Table 1.
Oral manifestations and complications in inflammatory bowel disease
| Oral tissue | Manifestations | Etiology |
| Lips | Lips swelling with or without fissures[12,15,16,21,22,34,36,156] | Crohn's disease |
| Angular cheilitis[15,22,31] | Fungal and bacterial infections, nutritional deficiency | |
| Erythema multiforme, Stevens-Johnson syndrome[143,144] | Infliximab; adalimumab | |
| Tongue | Fissuring[23] | Crohn's disease |
| Cobblestone plaques[17] | Crohn's disease | |
| Pyostomatitis vegetans[17,37,38,45] | Ulcerative colitis (more common) and Crohn's disease | |
| Aphthous stomatitis[11,31] | Nutritional deficiency; decreased heat shock protein 27 expression | |
| Taste disturbance[17,23,147,155] | Related to disease activity and nutritional habits; sulfasalazine; metronidazole | |
| Candida infections[78,131,132,141] | Corticosteroids; thiopurines; cyclosporin A; infliximab | |
| Erythema multiforme, Stevens-Johnson syndrome[143,144] | Infliximab; adalimumab | |
| Oral mucosa | Buccal edema[15,34,48] | Crohn's disease |
| (labial/buccal/ | Cobblestoning[12,14,15,21,24,34] | Crohn's disease |
| palatal/vestibular) | Deep linear ulceration[15,16,21-24,34,38] | Crohn's disease |
| Mucosal tags[12,16,21,29,34] | Crohn's disease | |
| Buccal sulcus ulcerations[20,34] | Crohn's disease | |
| Palatal ulcerations[20,44] | Crohn's disease | |
| Pyostomatitis vegetans[33,37,45-47,49,50] | Ulcerative colitis (more common) and Crohn's disease | |
| Aphthous stomatitis[11,22,29,31,45] | Nutritional deficiency; decreased heat shock protein 27 expression | |
| Lichen planus/lichenoid reaction[29,85,140,142] | Sulfasalazine; mesalazine; infliximab; | |
| certolizumab pegol | ||
| Erythema multiforme, Stevens-Johnson syndrome[143,144] | Infliximab; adalimumab | |
| Periodontal tissue | Mucogingivitis[12,21,22,32,34] | Crohn's disease |
| Cobblestoning[29,32] | Crohn's disease | |
| Pyostomatitis vegetans/pustular ulcerations[17,32,33,37,44,46,50] | Ulcerative colitis (more common) and Crohn's disease | |
| Nonspecific gingivitis[13,19,147] | Cause not clearly specified | |
| Periodontal diseases/periodontitis[20,156] | Cause not clearly specified | |
| Alveolar bone | Periapical lesions[30] | Related to disease activity |
| Alveolar bone loss[156] | Cause not clearly specified | |
| Teeth | Caries[20,30,39,40] | Related to disease activity and malabsorption |
| Hypoplasia of enamel[40] | Related to disease activity and malabsorption | |
| Salivary glands | Hyposalivation/dry mouth[23,36] | Granulomatous inflammation |
| Autoimmune changes in minor salivary glands | ||
| Salivary duct fistula[36] | Crohn's disease |