Clinical evaluation of dental enamel defects and oral findings in coeliac children

Abstract

Clinical evaluation of dental enamel defects and oral findings in coeliac children PurposeTo examine dental hard and soft tissue changes of coeliac children in order to increase the awareness of the pediatric dentists in prediagnosis of especially undiagnosed coeliac disease. Materials and methodsSixty children, 28 (46.7%) boys and 32 (53.3%) girls whose ages were between 6 to 16 years were included in the present study. Thirty children who had undergone endoscopy and diagnosed with the coeliac disease in the Şişli Hamidiye Etfal Hospital, İstanbul, Turkey, formed the study group. Also, thirty children clinically suspected of having the coeliac disease with the same gastrointestinal complaints had undergone endoscopy and proven not coeliac were chosen as the control group. Oral examination involved assessment of dentition and specific and unspecific dental enamel defects. Also, soft tissue lesions, clinical delay of the dental eruption, salivary flow rate, pH, and buffering capacity were examined. ResultsTwenty coeliac patients had enamel defects, however none in the control subjects. In the coeliac group, all enamel defects were diagnosed in permanent teeth and as specific in all children. Grade I dental enamel defects found mainly in the incisors. The clinical delayed eruption was observed in 10 (33.3%) of 30 coeliac children and none of the children in the control group. While the level of DMFT/S numbers and stimulated salivary flow rate were found significantly lower in the coeliac group, pH was found significantly higher. ConclusionOral cavity may be involved in coeliac disease and pediatric dentists can play an important role in the early diagnosis of the coeliac disease.

Coeliac disease and its implications on the oral health of children: A systematic review

“…21 Most studies concordantly confirm that defects classified as Grade I constitute the most frequent type of DEDs. 1,6,7,15,16,[22][23][24][25][26] The overall prevalence of enamel defects among children suffering from CD varies from 17.9% to 83.5%. These inconsistencies may be caused by several factors, such as different age at CD diagnosis, strict adherence to a gluten-free diet and its duration as well as the type of population represented in the study.…”

Extra-Intestinal Manifestations of Celiac Disease: What Should We Know in 2022?

“…Bramanti et al in 2014, reported that ED was more frequently observed in children with typical gastrointestinal manifestations, while aphthae were more prevalent in silent and undiagnosed CD [ 14 ]. Dental ED associated with CD are specific—they involve all the four quadrants, with color and enamel surface alteration following the sequence of dental mineralization [ 5 , 14 , 15 ]. Other ED, such as discolorations or opacities, especially if not symmetrical nor chronological, are considered unspecific [ 16 ].…”

“…There are multiple mechanisms responsible for oral manifestations in CD, which involve the direct effect of gluten sensitivity disorder or the consequences of malabsorption, with iron, folic acid, and vitamin (A-D-B12) deficiency [ 4 , 15 , 17 ]. Moreover, the celiac enteropathy induces an alteration of phospho–calcium metabolism, causing hypocalcemia and consequent dental demineralization [ 15 ].…”

“…For example, the HLA DQB1 has a protective role for ED and RAS in CD, while the HLA DR52-53 alleles are more commonly observed in children with alteration in dental enamel [ 14 ]. On the other hand, RAS can rely on many other factors such as family history, local trauma, stress, hormonal imbalance or immune changes, IBD, food hypersensitivity, and nutritional deficiencies [ 15 , 16 ]. Nevertheless, people manifesting RAS should be considered at-risk subjects for CD development despite the absence of any gastrointestinal symptoms and they should undergo the diagnostic process for CD exclusion [ 4 , 6 ].…”

Recurrent aphthous stomatitis as the only clinical sign of celiac disease in obese adolescent - case report and literature review

“…The cause of RAS is not clear [1,3]. It is seen in otherwise healthy people, but also in various infectious and non-infectious diseases, including celiac disease (CD) [1,[6][7][8][9][10][11][12][13][14][15]. In addition, RAS is associated with genetic predisposition, iron and vitamin B12 deficiency, local mechanical injuries, stress, and hormonal imbalance [16,17,18].…”