May is Cystic Fibrosis (CF) Awareness Month and as you may or may not know CF has many health concerns for those diagnosed with the disease. Oral health is often pushed to the way side for most of us, let alone for individuals dealing with the management of CF, who can have multiple lung treatments everyday. However, dental health is an extremely important component of nutrition, as the digestive system begins with our mouths and teeth. Some concerns for dental health and cystic fibrosis include antibiotic use, dental diseases, enamel defects, discoloration, and other oral habits that require both dental and nutritional implications.

Frequent use of antibiotics and constant medical care are all good news for CF patients because they lower the risk for gingivitis, plaque, and other dental diseases (1-3). Discoloration or staining of teeth is potentially a problem for CF and may be caused by the antibiotic tetracycline (2-4). Having CF can be especially stressful and therefore it is common to observe oral habits such as grinding of teeth, which can have a negative effect on dental health (2). Enamel defects are also of concern due to cavity formation and development of enamel pores that are caused by increased calcium and phosphate in the saliva. This may result in chipping and or translucency of teeth (3).

The role of a dietician within a care team is important for dental considerations. CF management is frequently accompanied by a high calorie diet to provide the extra energy that is needed to compensate for the work of breathing as well as other strains caused by CF. High caloric intake is associated with a larger consumption of sugar-containing foods and fermentable carbohydrates (such as bread) that can damage teeth (4). While dental caries seem to be less of an issue for the CF population, it is important to be aware of brushing and rinsing in between meals so that particles do not stick around for tooth decay promoting microorganisms. Growth velocity and bone development, including teeth, may be compromised if an individual with CF does not eat enough, which is another important component for oral and overall health (4).

Maintaining optimal dental health in congruence with CF is completely manageable with regular dental visits and routine care. Quality dentists that understand CF will adjust their care, such as performing teeth cleanings in upright positions rather than lying down as that may cause a coughing exacerbation (4). While CF care comes first, other aspects of health should not be overlooked. Both a pediatric dentist and dietitian within the CF care team can help keep teeth clean and healthy from early on by accommodating the patient and educating them on good oral hygiene and nutrition!

Happy Eating (and brushing)!

References:

1. Jagels AE & Sweeney EA. Oral health of patients with cystic fibrosis and their siblings. Journal of Dental Research. 1976;55:991-996.

2. Blacharsh C. Dental aspects of patients with cystic fibrosis: a preliminary case study. Journal of American Dental Association. 1979;95:106-110.

3. Narang A, Maguire A, Nunn JH, et al. Oral health and related factors in cystic fibrosis and other chronic respiratory disorders. Archives of Disease in Childhood. 2003;88:702-707.

4. Fernald G W, Roberts M W, Boat T F. Cystic Fibrosis: A Current Review. Pediatric Dentistry. The American Academy of Pediatric Dentristy Volume 12, Number 2.

Alexandria Wolz, Cooperative Intern for: