Abstract
Background: Celiac disease is an autoimmune chronic disease that affects the human’s intestine and subsequently reflects its effect on the entire body health by retardation the absorption and immune mediated complications cause the involvement of oral health. The present study intended to evaluate the impact of the histopathological disease activity upon dental enamel defects and dental caries.
 Subjects and methods: Forty celiac-diseased patients aged 7-11 years were collected from 3 different teaching hospitals in Baghdad classified by means of the histopathological activity of the intestinal disease according to modified Marsh-Rostami classification. Dental enamel defects were measured by Aine’s classification, while dental caries experience and severity were measured using d1-4mfs/t and D1-4MFS/T.
 Results: The majority of the sample came with partial villous atrophy of the small intestine (Marsh III-a) and almost half of the sample were with no celiac disease specific dental enamel defects (Aine’s 0), while Aine’s I was the most predominant than Aine’s II. Most missed surfaces due to dental caries in permanent teeth came with Marsh II.
 Conclusion: The more the severity of celiac disease histopathological activity the more the severity of celiac specific dental enamel defects and the less experienced dental caries.
 Keywords: Celiac disease, histopathological activity, dental enamel defects, dental caries.
Highlights
Celiac disease (CD) is a chronic hereditary autoimmune inflammatory disease leading to intestinal damage and malabsorption associated with serious health consequences.[1]
Higher Dental enamel defects (DED) in CD children was observed as compared to children devoid from the disease [10,13,14] in contrast to dental caries that was experienced at lesser extent in CD children.[13]. Another study showed no significant difference in prevalence of DED between CD children and others without the disease.[15,16] Another study reported no significant difference in caries experience in CD children.[16]
The aim of the current study was the estimation of the essential role that the oral cavity plays as a gate of the gastrointestinal tract at which the health of each may logically affects the other’s, CD was studied in children with mixed dentition to evaluate CD histopathological activity impact on DED and dental caries
Summary
Celiac disease (CD) is a chronic hereditary autoimmune inflammatory disease leading to intestinal damage and malabsorption associated with serious health consequences.[1]. Intestinal epithelial damage is caused by both innate and adaptive immune responses and that intraepithelial lymphocytes, those are elicited by the inflammation caused by gluten and mediated genetically and production of variant immunoglobulin such as tissue transglutaminase, anti-endomesial and anti-gliadin.[8]Modified Marsh-Rostami index had been developed to describe intestinal mucosal damage.[9] Orally, dental enamel defects DED can be identified in some CD patients and this plays a vital role for dentists to play pointing to the disease for diagnosis.[10] When any impaired function of the ameloblasts occurred due to environmental or nutritional deficiency factors, enamel formation would get impaired too.[11] A study by Abdul-Wahid et al [12] revealed an increase in the presence of unspecific dental enamel defects by the application of the Modified Developmental Defects of Enamel Index for 102 CD patients aged 2-35 years compared to the control group in primary and permanent dentitions while dental caries was experienced at higher extent in the primary teeth only. The aim of the current study was the estimation of the essential role that the oral cavity plays as a gate of the gastrointestinal tract at which the health of each may logically affects the other’s, CD was studied in children with mixed dentition to evaluate CD histopathological activity impact on DED and dental caries
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