Psoriasis and oral health: more than a skin-deep connection?
As a healthcare professional it never stops astounding me how much research uncovers about the complexities of the human body each year. We are constantly learning about ourselves and how various health conditions are influenced by others, and these new links are guiding us forwards into a new age of more holistic care which is very exciting.
For example, I recently read an article that explained how psoriasis could be linked to dental health.[i] It’s bizarre, in a way, to think that something like a relatively common skin condition could be related to the health of our teeth and gums, but there are a number of interesting links that have recently been made that indicate that this could be the case. But what if this new research could be used to understand the disease more and to treat it?
What is psoriasis?
As you may already be aware, psoriasis is one of those diseases that have mystified healthcare professionals for a long time. It can occur at any age without warning and continues to affect sufferers for the rest of their lives. It may not be life threatening, but the scaly patches of red, flaky skin can severely impact people’s quality of life, especially if they have extensive symptoms.
According to the NHS, around 2% of British people have psoriasis, meaning that millions of individuals are managing this chronic condition every day. The condition impacts men and women equally, and because of its nature, the symptoms tend to come and go in waves, sometimes causing only mild irritation and other times causing considerable discomfort.[ii]
Patches of irritated skin usually occur on the knees, elbows and scalp, but it’s not impossible for these patches to occur inside the mouth as well, including on the inside of the cheeks, on the tongue and on the lips.
Possible links
Research into possible connections between dental health and psoriasis are relatively recent, but there are a number of studies that have made interesting discoveries. For example, a study that examined 756 individuals found that people with periodontitis were far more likely to suffer from psoriasis compared to those who had good oral health.[iii] Another study that assessed the same relationship went further to suggest that the severity of periodontitis directly impacted the severity of the psoriasis in the individual.[iv]
As such, it’s definitely possible that comorbidity exists between these two conditions, and that periodontal disease, in particular, may be responsible for the incidence of psoriasis, and its severity.
Another interesting find from research into psoriasis and oral health is that individuals who have psoriasis are also more likely to have missing teeth and tooth decay. Of course, the missing teeth can be linked to possible prevalence of periodontitis, but the data also suggests that saliva may be somewhat to blame. Those with psoriasis have been found to have more acidic saliva that those without the condition, meaning that teeth are under more constant attack from acids that can wear away enamel and promote decay.[v]
What we can learn
There’s a fair amount of evidence to go on to suggest that oral health, once again, is at the root of other conditions. It’s becoming more and more certain that systemic health is heavily influenced by periodontal health, and this is just another case that ties into this belief.
As such, we need to think forward to the opportunity this gives us to understand these conditions better and potentially find relief for the millions of people who do suffer from psoriasis. Of course, we won’t know the full extent of the link between these conditions until more research is conducted, however, that doesn’t mean that we can’t make some difference right away. Ask patients if they suffer from psoriasis – if they do, we should tell them about this research and help them understand the possible associations. This is also an excellent opportunity for us to bring up other links such as the potential for periodontitis to be connected to heart diseases and stroke – the more patients understand, the more likely they are to take better notice of their periodontal health, clean interdentally and go that extra mile that we want them to in order to keep on top of their oral health.
At the end of the day, the human body is a highly complex organism, and whatever we learn moving forwards will only be one step closer towards deciphering how certain conditions interact. Until then, we can make a difference by keeping patients updated with what we learn – even if the link proves to be insubstantial, promoting better gum health will always have benefits.
For further information please call EndoCare on 020 7224 0999
[i] Healthline. Is Psoriasis Linked To Dental Health? Link: https://www.healthline.com/health/psoriasis/psoriasis-dental-health [Last accessed February 21].
[ii] NHS. Psoriasis. Link: https://www.nhs.uk/conditions/psoriasis/ [Last accessed February 21].
[iii] Mendes, V. et al. Periodontitis As Another Comorbidity Associated With Psoriasis: A Case Control Study. Link: https://aap.onlinelibrary.wiley.com/doi/abs/10.1002/JPER.18-0394 [Last accessed February 21].
[iv] Costa, A. et al. Periodontitis and the Impact of Oral Health on the Quality of Life of Psoriatic Individuals: A Case-control Study. Link: https://link.springer.com/article/10.1007/s00784-020-03600-1 [Last accessed February 21].
[v] Fadel, H. et al. Profiles of Dental Caries and Periodontal Disease in Individuals With or Without Psoriasis. Link: https://aap.onlinelibrary.wiley.com/doi/full/10.1902/jop.2012.120119?casa_token=i9RUmYtNuiEAAAAA%3AWhIDqPEsw3SVeES_Y9KD0bMR-7oobbzmyECvYe-AsJjdjKi2ptdGudi6y5wGn6jS3NUioeixNMpz8svy [Last accessed February 21].
