People with acromegaly (a condition with very high IGF‑1) often have enlarged and cracked tongues, but their overall tooth decay and gum health are similar to healthy folks if they keep up good oral hygiene. However, poor brushing can lead to gum inflammation in these patients, suggesting that high IGF‑1 might make the mouth more sensitive to neglect.

This study aimed to evaluate oral mucosal lesions, dental status, and metabolic associations in patients with acromegaly, and to explore the impact of treatment and comorbidities. This prospective case-control study included acromegaly patients and healthy controls. Oral health assessment was performed using the DMFT index, the Periodontal Screening Index (PSI), and the Plaque Index (PI).Oral hygiene practices were assessed through a structured questionnaire. Laboratory parameters, including GH, IGF-1, ACTH, cortisol, TSH, T4, fasting glucose, and HbA1c, were measured. Statistical analysis included group comparisons and correlation assessments with significance set at p < 0.05. There were no significant differences between groups in oral hygiene scores, DMFT values, PSI, or PI scores (p > 0.05). However, macroglossia (82.9%) and fissured tongue (51.4%) were significantly more common in patients with acromegaly (p < 0.001). In the acromegaly group, no significant associations were found between DMFT scores and clinical or hormonal parameters and a negative correlation was observed between oral hygiene and PSI scores (p < 0.05), and a positive correlation between PI and PSI scores (p < 0.001). No significant correlations were observed in the control group. Tongue lesions were significantly more prevalent in patients with acromegaly, regardless of disease status or treatment. While general oral health parameters were similar between groups, periodontal inflammation in acromegaly was linked to poor oral hygiene. These findings suggest that acromegaly may be a risk factor for periodontal disease. Routine oral health monitoring is essential in this population.