Oral Health Issues in Psoriasis: An Overview of the Literature

Background: Psoriasis and oral health are overlap in different ways, sometimes with complex and uncertain outcomes. Objective: It is to map the knowledge about the oral health status issues for psoriasis. Methods: We conducted qualitative systematic review of clinical trials literature. Results: There are different issues about oral health status related to the observed outcomes. It was recovered 830 studies, 11 were able to fill partially the inclusion criteria for this review with 293.231 participants. The highest level of evidence obtained was 2 A (Randomized Clinical Trial), for the oral psoriasis arthritis forms at TMJ issue with one study. About the periodontal diseases issue was obtained the second highest level of evidence 2B (Clinical Trial Case-Control), with 10 studies. Limitations: The main limitation was the lack of inclusion of unpublished studies. Conclusions: For clinicians It is important consider oral implications for all psoriasis patients. Among possible issues, it is relevant to state that the conventional treatments for psoriasis are able to produce oral adverse events [75]. Periodontal diseases, seems to be related to the severity of psoriasis, because the level of evidence was only 2B, although its intrinsic mechanisms are not known. Further studies are required to state a minimum dental care protocol. In general, for better outcomes in Psoriasis, professional must adopt an assessment risk scales, such as the “physical status classification system” from the American Society of Anesthesiologists (ASA) and observe statements, such those the American Dental Association, prior to any interventions, concerning to the degree of coverage and invasiveness of each dental procedure and the risk of adverse events before, during and after the consultation for these patients.