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At DC Perio & Implants we put great value on treatment the patient as a whole and not just the oral cavity. Here at DC Perio & Implants we fully understand that that systemic diseases can have a profound effect on the oral health and vice versa. Therefore, a proper review of medical past and current medical history is very important to us for initiating proper treatment for our patients.

Cystic Fibrosis is unfortunately a lethal genetic disease and has a profound affect on the oral and dental health. Cystic Fibrosis is caused by an autosomal recessive mutation to the cystic fibrosis transmembrane regularly (CFTR) gene. This defective gene disrupts the sodium and chloride ion movement across the cell membrane. Additionally, Cystic Fibrosis has affects on lungs, gastrointestinal tract, sinuses and the pancreas. But how does Cystic Fibrosis cause problems for teeth and gums? Often Cystic Fibrosis patients are prescribed multiple rounds of antibiotics which changes the natural flora of the mouth and the oral cavity and causes the teeth to be more susceptible to cavities. Furthermore, the prevalence of enamel defects, which is the other protective layer of the tooth, ranges from 30-50%. Because of the gastrointestinal complications that occur in Cystic Fibrosis patients 55-75% are also diagnosed with gastroesophageal reflux disease which causes stomach acid to enter the oral cavity and causes the erosion of the teeth.

With increased erosion of the teeth there is a decreased amount of minerals in the teeth and this predisposes the patients to have more increased risk for caries (cavities). Normally, saliva helps to protect the teeth by by buffering against sugars and acid in the mouth and maintains in neutral PH. However, in patients with Cystic Fibrosis the salivary gland can hypertrophy and it is assumed that the secretion of bicarbonate may be disrupted.

Other oral implications associated with Cystic Fibrosis include enamel hypoplasia and tooth discoloration, salivary gland involvement, increased incidence of dental caries, reservoir for potentially pathogenic respiratory bacteria, mouth breathing, and anterior open bite associated with nasal and sinus obstruction.

At DC Perio & Implants we are asked often about most effective ways to prevent the affects of Cystic Fibrosis on teeth and gums. Below please find some recommendations that we follow at DC Perio & Implants:

💧 Hydrate, Hydrate, Hydrate
🌾 Neutral Plant Based Diet
🥛 Daily Probiotics
🫖 Warm Salt Water Rinses
🦷 Xylitol containing toothpastes and gums
🍲 Mineral Broth Consumption (Vegan or Bone Broth)
🐠 Consumption of foods with Omega 3,6,9 fatty acids
🦷 Regular dental cleanings and treatment of caries

Armin Abron, DDS, MS

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