Prevalence Of Dental Enamel Defects Research Articles

Celiac Disease-Related Enamel Defects: A Systematic Review.

This systematic review aims to elucidate the intricate correlation between celiac disease (CD) and dental enamel defects (DED), exploring pathophysiological mechanisms, oral health implications, and a dentist's role in early diagnosis. Following PRISMA guidelines, a comprehensive search from 1 January 2013 to 1 January 2024 across PubMed, Cochrane Library, Scopus, and Web of Science identified 153 publications. After exclusions, 18 studies met the inclusion criteria for qualitative analysis. Inclusion criteria involved study types (RCTs, RCCTs, case series), human participants, English language, and full-text available. The search yielded 153 publications, with 18 studies meeting the inclusion criteria for qualitative analysis. Notable findings include a high prevalence of DED in CD patients, ranging from 50 to 94.1%. Symmetrical and chronological defects, according to Aine's classification, were predominant, and significant associations were observed between CD severity and enamel defect extent. The early recognition of oral lesions, particularly through Aine's classification, may signal potential CD even in the absence of gastrointestinal symptoms. Correlations between CD and dental health conditions like molar incisor hypomineralization (MIH) emphasize the dentist's crucial role in early diagnosis. Collaboration between dentists and gastroenterologists is essential for effective monitoring and management. This review consolidates current knowledge, laying the groundwork for future research and promoting interdisciplinary collaboration for improved CD-related oral health outcomes. Further large-scale prospective research is recommended to deepen our understanding of these issues.

Coeliac disease and its implications on the oral health of children: A systematic review.

Apart from various typical gastrointestinal symptoms, coeliac disease may have its clinical manifestations in the oral cavity which is the entrance of the gastrointestinal tract. A systematic review of literature was performed using the following databases: Medline, Scopus, EBSCOhost and Cochrane Library for Systematic Review. observational or experimental original studies published in English with full text available between January 2000 and December 2022, regarding children and adolescents under the age of 20. Risk of bias was determined with the use of Risk Of Bias In Non-randomised Studies of Exposure. Thirty-four studies were included in the review. The analysis confirmed a higher prevalence of numerous oral manifestations in coeliac disease concerning both hard and soft tissues. Our study found the prevalence of dental enamel defects to be at the level of 17.9%-83.5% (P value <0.047) and recurrent aphthous stomatitis of 8.3%-69% (P value <0.039). Oral manifestations may precede gastrointestinal symptoms. Patients presenting such manifestations should be screened for coeliac disease. The cooperation of gastroenterologists and dentists could lead to an increased detectability of coeliac disease.

Oral health of cystic fibrosis patients at a north american center: A pilot study

BackgroundThe objective of this study was to describe the oral health status of Cystic Fibrosis (CF) children in a US facility.Material and MethodsTwenty CF children ages 6-18 were recruited from Children’s Hospital of Wisconsin Pulmonary Clinic. Parents completed a health questionnaire. Clinical examinations checked dental caries using the dmft/DMFT index, dental hygiene using the Simplified Greene-Vermillion Index (DI-S), gingival inflammation using the Community Periodontal Index of Treatment Needs, and enamel defects using the modified Developmental Defects of Enamel Index.ResultsThe majority (90%) brush twice a day, 65% consume sugary snacks, and 70% visit the dentist every 6 months. Clinically, they presented DMFT 0.25 and dmft 0.90, fair oral hygiene with DI-S 1.02, 75% had mild gingivitis and 50% had enamel defects. The more antibiotics they took, significantly more frequent (p=0.007) and more severe (p=0.017) enamel defects were noted. Similar trend was found between the number of surgeries and the presence of enamel defects (p=0.076) and dental caries (p=0.028).ConclusionsWithin the limitations of this study, CF patients were found to be at oral health risk due to the high prevalence of dental enamel defects. Oral health for CF children should be part of the multidisciplinary care. Key words:Cystic fibrosis, oral health, teeth, United States.

