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Macedo L, Catarino M, Festas C, Alves P. Vulnerability in Children with Celiac Disease: Findings from a Scoping Review. CHILDREN (BASEL, SWITZERLAND) 2024; 11:729. [PMID: 38929308 PMCID: PMC11201835 DOI: 10.3390/children11060729] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/05/2024] [Revised: 06/08/2024] [Accepted: 06/10/2024] [Indexed: 06/28/2024]
Abstract
(1) Background: The scientific literature highlights that children diagnosed with celiac disease (CD) are at a heightened risk of experiencing physical, psychological, and social challenges, impacting their overall healthy childhood development. However, there remains a lack of a clear understanding regarding the factors that contribute to this vulnerability. The purpose of this study is to analyze and map the evidence on the sociopsychosomatic vulnerability of these children and identify gaps in this topic. (2) Methods: Following Joanna Briggs Institute's guidelines for scoping reviews, we executed a detailed search of key electronic databases and explored the grey literature to capture a broad spectrum of studies. Our focus was on identifying research that looked into the multiple dimensions of vulnerability-physical, psychological, and social-in children with CD. We included a diverse range of study designs as well as systematic reviews, ensuring a comprehensive analysis. The selection process was stringent, utilizing clearly defined inclusion and exclusion criteria. (3) Results: We identified 61 studies that met our inclusion criteria. The review highlighted significant adverse health outcomes in children with CD and elucidated various individual and environmental determinants that influenced these vulnerabilities. It also underscored the lack of assessment tools to evaluate the risk of health problems in this population. (4) Conclusions: The findings underscore a critical need for further research to deepen our understanding of the vulnerabilities associated with CD in children. Developing targeted assessment tools will be crucial in stratifying health risks and enhancing care strategies for this vulnerable population.
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Affiliation(s)
- Lúcia Macedo
- Âncora Community Care Unit, Gaia and Espinho Local Health Unit, 4430-037 Gaia, Portugal
- Institute of Health Sciences (ICS), Universidade Católica Portuguesa, 4169-005 Porto, Portugal; (C.F.); (P.A.)
- Center for Interdisciplinary Research in Health (CIIS), Institute of Health Sciences (ICS), Universidade Católica Portuguesa, 4169-005 Porto, Portugal;
| | - Marta Catarino
- Center for Interdisciplinary Research in Health (CIIS), Institute of Health Sciences (ICS), Universidade Católica Portuguesa, 4169-005 Porto, Portugal;
- Health Department, Polytechnic Institute of Beja, 7800-111 Beja, Portugal
- Institute of Health Sciences (ICS), Universidade Católica Portuguesa, 1649-023 Lisboa, Portugal
| | - Constança Festas
- Institute of Health Sciences (ICS), Universidade Católica Portuguesa, 4169-005 Porto, Portugal; (C.F.); (P.A.)
- Center for Interdisciplinary Research in Health (CIIS), Institute of Health Sciences (ICS), Universidade Católica Portuguesa, 4169-005 Porto, Portugal;
| | - Paulo Alves
- Institute of Health Sciences (ICS), Universidade Católica Portuguesa, 4169-005 Porto, Portugal; (C.F.); (P.A.)
