Dental and oral manifestations of celiac disease.

Itsa Cruz,Jm Amenabar,Fc Fraiz,A Celli,Lrs Assuncao

doi:10.4317/medoral.22506

Abstract

BackgroundThe objective of this study was to evaluate the dental and oral manifestations in patients with celiac disease.Material and MethodsThe sample consisted of 40 patients with the disease and 40 without the disease matched by age in southern Brazil. The CD group included patients previously diagnosed by positive anti-endomysial (IgA) examination and confirmed by small intestine biopsy. The presence of dental enamel defects and dental caries was evaluated by a calibrated researcher according to AINE’s and WHO’s criteria, respectively. The history of recurrent aphthous ulcers and dry mouth was obtained through reporting. For the evaluation of the salivary flow, the saliva samples were obtained through the non-stimulated and stimulated saliva collection method.Results There was a significant association between CD and dental enamel defects (OR=2.38, P=0.045) and dry mouth (OR=9.15, P=0.002). No difference was found for the report of recurrent aphthous ulcers and caries experience between the two groups. Patients with CD had normal pattern of unstimulated and stimulated saliva flow rates (0.67 ± 0.38 ml / min and 1.14 ± 0.47 ml / min, respectively). A higher occurrence of dental enamel defects was observed in patients with classic CD (P=0.054). Of the 1,962 permanent teeth, 59 presented dental enamel defects, 71.8% of which were in patients with CD (P=0.001), predominantly in molars (P=0.009).ConclusionsCD increased the likelihood of dental enamel defects and dry mouth sensation. The oral examination can be an important auxiliary tool for the identification of cases of the disease. Key words:Celiac disease, oral manifestations, dental enamel hypoplasia.

Highlights

Celiac disease (CD) is an autoimmune disorder affecting both the epithelium and the lamina propria of the small intestine in individuals who are genetically susceptible and intolerable to gluten
The sensation of dry mouth may be associated with decreased salivary flow [12] or with the presence of Sjögren’s syndrome, a condition associated with some CD patients [13]
The presence of dental enamel defects (DED) was not associated with age at CD diagnosis (P=0.102) and CD patients were 2.83 times more likely to have DED (P=0.045) (Table 2)

Summary

Introduction

Celiac disease (CD) is an autoimmune disorder affecting both the epithelium and the lamina propria of the small intestine in individuals who are genetically susceptible and intolerable to gluten. In addition to systemic manifestations of the disease, some clinical disorders of the oral cavity, such as dental enamel defects (DED), recurrent aphthous ulcers (RAU), and salivary disorders, may occur during the course of CD [5]. A study carried out in Brazil have shown that the prevalence of celiac disease is considerably higher than previously resumed [15]. A high prevalence of CD (1:417) was observed in the city of Curitiba, Southern of Brazil, where 2,086 healthy individuals and blood donors were evaluated [17]. The aim of this study was to investigate the prevalence and oral manifestations of CD in southern Brazil comparatively to a control group. The objective of this study was to evaluate the dental and oral manifestations in patients with celiac disease. The oral examination can be an important auxiliary tool for the identification of cases of the disease

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Conclusion