Abstract
BackgroundA close correlation between celiac disease (CD) and oral lesions has been reported. The aim of this case-control study was to assess prevalence of enamel hypoplasia, recurrent aphthous stomatitis (RAS), dermatitis herpetiformis and atrophic glossitis in an Italian cohort of patients with CD.MethodsFifty patients with CD and fifty healthy subjects (age range: 3–25 years), matched for age, gender and geographical area, were evaluated by a single trained examiner. Diagnosis of oral diseases was based on typical medical history and clinical features. Histopathological analysis was performed when needed. Adequate univariate statistical analysis was performed.ResultsEnamel hypoplasia was observed in 26% cases vs 16% in controls (p > 0.2; OR = 1.8446; 95% CI = 0.6886: 4.9414). Frequency of RAS in the CD group was significantly higher (36% vs 12%; p = 0.0091; OR = 4.125; 95% CI = 1.4725: 11.552) in CD group than that in controls (36% vs 12%). Four cases of atrophic glossitis and 1 of dermatitis herpetiformis were found in CD patients vs 1 and none, respectively, among controls.ConclusionThe prevalence of enamel hypoplasia was not higher in the study population than in the control group. RAS was significantly more frequent in patients with CD.
Highlights
A close correlation between celiac disease (CD) and oral lesions has been reported
As the mouth is very easy to examine, oral lesions can provide a valuable clinical clue for early diagnosis of CD [12]; among the atypical aspects of CD, in the international literature has been reported some affections interesting the oral cavity, the most common are recurrent aphthous stomatitis (RAS) [13,14,15] and dental enamel defects [8,13,16,17,18,19,20,21], in addition have been described the association between CD and unspecific forms of atrophic glossitis [22], oral manifestations of dermatitis herpetiformis [23], Sjögren's syndrome [24,25] and oral lichen planus [26,27]
The grade 1 enamel defects were generally localized on incisor surfaces (Figure 1) and cuspid surfaces, with dimensions from 1 to 3 mm and with a round-oval form, while that of grade 2 were on the canine and premolar vestibular surface
Summary
A close correlation between celiac disease (CD) and oral lesions has been reported. The aim of this case-control study was to assess prevalence of enamel hypoplasia, recurrent aphthous stomatitis (RAS), dermatitis herpetiformis and atrophic glossitis in an Italian cohort of patients with CD. As the mouth is very easy to examine, oral lesions can provide a valuable clinical clue for early diagnosis of CD [12]; among the atypical aspects of CD (extra-intestinals), in the international literature has been reported some affections interesting the oral cavity, the most common are recurrent aphthous stomatitis (RAS) [13,14,15] and dental enamel defects [8,13,16,17,18,19,20,21], in addition have been described the association between CD and unspecific forms of atrophic glossitis [22], oral manifestations of dermatitis herpetiformis [23], Sjögren's syndrome [24,25] and oral lichen planus [26,27] These disorders, in absence of a typical intestinal symptomatology, can represent useful clues for a timely diagnosis [7,22]
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