Does the introduction of gluten-free diet influence the prevalence of oral soft tissue lesions in celiac disease?

Abstract

Aims and Objectives: Celiac disease (CD) is characterized by oral manifestations in the soft tissues. The introduction of a gluten-free diet (GFD) may be related to change in the prevalence of oral changes and symptoms. The aim of the study was to evaluate the prevalence of oral soft tissue lesions in a pediatric Portuguese population with CD compared with healthy controls, and secondarily to assess the relationship between the onset of the GDF and the prevalence of oral manifestations. Materials and Methods: A case–control study was performed: 80 patients with CD and 80 healthy subjects as controls, aged 6–18 years. Data were gathered through a structured protocol, consisting of a clinical record (questionnaire) and an intraoral observational examination. For the descriptive analysis of the results, relevant summary statistics were applied. Descriptive and inferential (mainly nonparametric tests) analyses were carried out with the Statistical Package for the Social Sciences software (IBM SPSS) version 24.0. P < 0.05 was considered as significant. Results: Although soft tissue changes such as angular cheilitis, atrophic glossitis, and geographic tongue were found to be more common in the CD group, no differences were found between the two groups. The prevalence of aphthous ulcerations was higher in the CD group, with a highly significant difference between the two groups (P < 0.001). One-third of the patients with CD with aphthous ulcers refer that the beginning of the GFD influenced the improvement of this oral mucosa alteration, with a statistically significant difference (P = 0.007). Conclusion: The Portuguese population with CD had a higher prevalence of aphthous ulcerations and this oral manifestation decreased with the introduction of a GFD.