• How Can Cystic Fibrosis Affect the Teeth?

    Did you know that people with cystic fibrosis (CF) generally have fewer cavities and cases of gum disease than people without CF?  This is especially notable because those with CF often follow a high-fat, high-carbohydrate diet, which has been found to promote tooth decay.  However, enamel defects have been regularly reported in people with CF.

    Understanding the relationship between cystic fibrosis and the effects on teeth and gums can help those with CF have a clearer path to achieve good oral health.

    What is cystic fibrosis?
    Cystic fibrosis is an inherited disorder that causes severe damage to the lungs, digestive system and other organs in the body.

    CF affects the cells that produce mucus, sweat and digestive juices.  These secreted fluids are normally thin and slippery.  But in people with CF, a defective gene causes the secretions to become sticky and thick.  Instead of acting as lubricants, the secretions plug up tubes, ducts and passageways, especially in the lungs and pancreas.

    Although cystic fibrosis is progressive and requires daily care, people with CF are usually able to attend school and work, and often have a better quality of life than people with CF had in previous decades.  I

    How does cystic fibrosis affect teeth?

    Enamel problems happen more often and more severely in people with CF than in those without CF.

    Evidence shows that people with cystic fibrosis have fewer enamel defects in primary (baby) teeth than in permanent teeth.  This may be due to the loss of mineralization (the body’s natural enamel repair process) caused by the CFTR gene during tooth development.

    Enamel is considered the hardest tissue in the body, but it is also vulnerable.  Sugar from food connects with plaque bacteria and produces acid.  Over time, this causes a breakdown in the enamel.  Many researchers believe that people with CF have altered saliva that protects enamel from breaking down because it has more minerals.  This makes the mouth less acidic, resulting in fewer cavities.

    Studies also show that people with CF have more plaque and tartar than people without CF, but still have little to no signs of gum disease. However, it is suggested that the bacteria living in plaque may show up later in the lungs, which could affect the health of people living with CF.

    Frequent Antibiotic or Pancreatic Enzyme Use

    Antibiotics and pancreatic enzymes are an essential part of every CF treatment plan.  Research shows that the low reports of cavities and gum disease in people with CF are likely due to the long-term use of these drugs.  Antibiotics taken by people with CF enter plaque and gum tissue, which reduces bacteria.  pancreatic enzymes that are used to treat cystic fibrosis also lesson plaque and tartar buildup on teeth.

    However, the antibiotic tetracycline should be used with caution as it can cause unwanted yellow, gray or brown discoloration on teeth.  For this reason, children under 8 years old should not use tetracycline due to the risk of permanent staining.  Adults often avoid tetracycline as well, since alternatives are usually available.

    Are children and adults affected in the same way?

    For over 40 years, research has shown that children with CF have fewer cavities.

    There are several possible reasons for this.  As children age, poor dental habits might increase their risk of cavities.  Younger children often brush their teeth, go to the dentist, and use fluoride treatments more frequently.  Evidence shows that up to 90 percent of children with cystic fibrosis brush their teeth at least twice a day, which may help with reducing cavities.  However, this evidence also shows that more than 65 percent of adults with CF have poor oral hygiene.

    Plus, antibiotics that are commonly prescribed to children with CF target bacteria found in the lungs and mouth.  However, this antibiotic use often changes in adolescence.  Most teens and young adults with CF often switch to inhaled antibiotics that generally do not reduce bacteria found in the mouth.

    How do those with cystic fibrosis keep teeth and gums healthy?

    It is important to remember that dental health is necessary for everyone, including people who live with CF.  Visiting the dentist at least two times a year, as well as brushing and flossing regularly, are key factors of a healthy dental care routine for both children and adults.

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