- Center for Interdisciplinary Research in Health (CIIS), Institute of Health Sciences (ICS), Universidade Católica Portuguesa, 4169-005 Porto, Portugal;
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Winkler JR, Dixon BL, Singh I, Soto R, Qiu Y, Zhang Y, Porucznik CA, Stanford JB. Prenatal exposure to environmental toxins and comprehensive dental findings in a population cohort of children. BMC Oral Health 2024; 24:326. [PMID: 38468230 DOI: 10.1186/s12903-023-03786-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2022] [Accepted: 12/15/2023] [Indexed: 03/13/2024] Open
Abstract
Environmental toxins are known to have many impacts on growth and development in humans, starting in utero. Alterations in amelogenesis, caused by chemical and physical trauma that occur during the antenatal, perinatal and postnatal time periods, may result in developmental defects in deciduous and permanent tooth enamel, as demonstrated in animal studies. These defects can be clinically visible and result in a variety of morphological and functional problems in the dentition. Since enamel does not remodel after formation, it may serve as a permanent record of insults during organ development.Our primary purpose was to investigate any possible relationship between intrauterine exposure to endocrine disrupting chemicals (phenols and phthalates) and developmental defects in enamel in children, while also accounting for fluoride exposure. Our secondary purpose was to report descriptively on findings from comprehensive dental examinations performed on 356 children that were drawn from the general paediatric population. A cohort of children from the Utah Children's Project (N = 356) that had full medical exams, comprehensive medical and family histories and available biospecimens were given extraoral and intraoral examinations. They also completed an oral health questionnaire. Standardized intraoral photographs were taken of the teeth and viewed by standardised examiners and the dental observations were recorded for a full inventory of findings, including: tooth morphology, caries, restorations, colorations, attrition, erosion, fractures and hypomineralization. Perinatal maternal urine samples were assessed for the concentration of fluoride, phenols and phthalates, including bisphenol A (BPA).Pairwise statistical analyses were done to correlate the dental findings with one another and with the presence of environment chemicals found in the urine samples. Hypomineralization was the most common finding (96% of children; 37% of deciduous teeth, 42% of permanent teeth), consistent with molar incisor hypomineralization (MIH) described in other human populations. No consistent correlations were seen between dental findings and the presence of phenols and phthalates in prenatal urine, but the number of samples available for the assessment was limited (n = 35).In conclusion, we found a high proportion of dental hypomineralization in a population based paediatric cohort, but did not find an association with prenatal exposure to phenols and phthalates.
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Affiliation(s)
- James R Winkler
- School of Dentistry, University of Utah, Salt Lake City, UT, USA
| | - Barbara L Dixon
- School of Dentistry, University of Utah, Salt Lake City, UT, USA
| | - Ishita Singh
- Department of Pediatrics, University of Utah School of Medicine, Salt Lake City, UT, USA
| | - Ray Soto
- Division of Public Health, Department of Family and Preventive Medicine, University of Utah School of Medicine, 375 Chipeta Way, Suite A, Salt Lake City, UT, 84108, USA
| | - Yuqing Qiu
- Division of Epidemiology, Department of Internal Medicine, University of Utah School of Medicine, Salt Lake City, UT, USA
| | - Yue Zhang
- Division of Epidemiology, Department of Internal Medicine, University of Utah School of Medicine, Salt Lake City, UT, USA
| | - Christina A Porucznik
- Division of Public Health, Department of Family and Preventive Medicine, University of Utah School of Medicine, 375 Chipeta Way, Suite A, Salt Lake City, UT, 84108, USA
| | - Joseph B Stanford
- Division of Public Health, Department of Family and Preventive Medicine, University of Utah School of Medicine, 375 Chipeta Way, Suite A, Salt Lake City, UT, 84108, USA.
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Inchingolo AD, Dipalma G, Viapiano F, Netti A, Ferrara I, Ciocia AM, Mancini A, Di Venere D, Palermo A, Inchingolo AM, Inchingolo F. Celiac Disease-Related Enamel Defects: A Systematic Review. J Clin Med 2024; 13:1382. [PMID: 38592254 PMCID: PMC10932357 DOI: 10.3390/jcm13051382] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2024] [Revised: 02/22/2024] [Accepted: 02/25/2024] [Indexed: 04/10/2024] Open
Abstract
INTRODUCTION 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. MATERIALS AND METHODS 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. RESULTS 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. CONCLUSIONS 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.
