A group of three distraught and decaying teeth.

How IBD Has Impacted My Teeth

Is it just me, or are toothaches just the absolute worst? I have experienced so much pain with my IBD. But then, there's a toothache! Another level of completely different pain.

It's like my abdomen is accustomed to pain so that's fine – but my mouth?! No, no, no!

When I was young, I had fairly decent teeth. I remember being told they were perfectly straight by a dentist when I was in junior school.

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I never considered my teeth to be unhealthy before

I do have weak enamel, which the dentists always blame my mam for (trauma, smoking, alcohol use when I was in the womb), which she categorically denies. I guess it depends on what they class as trauma?

I fell over in the schoolyard and managed to hit the floor with my front tooth. I have no idea how it happened because the rest of my face didn’t touch the ground; I didn't scrape anything or even bite my lip!

This resulted in half of my front tooth breaking off. I had a crown and all was well – until the line where it was connected went brown. I smoked for about 15 years, so the discoloration is probably on me.

I'd never considered my teeth to be particularly unhealthy, but they were prone to chipping easily. Then, during a prolonged flare a couple of years ago, I developed abscesses and tooth decay.

Looking back on tooth problems during a flare

I had two extracted within a few weeks of each other, and they began to crumble whilst being removed. I remember it vividly because we went on holiday and I was gutted that I couldn’t eat all of the local seafood because of the pain in my mouth!

I remember how bad my health was because I remember how much I struggled during that holiday. There were a lot of steps to the B&B and I was very weak.

I swear the palpitations had me thinking I was just going to keel over and die right there a few times when trying to climb them. I was out of breath just walking on the flat, so imagine me climbing step after step!

Gum recession is something else that was never a problem, but then all of a sudden, it was.

I hadn’t linked my teeth issues to IBD until I began to look into it. I wrote about my findings recently on my personal blog, "Social Media, IBD, and an Ostomy." Then, I began considering how those findings linked to my own teeth.

How is IBD linked to my tooth health?

Limited diet

My diet when unwell is often very limited, so I don’t get all of the nutrition I should which can impact tooth health. Malnutrition in general can prevent our bodies from healing well, so any damage to the teeth and gums is harder to recover from, especially when your body is fighting a battle elsewhere.

Vitamin D deficiency, which I often have due to IBD, leads to poor absorption of minerals like calcium and phosphorus, which are crucial for enamel strength.

Maintaining my weight was a struggle for years, so I often ate foods high in sugar. Obviously, this is never good for your teeth either.

How certain drinks impacted my teeth

I drank a lot of fruit juice in an attempt to at least get some nutrition, but the juice is obviously acidic.

Pepsi was my "go-to" for energy during the day, which we all know packs a sugar punch!

I also used to drink a lot of water with lemon in to encourage me to drink throughout the day, not realizing that the lemon was actually really bad news for my teeth! Acid erodes the enamel, which can leave teeth brittle, which could have contributed to my teeth easily chipping.

Ulcerative colitis symptoms

Dehydration and periods of vomiting whilst in a flare can also cause acid damage, leading to enamel erosion and brittle teeth.

I clench my teeth when I am in pain, which can wear away the enamel.

Chronic fatigue, long flares, depression, and recovering from multiple surgeries have all affected how I have looked after my teeth. I am ashamed to admit that brushing and flossing twice a day did NOT always happen.

I always brushed in the morning as part of my routine, but a nighttime routine was often non-existent. I know I should have looked after them better, but I also know I couldn’t have forced myself to find the energy in the evening, no matter how hard I’d tried!

Medication side effects

Some of the medication to manage my pain made me grind my teeth. I was able to stop myself in the daytime, but I continued to do it in my sleep. This can wear away the enamel.

I was on prednisone for a long time, which can reduce the amount of calcium in the teeth. This can ultimately lead to tooth decay – and could have contributed to my crumbling teeth.

Immunosuppressants may also play a role in my body’s ability to fight infection, contributing to abscesses and inflamed gums.

Is gum disease more common in people with IBD?

Studies have found an increased prevalence, and severity, of gum disease in people with IBD. The leading factor is thought to be the inflammatory response, but it’s also been linked to the oral microbiota.1

Gum disease starts as gingivitis and develops into periodontitis if untreated. Periodontitis affects the tissues that support the teeth, which can eventually become loose and fall out if it is untreated. It can also cause painful abscesses and receding gums.

I am finally working on better, straighter, and whiter teeth! I don't usually blog about anything that is not IBD/ostomy-related, but I will be writing about the process. Stay tuned!

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