Autoimmune Series: Oral Health Impact of Psoriasis

This month we’re going to focus on a more well known autoimmune disease that affects 8 million Americans and more than 125 million individuals across the world; psoriasis. Psoriasis is the result of skin cells reproducing too quickly as a result of the immune response. When the body is not able to shed these excess cells as they produce, the symptom of red, thickened and scaly patches on skin occur.

Image detailing Psoriasis as a part of skin layers.
Illustration showing where Psoriasis affects skin cells.

While psoriasis is a genetic autoimmune disorder, it’s worsened by illness, stress, alcohol and other potential factors. Lesions in your mouth may occur if the overproducing cells make their way to the oral cavity. The lesions are typically rare, but if found on the lips can be the first sign of the psoriasis diagnosis. Otherwise, if you’ve already been diagnosed and notice lesions in your mouth, speak with your dentist or dermatologist.

There are 5 different types of psoriasis. 

-Plaque Psoriasis: One of the most commonly known types of psoriasis. It’s characterized by scaly patches of skin and can often be itchy and may even crack and bleed.

-Guttate: This type presents with small round lesions and usually presents in childhood. Sometimes this type is triggered by strep infection. 

-Inverse: This form is often found in combination with other types of psoriasis. It presents as shiny lesions found in skin folds, behind the knees, in the under arms etc.

-Pustular: Typically found on hands and feet, this form presents with white pustules. The pustules are filled with white blood cells as a result of the immune response. Even though it’s not an infection, it often looks like one. 

Erythrodermic: The most rare form, this psoriasis is particularly severe. This form presents as extreme redness all over the body, often becoming itchy and painful and can cause the skin to peel. You should see a doctor immediately if any of these symptoms occur as this form can be life threatening. Erythrodermic psoriasis is often found in individuals with uncontrolled plaque psoriasis.

Gum disease may affect autoimmune disease and vice versa.
Any autoimmune disease can increase bleeding and inflammation of the gums.

Linking this particular disease to oral health beyond its manifestation still requires more research, but in Norway, a study found that 24% of participants with psoriasis had moderate to severe periodontitis. In contrast, only 10% of the control group without psoriasis suffered from moderate to severe periodontal disease. At the end of the study, the assumption was made that the link between the two diseases is likely due to the immune response. No definitive link has been found, so more research is needed to further understand what if any impact periodontal disease and psoriasis have on each other. 

Dealing with these different forms of psoriasis can be very difficult but as research continues, it is our hope that further understanding will progress. If a link is found between psoriasis and periodontal disease we will strive to provide treatment that can ease the symptoms of both diseases if possible. In the meantime, if you suffer from psoriasis or any autoimmune disease it seems that good oral health can often improve symptoms. At Ballard Dental Arts it is our goal to treat patients with the best care possible, and that means looking at how we can improve other diseases you may suffer from. Good oral health is good for overall health! If you suffer from psoriasis and would like to discuss how we can further improve your oral health, we can talk it over at your next visit.

Psoriasis lesions covering the hands.
Psoriasis affecting the hands.

References

Colgate: https://www.colgate.com/en-us/oral-health/conditions/immune-disorders/how-to-treat-your-psoriasis-mouth-symptoms-0715

National Psoriasis Foundation https://www.psoriasis.org/advance/gum-disease-more-likely-in-people-with-psoriasis

NCBI: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4280688/

Mayo Clinic: https://www.mayoclinic.org/diseases-conditions/psoriasis/symptoms-causes/syc-20355840

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