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Affiliation(s)
- Alessio Danilo Inchingolo
- Department of Interdisciplinary Medicine, School of Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy; (A.D.I.); (G.D.); (F.V.); (A.N.); (I.F.); (A.M.C.); (A.M.); (D.D.V.); (A.M.I.)
| | - Gianna Dipalma
- Department of Interdisciplinary Medicine, School of Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy; (A.D.I.); (G.D.); (F.V.); (A.N.); (I.F.); (A.M.C.); (A.M.); (D.D.V.); (A.M.I.)
| | - Fabio Viapiano
- Department of Interdisciplinary Medicine, School of Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy; (A.D.I.); (G.D.); (F.V.); (A.N.); (I.F.); (A.M.C.); (A.M.); (D.D.V.); (A.M.I.)
| | - Anna Netti
- Department of Interdisciplinary Medicine, School of Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy; (A.D.I.); (G.D.); (F.V.); (A.N.); (I.F.); (A.M.C.); (A.M.); (D.D.V.); (A.M.I.)
| | - Irene Ferrara
- Department of Interdisciplinary Medicine, School of Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy; (A.D.I.); (G.D.); (F.V.); (A.N.); (I.F.); (A.M.C.); (A.M.); (D.D.V.); (A.M.I.)
| | - Anna Maria Ciocia
- Department of Interdisciplinary Medicine, School of Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy; (A.D.I.); (G.D.); (F.V.); (A.N.); (I.F.); (A.M.C.); (A.M.); (D.D.V.); (A.M.I.)
| | - Antonio Mancini
- Department of Interdisciplinary Medicine, School of Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy; (A.D.I.); (G.D.); (F.V.); (A.N.); (I.F.); (A.M.C.); (A.M.); (D.D.V.); (A.M.I.)
| | - Daniela Di Venere
- Department of Interdisciplinary Medicine, School of Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy; (A.D.I.); (G.D.); (F.V.); (A.N.); (I.F.); (A.M.C.); (A.M.); (D.D.V.); (A.M.I.)
| | - Andrea Palermo
- College of Medicine and Dentistry, Birmingham B4 6BN, UK;
| | - Angelo Michele Inchingolo
- Department of Interdisciplinary Medicine, School of Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy; (A.D.I.); (G.D.); (F.V.); (A.N.); (I.F.); (A.M.C.); (A.M.); (D.D.V.); (A.M.I.)
| | - Francesco Inchingolo
- Department of Interdisciplinary Medicine, School of Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy; (A.D.I.); (G.D.); (F.V.); (A.N.); (I.F.); (A.M.C.); (A.M.); (D.D.V.); (A.M.I.)
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Coelho M, Bernardo M, Mendes S. Oral Health-Related Quality of Life in Celiac Portuguese Children: a cross-sectional study. Eur Arch Paediatr Dent 2023; 24:759-767. [PMID: 37747657 PMCID: PMC10657324 DOI: 10.1007/s40368-023-00842-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Accepted: 09/02/2023] [Indexed: 09/26/2023]
Abstract
PURPOSE Celiac Disease (CD) presents a wide variety of clinical signs and symptoms, including oral manifestations. This study pretended to characterize Oral Health-Related Quality of Life (OHRQoL) and reported oral manifestations in children with CD. METHODS Target-population were children with CD. An online questionnaire, applied to children's parents, collected information about OHRQoL (using the Early Childhood Oral Health Impact Scale-ECOHIS), oral health behaviours, and history of oral manifestations. Data analysis included descriptive statistics, Mann-Whitney, Kruskall-Wallis, and Spearman correlation tests (α = 0.05). RESULTS The sample included 146 celiac patients, with a mean age of 10.5 years (sd = 4.1). Mean ECOHIS score was 5.2 (sd = 6.8). The most frequently reported oral manifestations were recurrent aphthous stomatitis (46.6%), dental caries (45.2%) and dental opacity (39%). About one third of the participants mentioned improvements in oral health when a gluten-free diet was introduced. Most of the reported oral manifestations had a significant association with the ECOHIS score (p < 0.05). CONCLUSIONS The OHRQoL of children was good, however oral manifestations had a negative impact on OHRQoL. The most reported oral manifestations were recurrent aphthous stomatitis, dental caries, and dental opacities. Oral health professionals must be aware about the heterogeneity of the disease, to recognize oral manifestations associated and their importance in the early diagnosis to reduce complications and to an improvement in the OHRQoL of these patients.
