Oral and dental status in children with intestinal failure: A descriptive cross-sectional study

Children with intestinal failure often experience feeding difficulties and complex daily care needs, yet their oral and dental health remains underexplored. We aimed to describe oral and dental health characteristics in pediatric intestinal failure.

A cross-sectional study was conducted in 2024 at a tertiary pediatric Intestinal Failure and Rehabilitation Clinic. Clinical data, parenteral support, feeding characteristics, and oral hygiene habits were assessed. A pediatric dentist evaluated dental status, including plaque, gingival inflammation, calculus, caries experience, and enamel hypoplasia, using clinical examination and intraoral scans.

The study included 22 patients (45.5% females, median age 7.2 [IQR 4.9-12.4] years). Intestinal failure etiologies included short bowel syndrome (50%), congenital enteropathies (27.3%), and dysmotility (22.7%). Most patients (72.7%) required daily parenteral support, over a median of 10.5 h/day. Restricted oral intake was noted in 11/22 (50%) patients. Only 18.2% brushed their teeth twice daily, whereas 54.5% reported no regular daily brushing. Dental calculus was present in 14/22 (63.6%) patients. Patients had clinically meaningfully higher plaque, gingival, and calculus scores than normal reference values. Lower tooth-brushing frequency was associated with worse plaque and gingival scores. No significant association was found with restricted eating or parenteral support. Dental caries affected 4/22 (18.2%) patients, and enamel hypoplasia was observed in 8/12 (66.7%) children over six years, often involving all permanent first molars.

Children with intestinal failure frequently exhibit poor oral hygiene, gingival inflammation, dental calculus, and enamel defects. Oral hygiene counseling, nutritional rehabilitation, and dental follow-up should be integrated into their multidisciplinary care.