Introduction and objective:
Inflammatory bowel disease (IBD), comprising Crohn’s disease (CD) and ulcerative colitis (UC), is a chronic inflammatory condition with systemic and extra-intestinal manifestations. Clinical findings in the oral cavity include, among others, a higher caries burden and microbiome dysbiosis linked to the oral-gut axis with Streptococcus mutans playing an important role.

Material and methods:
The study included 110 IBD patients in remission (73 CD, 37 UC) and 50 controls. Participants underwent oral cavity examination (DMFT, API) and completed a questionnaire on oral hygiene. Unstimulated saliva from IBD patients was analysed for S. mutans detection by PCR and serotyping by multiplex (c, e, f) and singleplex (k) PCR.

Results:
DMFT was higher in CD and UC patients (mean=19.08 and 19.51) than controls (mean=15.04; p=0.007), with elevated D (p<0.001) and M (p=0.011) components in CD group and no difference in F component. API was higher in CD group than in controls (mean=67.77 vs 53.03; p=0.020), with significant differences in API ranges for CD vs controls (p<0.001) and UC vs controls (p<0.05). Insufficient oral hygiene was noted in 49% of CD and 43% of UC patients, and average hygiene in 41% of CD and 46% of UC. Oral hygiene habits differed only in toothbrushing frequency, with CD patients brushing less frequently than controls (p=0.017). Higher D component counts and API were associated with increased IBD odds. CD and UC patients were 5.95- and 5.17-fold more likely to have insufficient or average oral hygiene. S. mutans was detected in 78% of IBD patients, with serotype k in 31%. In UC group, rural residence was linked to higher DMFT, with no such effect in CD patients.

Conclusions:
These findings underscore the importance of targeted oral hygiene education for IBD patients and support further research on the oral microbiome.