Association of Crohn's disease with periodontal disease risk and severity: a meta-analytic study

Crohn's disease (CD) is a chronic inflammatory disorder with systemic manifestations, including potential effects on oral health. Evidence regarding its association with periodontal disease remains inconsistent.

We systematically searched PubMed, Embase, Web of Science, Scopus, Cochrane Library, CNKI, and WanFang Data up to August 28, 2025, for observational studies comparing periodontal -outcomes in adults with CD and non-inflammatory bowel diseases controls. Random-effects meta--analyses were -performed to estimate pooled odds ratios (ORs) for prevalence and standardized mean differences (SMDs) for clinical parameters. Subgroup and sensitivity analyses were conducted.

Thirty-four studies, including 6482 CD patients and 9137 controls, were analyzed. CD was -associated with a higher risk of periodontitis (OR = 2.14, 95% confidence interval [CI]: 1.65-2.77). Clinical periodontal parameters were also significantly worse in CD patients: probing depth (SMD = 0.42), clinical attachment loss (CAL) (SMD = 0.50), bleeding on probing (SMD = 0.47), plaque index (SMD = 0.39), and gingival index (SMD = 0.31). Associations were stronger in European populations and in studies using CAL criteria. Sensitivity analyses confirmed the robustness of results.

CD is associated with increased prevalence and severity of periodontal disease. These -findings support routine periodontal screening and integrated multidisciplinary management for CD patients, highlighting shared inflammatory pathways as potential therapeutic targets.