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Affiliation(s)
- M Coelho
- Unidade de Investigação em Ciências Orais e Biomédicas (UICOB), Faculdade de Medicina Dentária, Universidade de Lisboa, Rua Prof. Teresa Ambrósio, Cidade Universitária, 1600-277, Lisbon, Portugal
| | - M Bernardo
- Unidade de Investigação em Ciências Orais e Biomédicas (UICOB), Faculdade de Medicina Dentária, Universidade de Lisboa, Rua Prof. Teresa Ambrósio, Cidade Universitária, 1600-277, Lisbon, Portugal
| | - S Mendes
- Unidade de Investigação em Ciências Orais e Biomédicas (UICOB), Faculdade de Medicina Dentária, Universidade de Lisboa, Rua Prof. Teresa Ambrósio, Cidade Universitária, 1600-277, Lisbon, Portugal.
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Wieser H, Ciacci C, Gizzi C, Santonicola A. Otorhinolaryngological Manifestations and Esophageal Disorders in Celiac Disease: A Narrative Review. J Clin Med 2023; 12:7036. [PMID: 38002650 PMCID: PMC10672081 DOI: 10.3390/jcm12227036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2023] [Revised: 11/01/2023] [Accepted: 11/07/2023] [Indexed: 11/26/2023] Open
Abstract
Celiac disease (CeD) is a chronic gluten-sensitive immune-mediated enteropathy characterized by numerous intestinal and extra-intestinal signs and symptoms. Among extra-intestinal manifestations, otorhinolaryngological (ORL) complaints in CeD are relatively rare and their relation to CeD is frequently overlooked by physicians. Recent studies underlined that the prevalence of recurrent aphthous stomatitis, aphthous ulcers, geographic tongue, and xerostomia was significantly increased in CeD patients compared with healthy individuals. However, data about the other oral manifestations of CeD, such as atrophic glossitis, glossodynia, angular cheilitis, and salivary abnormalities, are scanty. Further ORL conditions associated with CeD include sensorineural hearing loss, nasal abnormalities, and obstructive sleep apnea. Moreover, several esophageal disorders such as gastroesophageal reflux disease and eosinophilic esophagitis have been associated with CeD. The pathophysiological link between both ORL and esophageal manifestations and CeD might be further investigated. In addition, also the role of gluten-free diet in improving these conditions is largely unclear. Certainly, otorhinolaryngologists can play an important role in identifying people with unrecognized CeD and may help prevent its long-term complications. The aim of this narrative review is to analyze the latest evidence on the association between CeD and ORL and esophageal manifestations.
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Affiliation(s)
- Herbert Wieser
- Hamburg School of Food Science, Institute of Food Chemistry, University of Hamburg, 20146 Hamburg, Germany;
| | - Carolina Ciacci
- Gastrointestinal Unit, Department of Medicine, Surgery and Dentistry “Scuola Medica Salernitana”, University of Salerno, 84131 Salerno, Italy; (C.G.); (A.S.)
| | - Carolina Gizzi
- Gastrointestinal Unit, Department of Medicine, Surgery and Dentistry “Scuola Medica Salernitana”, University of Salerno, 84131 Salerno, Italy; (C.G.); (A.S.)
| | - Antonella Santonicola
- Gastrointestinal Unit, Department of Medicine, Surgery and Dentistry “Scuola Medica Salernitana”, University of Salerno, 84131 Salerno, Italy; (C.G.); (A.S.)
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Turska-Szybka A, Dąbrowska E, Głogowska K, Janczewska A, Olczak-Kowalczyk D, Piekoszewska-Ziętek P. Coeliac disease and its implications on the oral health of children: A systematic review. J Paediatr Child Health 2023; 59:1105-1111. [PMID: 37712495 DOI: 10.1111/jpc.16494] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Revised: 08/15/2023] [Accepted: 09/03/2023] [Indexed: 09/16/2023]
Abstract
AIM 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. METHODS A systematic review of literature was performed using the following databases: Medline, Scopus, EBSCOhost and Cochrane Library for Systematic Review. INCLUSION CRITERIA 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. RESULTS 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). CONCLUSION 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.