Prevalence of Dental Enamel Defects, Aphthous-Like Ulcers and Other Oral Manifestations in Celiac Children and Adolescents: A Comparative Study

Objectives: Celiac disease (CD) is an autoimmune disease with typical, atypical and asymptomatic forms, in which many oral manifestations have been recognized. This study aims to evaluate the prevalence of oral manifestations as well as explore if oral examination could be used as a first diagnostic screening tool for atypical or asymptomatic forms. Study Design: 45 CD patients, between 2 and 18 years (mean age 10.3) and 45 healthy subjects, age and gender-matched, were examined for hard and soft tissue lesions such as dental enamel defects (DED), dental caries, aphthous-like ulcers (ALU), atrophic glossitis, geographic tongue, median rhomboid glossitis. Results: Statistically significant differences between the two groups were observed for the prevalence of DED (in 64,4% CD and 24,46% control patients, p=0.001), their location in the teeth (incisal: p=0.0001, middle: p=0.002, cervical: p=0.007), as well as for the prevalence of ALU (in 40% CD as opposed to 4,44% control patients, p=0.001). Conclusion: The presence of DED and ALU could be used as a sign of alert for possible atypical and asymptomatic forms of CD.

A Comparison of the Prevalence of Dental Enamel Defects and Other Oral Findings in Children with and Without Celiac Disease

Background: Dental enamel defects and other oral manifestations are reported to occur more commonly in children with celiac disease (CD). Our aim was to investigate the frequency and distribution of enamel defects and dental caries, and the presence of other oral findings in children with CD and to compare them to a group of children without CD. Methods: From 200 index cases with CD, 65 cases aged between three to 16 years accepted to participated in the study after an oral explanation for the parents. In addition, 60 healthy, age, and sex matched subjects without CD were chosen as control group. Enamel defects were classified according to the Aine criteria and dental caries was recorded by calculation of DMFT/dmft indices. The presence of other oral findings, such as aphthous ulcers and xerostomia, were recorded. Chi-Square test and Mann-Whitney test were used for comparison of data. P values < 0.05 were considered statistically significant. Results: A total of 65 children with CD and 60 non-CD subjects were studied. There were significantly more enamel defects in children with CD compared to the control group (P = 0.01). Grade I was the most common enamel defect in both groups. Symmetric and non-specific enamel defects were observed in 45% and 14% of CD subjects and in 12% and 12% of the control group (P = 0.001). The location of enamel defects in permanent and deciduous teeth was more prominent in anterior teeth with a coronal distribution involving the incisor and middle parts of the teeth. The dmft index was significantly higher in the control group compared to the CD group (P = 0.003). With the exception of xerostomia, there was no difference in other oral manifestations between groups. Conclusions: Enamel defects are more common in children with CD compared to those without this disease. This finding should alert health care providers to consider testing for CD.

Prevalence of developmental defects of the enamel in primary dentition in a bogotan population

To determine in an area with systemic fluoridation, the prevalence of development of enamel defects in children's primary teeth between 4-6 years old from a public school in Bogota, Colombia. A simple random sample was conducted in 153 students, obtaining 62 healthy children, detailed dental clinical assesment were performed in them. The examiner was calibrated by an expert in the modified index of Dental Enamel Defects from the International Dental Federation obtaining a kappa inter-examiner and intra-examiner measures of 0.9 and 0.8, respectively. An informed consent and approval of the study by the Ethical Committee of the School of Dentistry at the Universidad Nacional de Colombia were obtained. The prevalence of dental enamel defects was 74.2 % (62.1 - 83.4) 95 % CI, distributed in: demarcated opacities 86.9 % (74.3-93.3) 95 % CI, diffuse opacities 76.1 % (62.4-85.7) 95 % CI and hypoplasia 2.2 % (0.4-11.1) 95 % CI. The most frequent combination of defects in an individual was demarcated and diffuse opacities. The most affected maxilla was the superior 54.6 % and the most compromised teeth were the second molar 56 %. The average teeth affected with dental enamel defects per individual was 4.7 ± SD 2.6. The high prevalence of dental enamel defects found, despite low severity, suggests more attention of the health authorities leading preventive programs. More studies should be done with standardized methodologies in order to estimate the overall prevalence of the defects.

