Abstract
Patients involved on coeliac disease (CD) have atypical symptoms and often remain undiagnosed. Specific oral manifestations are effective risk indicators of CD and for this reason an early diagnosis with a consequent better prognosis can be performed by the dentist. There are not researches analysing the frequency of these oral manifestations in potential coeliac patients. The aim of this study is to investigate the oral hard and soft tissue lesions in potential and ascertained coeliac children in comparison with healthy controls. 50 ascertained children, 21 potential coeliac patients, and 54 controls were recruited and the oral examination was performed. The overall oral lesions were more frequently present in CD patients than in controls. The prevalence of oral soft tissue lesions was 62% in ascertained coeliac, 76.2% in potential coeliac patients, and 12.96% in controls (P < 0.05). Clinical dental delayed eruption was observed in 38% of the ascertained coeliac and 42.5% of the potential coeliac versus 11.11% of the controls (P < 0.05). The prevalence of specific enamel defects (SED) was 48% in ascertained coeliac and 19% in potential coeliac versus 0% in controls (P < 0.05; OR = 3.923). The SED seem to be genetically related to the histological damage and villous atrophy.
Highlights
Coeliac disease (CD), one of the most frequent chronic diseases among Caucasians, is an immune-mediated enteropathy that affects genetically susceptible subjects following exposure to gluten in the diet
A total sample of one hundred and twenty-five children was examined: 50 ascertained coeliac patients belonged to the A Group, 21 potential coeliac patients belonged to the B Group, and 54 control subjects belonged to the C Group
Several researches have shown the presence of oral mucosal lesions in CD, our study reports the first evaluation of the risk and the prevalence of such lesions in potential coeliac patients, whose oral manifestations had never been analyzed
Summary
Coeliac disease (CD), one of the most frequent chronic diseases among Caucasians, is an immune-mediated enteropathy that affects genetically susceptible subjects following exposure to gluten in the diet. Coeliac disease develops as a consequence of the association between this environmental trigger and a genetically predisposed host (HLA-DQ2/DQ8 genes), with the possible concurrence of other environmental cofactors. This condition leads the patients to an inflammatory enteropathy, with villous atrophy of the intestinal mucosa, crypt hyperplasia, and an inflammatory infiltrate in the adjacent connective tissue, associated with an increase of intraepithelial lymphocytes [2]. Potential coeliac disease is diagnosed in patients who report positive coeliac-related antibodies but with normal mucosa at the jejunal biopsy These patients are at risk for developing a typical CD enteropathy later in life, there is no evidence to keep managing them with a gluten-free diet
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