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Affiliation(s)
- Anna Turska-Szybka
- Department of Paediatric Dentistry, Faculty of Dental Medicine, Medical University of Warsaw, Warsaw, Poland
| | - Ewelina Dąbrowska
- Students' Scientific Group by Department of Paediatric Dentistry, Faculty of Dental Medicine, Medical University of Warsaw, Warsaw, Poland
| | - Karen Głogowska
- Students' Scientific Group by Department of Paediatric Dentistry, Faculty of Dental Medicine, Medical University of Warsaw, Warsaw, Poland
| | - Anna Janczewska
- Students' Scientific Group by Department of Paediatric Dentistry, Faculty of Dental Medicine, Medical University of Warsaw, Warsaw, Poland
| | - Dorota Olczak-Kowalczyk
- Department of Paediatric Dentistry, Faculty of Dental Medicine, Medical University of Warsaw, Warsaw, Poland
| | - Paula Piekoszewska-Ziętek
- Department of Paediatric Dentistry, Faculty of Dental Medicine, Medical University of Warsaw, Warsaw, Poland
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Lucchese A, Di Stasio D, De Stefano S, Nardone M, Carinci F. Beyond the Gut: A Systematic Review of Oral Manifestations in Celiac Disease. J Clin Med 2023; 12:3874. [PMID: 37373569 DOI: 10.3390/jcm12123874] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Revised: 05/30/2023] [Accepted: 06/03/2023] [Indexed: 06/29/2023] Open
Abstract
BACKGROUND Celiac disease (CD) is a chronic immune-mediated gluten-sensitive enteropathy, affecting about 1% of the population. The most common symptoms include diarrhea, abdominal pain, weight loss, and malabsorption. Extra-intestinal symptoms include oral manifestations. This systematic review aims to catalog and characterize oral manifestations in patients with CD. METHODS a systematic literature review among different search engines using PICOS criteria has been performed. The studies included used the following criteria: tissues and anatomical structures of the oral cavity in humans, published in English and available in full text. Review articles and papers published before 1990 were excluded. RESULTS 209 articles were identified in the initial search. In the end, 33 articles met the selection criteria. The information extracted from the articles was classified based on the type of oral manifestation. Recurrent aphthous stomatitis (34.6%), atrophic glossitis and geographic tongue (15.26%), enamel defects (42.47%), delayed dental eruption (47.34%), xerostomia (38.05%), glossodynia (14.38%), and other manifestations including cheilitis, fissured tongue, periodontal diseases, and oral lichen planus were found in the celiac subjects of the studies analyzed. The quality of articles on the topic should be improved; however, oral manifestations in CD patients are widely described in the literature and could help diagnose celiac disease.
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Affiliation(s)
- Alberta Lucchese
- Multidisciplinary Department of Medical-Surgical and Dental Specialties, University of Campania "Luigi Vanvitelli", 80138 Naples, Italy
| | - Dario Di Stasio
- Multidisciplinary Department of Medical-Surgical and Dental Specialties, University of Campania "Luigi Vanvitelli", 80138 Naples, Italy
| | | | - Michele Nardone
- Asst Melegnano Martesana, Regione Lombardia, Adda District, 20077 Vizzolo Predabissi, Italy
| | - Francesco Carinci
- Department of Translational Medicine, University of Ferrara, 44121 Ferrara, Italy
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Bulut M, Tokuc M, Aydin MN, Ayyildiz Civan H, Polat E, Dogan G, Altuntas C, Bayrak NA, Beser OF. Nutrition and oral health in children with recently and previously diagnosed celiac disease. Clin Oral Investig 2023:10.1007/s00784-023-04971-x. [PMID: 36961593 DOI: 10.1007/s00784-023-04971-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2022] [Accepted: 03/19/2023] [Indexed: 03/25/2023]
Abstract
OBJECTIVES To evaluate the nutritional and oral health status of children with previously diagnosed celiac disease (CD) who follow a gluten-free diet and recently diagnosed CD patients. MATERIALS AND METHODS Previously and recently diagnosed groups were formed from children with CD, aged 4 to 15 years. A questionnaire was completed about the children's dental history and nutritional and oral hygiene habits. All the children underwent an oral examination, and dmft-DMFT indices were determined. Dental plaque status, periodontal health, and dental enamel defects were recorded. Oral soft tissues were examined for the presence of lesions. Unstimulated salivary flow rate and pH value were evaluated. RESULTS A statistically significant difference was determined between the previously and recently diagnosed patients in terms of toothpaste preference (p=0.003), frequency of going to the dentist (p=0.039), and the types of dental treatment they had received (p=0.001). A statistically significant difference was determined between the previously and recently diagnosed patient groups in terms of dmft values (p=0.005). CONCLUSIONS Children with CD should be directed to a pediatric dentist to improve oral and dental health, relieve the symptoms of oral mucosal lesions, be informed about enamel defects, and be encouraged to use gluten-free oral care products. CLINICAL RELEVANCE The collaboration of pediatric gastroenterologists and pediatric dentists can prevent the progression of oral symptoms in children with CD and eliminate long-term complications in terms of both oral health and multisystemic problems.