Oral aspects in celiac disease children: clinical and dental enamel chemical evaluation

The aim of this study was to evaluate the oral manifestations of celiac disease (CD), the chemical composition of dental enamel, and the occurrence of CD in children with dental enamel defects (DEDs). In the study, 52 children with CD and 52 controls were examined for DEDs, recurrent aphthous stomatitis (RAS), dental caries experience, and salivary parameters. In addition, 10 exfoliated primary enamel molars from each group were analyzed by energy dispersive x-ray spectroscopy and Fourier transform infrared spectroscopy. Fifty children with DEDs were submitted to CD diagnosis. Among the children with CD, a higher prevalence of DEDs (P = .00001) and RAS (P = .0052), lower caries experience (P = .0024), and reduction of salivary flow (P = .0060) were observed. Dental enamel from the children with CD demonstrated a lower calcium-to-phosphorus ratio (P = .0136), but no difference in the carbonate-to-phosphate ratio (P = .5862) was observed. In the multivariate analysis, CD was a protective factor for caries (OR = 0.74) and a risk factor for RAS (OR3.23). The children with CD presented with more RAS, DEDs, reduction of salivary flow, and chemical alterations in the enamel.

Dental enamel defects in adult coeliac disease: Prevalence and correlation with symptoms and age at diagnosis

BackgroundCoeliac disease is a condition characterized by a wide spectrum of clinical manifestations. Any organ can be affected and, among others, dental enamel defects have been described. Our aims were to study the prevalence of dental enamel defects in adults with coeliac disease and to investigate a correlation between the grade of teeth lesion and clinical parameters present at the time of diagnosis of coeliac disease. MethodsA dental examination was performed in 54 coeliac disease patients (41 F, mean age 37±13years, mean age at diagnosis 31±14years). Symptoms leading to diagnosis were diarrhoea/weight loss (32 pts.), anaemia (19 pts.), familiarity (3 pts.); none of the patients was diagnosed because of enamel defects. At the time of evaluation, they were all on a gluten-free diet. Enamel defects were classified from grade 0 to 4 according to its severity. ResultsEnamel defects were observed in 46/54 patients (85.2%): grade 1 defects were seen in 18 patients (33.3%) grade 2 in 16 (29.6%), grade 3 in 8 (14.8%), and grade 4 in 4 (7.4%). We also observed that grades 3 and 4 were more frequent in patients diagnosed with classical rather than non-classical coeliac disease (10/32 vs. 2/20). However, this was not statistically significant. ConclusionThis study confirms that enamel defects are common in adult coeliac disease. Observation of enamel defects is an opportunity to diagnose coeliac disease.

Oral findings in children with celiac disease

Aim: To investigate whether Turkish children with celiac disease (CD) show dental enamel defects (DEDs), recurrent aphthous stomatitis (RAS), teeth missing, and xerostomia, and to compare the results with age- and sex-matched healthy children. Materials and methods: The oral cavity was explored in 81 patients with CD (mean age 8.7 ± 3.7 years; age range 2.5 to 17 years) and in 20 healthy controls. Enamel defects, teeth missing, RAS, and xerostomia were established. Results: Forty-three (53.1%) celiac patients and 5 (25%) control subjects had enamel defects. Enamel defects occurred more frequently in patients (P = 0.025) compared to controls. Regarding RAS, 39 (48.1%) patients and 1 (5%) control had aphthous ulcers (P = 0.0001). Teeth missing and xerostomia were detected in 11 (13.6%) and 47 (58%) patients, respectively. Patients with xerostomia were significantly greater in number compared to healthy children (P = 0.008). In the present study, the prevalence of DEDs, RAS, and xerostomia was greater in celiac patients than in healthy controls. Conclusion: Early recognition of children with specific DEDs, RAS, and xerostomia and thus their referral to pediatricians might help in early diagnosis of CD.

