Adults with atopic dermatitis (AD) may face a higher risk of poor oral health and dysbiosis; therefore, dermatologists should discuss oral hygiene and recommend dental referrals when needed. The study was published in the International Dental Journal.
Furthermore, AD may be linked to higher plaque and gingival index scores and an abundance of bacteria linked to periodontal disease, the authors wrote.
"The findings of this study highlight the need for awareness of the increased severity of oral disease in AD patients," wrote the authors, led by Aaya Shahin of the Hebrew University of Jerusalem in Israel (Int Dent J, November 9, 2024).
The prospective, sex- and age-matched case-control study compared 45 adults with dermatologist-verified AD to 41 controls, with an average age of approximately 36. A certified dentist assessed oral health using standardized indices for gingival, periodontal, and oral hygiene status, as well as caries severity, with higher scores indicating worse outcomes.
Prosthodontic status, including restorations, crowns, implants, were also recorded. AD severity was evaluated using validated tools with higher scores reflecting greater severity. Oral microbiome samples were collected from each participant using sterile swabs and curettes during the oral and dermatological exams, they wrote.
Oral examinations revealed poorer oral hygiene and higher plaque index scores among AD patients compared to controls, with severe plaque (24.4% versus 7.3%) and poor oral hygiene (20% versus 2.4%) significantly more common in the AD group. While there was no significant difference in caries severity, overall oral disease prevalence, or prosthodontics, AD patients showed a trend toward more severe gingivitis (44.4% versus 24.4%, p = .05).
Additionally, AD patients exhibited significantly higher oral microbial diversity (p = .0007), particularly in the 20-39 age group, and increased abundance of 40 bacterial taxa, including periodontitis- and gingivitis-associated species. Health-associated bacteria were less abundant, while caries-associated bacteria were lower in the AD group, the authors wrote.
However, the study had limitations. The AD group mainly consisted of patients with mild to moderate severity; therefore, the findings may not apply to more severe cases, they wrote.
"We encourage dermatologists treating these patients to discuss oral hygiene and consider referrals to dentists, particularly periodontal disease experts," Shahin and co-authors wrote.