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Affiliation(s)
- M Bulut
- Department of Pediatric Dentistry, Faculty of Dentistry, Istanbul Okan University, Istanbul, Türkiye.
| | - M Tokuc
- Department of Pediatric Dentistry, Faculty of Dentistry, Istanbul Okan University, Istanbul, Türkiye
| | - M N Aydin
- Department of Pediatric Dentistry, Faculty of Dentistry, Istanbul Okan University, Istanbul, Türkiye
| | - H Ayyildiz Civan
- Pediatric Gastroenterology, Hepatology and Nutrition, I.A.U. VM Medical Park Hospital Florya, Istanbul, Türkiye
| | - E Polat
- Pediatric Gastroenterology, Hepatology and Nutrition, Sancaktepe Sehit Prof Dr Ilhan Varank Training & Research Hospital, University of Health Sciences, Istanbul, Türkiye
| | - G Dogan
- Department of Pediatric Gastroenterology, Hepatology and Nutrition, Bezmialem Vakif University Faculty of Medicine, Istanbul, Türkiye
| | - C Altuntas
- Department of Pediatric Gastroenterology, Hepatology and Nutrition, Istinye University Faculty of Medicine, Istanbul, Türkiye
| | - N A Bayrak
- Pediatric Gastroenterology, Hepatology and Nutrition, Zeynep Kamil Women & Children's Training & Research Hospital, University of Health Sciences, Istanbul, Türkiye
| | - O F Beser
- Department of Paediatric Gastroenterology, Hepatology and Nutrition, Cerrahpasa Medical Faculty, Istanbul University-Cerrahpasa, Istanbul, Türkiye
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Liu J, Lundemann AKJ, Reibel J, Pedersen AML. Salivary gland involvement and oral health in patients with coeliac disease. Eur J Oral Sci 2022; 130:e12861. [PMID: 35247226 PMCID: PMC9314853 DOI: 10.1111/eos.12861] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2021] [Accepted: 02/15/2022] [Indexed: 01/25/2023]
Abstract
Coeliac disease (CD) is a chronic immune‐mediated enteropathy triggered by ingestion of gluten. The aim of this study was to investigate if the salivary glands as a component of the mucosal immune system are involved in CD, leading to sialadenitis and salivary gland dysfunction and associated oral manifestations. Twenty patients with CD aged 49.2 (SD 15.5 years) and 20 age‐ and gender‐matched healthy controls underwent an interview regarding general and oral health, serological analysis, a clinical oral examination including bitewing radiographs, Candida smear, assessment of salivary mutans streptococci and lactobacilli levels, unstimulated and chewing‐stimulated whole and parotid saliva flow rates, analysis of secretory IgA, and a labial salivary gland biopsy. Xerostomia, mucosal lesions, dry/cracked lips and focal lymphocytic sialadenitis were more prevalent and extensive in patients with CD than in healthy controls. Moreover, the patients had less gingival inflammation and higher whole saliva flow rates than the healthy controls, but did not differ regarding dental health and levels of cariogenic bacteria and Candida. The major salivary gland function appears unaffected, contributing to maintenance of a balanced microbiota and oral health in CD patients. Xerostomia and labial dryness may be related to minor salivary gland inflammation and subsequent impaired mucosal lubrication.
