Orofacial granulomatosis and oral Crohn disease
Their oral features and the awareness among dental clinicians.
Fig. 1 Examples of possible oral manifestations in both OFG and oral CD. A) Lower lip swelling with a midline fissure, B) vestibular tags lower jaw, C) gingival erythema upper jaw, D) edematous hyperplastic gingiva upper jaw, E) gingival ulceration buccal sulcus and gingiva region 45, F) cobblestoning in right buccal mucosa. Photo: Creative Commons, Anne Skaare.
Orofacial granulomatosis (OFG) and Crohn disease (CD) are chronic inflammatory disorder. Both results in increased morbidity due to enlargement of the lips, gingival hyperplasia, and/or painful oral erythema or ulcers. In addition, CD also involves other parts of the gastro-intestinal tract with symptoms like abdominal pain, diarrhea, weight loss, and poor appetite. No epidemiological data on OFG exists and the relationship between OFG and CD is still unclear. Symptoms of OFG and CD often manifest themselves in children and youngsters. It is, therefore, important that dental clinicians are familiar with the oral signs and manifestations of OFG and oral CD. Examples of possible oral manifestations in both OFG and oral CD are shown in Figure 1.
In the present questionnaire study, approximately half of the respondents (dentists and dental hygienists in the public dental service in Norway) were aware of OFG (41.2%) and oral CD (57.8%). One-quarter (24.6%) reported that they most likely had seen a patient with OFG and 20.6% with oral CD. Recently graduated dentists (≤10 years ago) were more aware of OFG and oral CD than those who graduated>10 years ago (p≤0.001). Regarding dental hygienists, this difference was observed for OFG only (p<0.05). Country of education did not influence the clinicians’ reported knowledge. Approximately 90% would refer a patient suspected of having OFG or oral CD either to a dental specialist or to a physician.
The high prevalence of clinicians that report on having observed possible OFG and oral CD in this study may indicate that OFG and/or oral CD are under-reported and that OFG in particular is more common than hitherto believed. The high frequency of awareness was promising for the benefit of the patients.
A. B. Skaare, E. S. Hovden, B. B. Herlofson, T. M. Søland. Orofacial granulomatosis: a questionnaire study among Norwegian dental clinicians. European Archives of Paediatric Dentistry