Oral Findings and Salivary Parameters in Children with Celiac Disease: A Preliminary Study

Objective: The aim of this study was to investigate the prevalence of dental enamel defects, recurrent aphthous stomatitis (RAS) and caries experience and to measure salivary flow rate, buffer capacity, saliva and plaque pH and salivary cariogenic microflora in patients with celiac disease (CD) compared to healthy subjects. Subjects and Methods: Thirty-five patients, aged 6-19 years, with a diagnosis of CD and 35 healthy children of the same age participated in the study. Enamel defects were diagnosed and classified using Aine's classification. The patients with RAS and dental caries were recorded using WHO criteria. The parents were interviewed about various oral health-related factors. Saliva samples were collected to measure the stimulated salivary flow rate, buffer capacity and pH values of saliva and plaque. Salivary mutans streptococci and lactobacilli were counted. Results: The enamel defects and RAS prevalence were statistically higher (40 and 37.1%, respectively) in the CD group, and the prevalence of salivary mutans streptococci (48 and 14%) and lactobacilli (51 and 34%) colonization was statistically lower (p = 0.012, p = 0.010) in the CD group; the DMFS and dfs values were similar in both groups. Conclusion: CD appeared to be associated with a significantly higher prevalence of developing enamel defects and RAS, but a lower prevalence of salivary mutans streptococci and lactobacilli colonization, and the diagnosis of these oral manifestations might be helpful for an early diagnosis of CD.

Implications of gluten exposure period, CD clinical forms, and HLA typing in the association between celiac disease and dental enamel defects in children. A case–control study

The association between coeliac disease (CD) and dental enamel defects (DED) is well known. The aim of this study was to investigate the prevalence of DED in children with CD and to specifically find the association of DED and gluten exposure period, CD clinical forms, HLA class II haplotype. This study was designed as a matched case-control study: 250 children were enrolled (125 coeliac children - 79 female and 46 male, 7.2 +/- 2.8 years and 125 healthy children). Data about age at CD diagnosis, CD clinical form, and HLA haplotype were recorded. Dental enamel defects were detected in 58 coeliac subjects (46.4%) against seven (5.6%) controls (P < 0.005). We found an association between DED and gluten exposure period, as among CD subjects the mean age at CD diagnosis was significantly (P = 0.0004) higher in the group with DED (3.41 +/- 1.27) than without DED (1.26 +/- 0.7). DED resulted more frequent (100%) in atypical and silent CD forms than in the typical one (30.93%). The presence of HLA DR 52-53 and DQ7antigens significantly increased the risk of DED (P = 0.0017) in coeliac children. Our results confirmed a possible correlation between HLA antigens and DED.

Prevalence of dental enamel defects in celiac patients with deciduous dentition: a pilot study

To describe the prevalence of unspecific and systematic enamel defects in children with deciduous dentition diagnosed with celiac disease compared with a control group. Thirty children (mean age 3.6 yrs) diagnosed with celiac disease and a reference group (n = 30; mean age 3.8 yrs) were studied to determine the prevalence of enamel defects. Both groups had complete deciduous dentition. Unspecific and systematic enamel defects were evaluated according to Aine criteria. Enamel defects were detected in 83.3% of the celiac children versus 53.3% of the control children (P = .025). The corresponding figures for symmetric defects were 73.3% and 23.3% (P < .001), respectively. The most frequent defect severity classification was Aine grade 1. Dental enamel defects were most frequently detected in deciduous molars (45.1%), followed by deciduous incisors. This study showed significantly more systematic enamel defects in children with celiac disease and deciduous dentition compared with a control group in the same stage of dentition. Dental examination of these defects may be useful to alert for this disease.