The Association Between Oral Health and Skin Disease

OBJECTIVE: Oral health and mucocutaneous inflammation might play an important role in the etiopathogenesis of many skin diseases, especially those that also involve the oral mucosa. This review examines the relationship between skin conditions and various oral health metrics to better understand how oral diseases, especially periodontitis, might influence the development or prognosis of several conditions, including aphthous stomatitis, atopic dermatitis, lichen planus, pemphigus, pemphigoid, and psoriasis. METHODS: Using the PubMed search engine between Summer 2017 and Summer 2018, searches were performed for: oral health OR oral hygiene AND psoriasis, eczema, dermatitis, hidradenitis suppurativa, acne inversa, pyoderma gangrenosum, Sweet's syndrome, neutrophilic dermatosis, subcorneal pustular dermatosis, hives, urticaria, cutaneous lupus, pemphigoid, pemphigus, or lichen planus OR aphthous stomatitis. The abstract of articles written in English were reviewed by the investigators and selected for inclusion if the study involved a correlation between oral health/hygiene and skin disease. After studies were included, the references were reviewed for additional relevant studies. Diseases listed in the search terms that were not ultimately discussed in this review did not produce any articles of relevance. RESULTS: Aphthous stomatitis is correlated with poor periodontal health and greater plaque accumulation. Atopic dermatitis shows an association with gingivitis, toothaches, and oral infections. Heavier enamel plaque burden and reduced oral care are implicated in the exacerbation of lichen planus. Mucous membrane pemphigoid and pemphigus are intimately influenced by oral health, underscoring the important role of good oral health and hygiene. Psoriasis presents a strong connection with oral streptococcal bacterial burden, has been shown to be improved or even cured with tonsillectomy, and has treatment outcomes that are generally associated with periodontal disease. CONCLUSION: Comorbid disease associations are frequently being reported in dermatology, spurring collaboration between multiple specialists and dermatologists. This review emphasizes a need for closer collaboration between dermatologists and dentists to treat several common skin diseases.