, to be genetic, and possibly brought on by stress, medication use, and even the weather. Recently, possible links between oral health and psoriasis are under investigation.
SCIENTIFIC STUDIES
Researchers at Ohio State College of Medicine (OhioStateMed) in Columbus began looking for triggers for psoriasis, starting in the mouth, due to the fact that strep throat is a known trigger. They surveyed 265 patients from a dermatology clinic at OhioStateMed, of which 100 had psoriasis. Information was collected on patient skin condition, patient-reported outcomes, dietary intake, dental care, and oral hygiene.
Results indicated that oral pain and discomfort were indicators of psoriasis. Patients rating their gingival health as poor or very poor and experiencing gingival pain, were more likely to develop more severe cases of psoriasis than those with good oral health. Family history, obesity, and smoking were also recognized as factors. In addition, the study found that consuming fresh fruit at least once a day had a positive impact.
Though the results of the study—published in the November 17, 2019 issue of the Dermatology Times—are based on a small patient sampling with some limitations, the researchers concluded that the preliminary findings support the premise that oral care and hygiene may benefit patients by reducing the severity of psoriasis.
A similar study, recently published in the Journal of Investigative Dermatology, assessed the oral health of 100 patients with psoriasis and 101 controls. Researchers assessed oral health using standardized methods such as bleeding on probing and decayed, missing, filled teeth evaluations. Consistently higher values of these measures in addition to periodontal inflammation were reported for patients with psoriasis than their control counterparts. They concluded that regular dental exams and periodontal assessment should be a critical part of psoriasis management.
INCREASE IN PERIODONTAL DISEASE RISK
Traditional treatments for psoriasis include the use of creams, medications, and ultraviolet light therapy. But in light of such findings, good oral health practices and dietary improvements, smoking cessation, and diabetes management may lend even more weight to alleviating symptoms.
The upshot for oral health professionals is that because psoriatic symptoms are often visible in the dental setting, dental hygienists should be prepared to gather detailed medical histories and advise patients on the relationship between their oral health and their psoriasis status, and the importance of integrating regular dental checkups into psoriasis management. Clinicians can view psoriasis symptoms as red flags for periodontal disease risk.
