Immunoglobulin A deficiency and oral health status: a case–control study

Introduction: Immunoglobulin A (IgA) is important for mucosal health. Selective IgA deficiency (IgAD) is the most common primary immunodeficiency but its effect on oral health is unclear. The aim of this study was to investigate dental, periodontal and oral mucosal health in IgAD individuals.
Material and methods: In total, 32 adult IgAD subjects were compared with 63 randomly selected individuals. Participants answered questionnaires regarding general and oral health and underwent oral examination, including examination using the periodontal screening and recording (PSR) system and dental examination using the DMF system.
Results: The IgAD individuals had significantly more often undergone tonsillectomy (44% versus 24%, p= 0.046 ) and adenoidectomy (31% versus 8%, p= 0.003 ) compared with the controls. Furthermore, the IgAD subjects reported having pharyngitis, stomatitis and herpes labialis significantly more often. There was no significant difference in periodontal health ( mean PSR index ; 1.87 versus 1.77) or dental health ( mean DMFS ; 51.3 versus 53.7 ) between the two cohorts. A positive correlation between Helicobacter pylori infection and severity of periodontitis was found ( p= 0.036).
Conclusion: IgAD predisposes to oral mucosal infections but does not influence periodontal or dental health. This is the first controlled study to include detailed clinical history and investigations, together with full oral and dental examination, in adults with IgAD.