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

BACKGROUND: 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. METHODS: 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. RESULTS: 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. CONCLUSIONS: 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.