Does Oral Health Affect Psoriasis?

Patients with psoriasis and poor oral health may experience more severe psoriasis symptoms than those with better oral health, according to dermatologists at The Ohio State University Wexner Medical Center in Columbus. The findings offer a clearer picture of the relationships between the oral microbiome, induction of autoimmune conditions, and modifiable risk factors, such as diet and oral care.

In the study, “The Impacts of Oral Health Symptoms, Hygiene, and Diet on the Development and Severity of Psoriasis” researchers administered a questionnaire to 265 patients at Ohio State’s dermatology clinics. Of those surveyed, 100 patients had psoriasis and 165 did not have the autoimmune disease.

“We’re looking for some sort of trigger that sets off the immune system. Because strep throat is one of the known triggers and the microbiome of oral bacteria is complex, that became our starting point,” says Benjamin Kaffenberger, MD, a dermatologist at the Ohio State Wexner Medical Center and lead author. “We wondered if poor oral health could be a risk factor for psoriasis.”

Patients with psoriasis who rated their periodontal health as poor or very poor exhibited significantly more severe psoriasis symptoms than those with healthy gingiva. Statistically significant predictors of psoriasis development included experiencing oral pain in the last 12 months. Similarly, severity of psoriasis was associated with self-rated poor gum health and speech difficulties due to oral health issues.

“While these relationships remain preliminary, and do not imply causation, clinicians could consider explaining the interrelationships of oral health and psoriasis with patients, and encouraging behaviors that would promote oral health, such as regular brushing and flossing, as well as regular dental examinations,” notes Paul Macklis, MS, first author of the study and a medical student at The Ohio State University College of Medicine.

More than 8 million Americans are affected by this autoimmune condition¹ that manifests as itchy, patchy red skin with silvery scales. Severe psoriasis can cover large portions of the body and patients can also have severe joint pain.

The findings, published in the Dermatology Online Journal, suggest diet may also play a part in the development and severity of psoriasis, as patients who reported consuming fresh fruit at least once a day experienced milder psoriasis symptoms. Healthy habits, such as losing weight, and avoiding alcohol and cigarettes, are also associated with less severe psoriasis.

While further research is needed, Macklis notes communication between dermatologists and dentists could play a pivotal role in the management of psoriasis and broaden the scope of potential therapeutic options.

REFERENCE

1. National Psoriasis Foundation. Statistics. Available at: https://www.psoriasis.org/content/statistics. Accessed December 4, 2019.