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Affiliation(s)
- Jason Liu
- Section for Oral Medicine/Oral Biology and Immunopathology, Department of Odontology, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Ann-Kristine Juncker Lundemann
- Section for Oral Medicine/Oral Biology and Immunopathology, Department of Odontology, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Jesper Reibel
- Section for Oral Medicine/Oral Biology and Immunopathology, Department of Odontology, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Anne Marie Lynge Pedersen
- Section for Oral Medicine/Oral Biology and Immunopathology, Department of Odontology, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
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Alsadat FA, Alamoudi NM, El-Housseiny AA, Felemban OM, Dardeer FM, Saadah OI. Oral and dental manifestations of celiac disease in children: a case-control study. BMC Oral Health 2021; 21:669. [PMID: 34965875 PMCID: PMC8715621 DOI: 10.1186/s12903-021-01976-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2021] [Accepted: 11/16/2021] [Indexed: 02/03/2023] Open
Abstract
Background Celiac disease (CD) is an immune-mediated enteropathy. CD may also involve complications with the oral cavity, which can result in various dental and oral pathologies. There are currently a limited number of studies on the oral manifestation of CD. This study aims to compare the oral manifestations of children with CD against healthy controls in Saudi Arabia.
Materials and methods This study includes 208 children aged 6–14 years, distributed equally into CD patients and healthy controls. A parent completed and validated the interview questionnaire, which included the child's personal information and medical history. A dental examination was undertaken to measure possible recurrent aphthous stomatitis (RAS), dental enamel defects (DEDs), dental caries experience, and dental malocclusion. Data were analyzed using descriptive statistics and bivariate and multivariate analysis. Results Two hundred and eight participants were included (104 CD patients and 104 controls). The mean age for CD patients was 10.67 ± 2.39 years and 10.69 ± 2.36 for the healthy controls. CD children had more RAS than controls (42.3% vs. 15.4%, P < 0.001) (OR = 4.03, 95% CI = 2.09–7.81) and more DEDs than healthy controls (70.2% vs. 34.6%, P < 0.001) (OR = 4.45, 95% CI = 2.48–7.97). No significant difference was found in the frequency of malocclusion between cases and controls. Conclusion Saudi Arabian children with CD had a greater number of clinical findings of RAS and DEDs than healthy controls. Pediatric dentists should consider the possibility of CD in child patients presenting with RAS or DEDs.
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Affiliation(s)
- Farah A Alsadat
- Dental Department, Jubail General Hospital, Ministry of Health, P.O. Box 1275, Al Jubail, 31951, Saudi Arabia.
| | - Najlaa M Alamoudi
- Pediatric Dentistry Department, Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Azza A El-Housseiny
- Pediatric Dentistry Department, Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia.,Pediatric Dentistry Department, Faculty of Dentistry, Alexandria University, Alexandria, Egypt
| | - Osama M Felemban
- Pediatric Dentistry Department, Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Faisal M Dardeer
- Pediatric Dentistry Department, Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Omar I Saadah
- Department of Pediatrics, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia.,Pediatric Gastroenterology Unit, Department of Pediatrics, King Abdulaziz University Hospital, Jeddah, Saudi Arabia
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11
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General Health, Systemic Diseases and Oral Status in Adult Patients with Coeliac Disease. Nutrients 2020; 12:nu12123836. [PMID: 33334061 PMCID: PMC7765540 DOI: 10.3390/nu12123836] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2020] [Revised: 12/07/2020] [Accepted: 12/14/2020] [Indexed: 12/23/2022] Open
Abstract
The prevalence of coeliac disease in the general population is 0.5–1%; however, most patients remain undiagnosed until adult age. In some cases, the onset is represented by sub-clinical signs, some of which can be found in the mouth. The aim of this research was to identify any associations between the clinical characteristics of coeliac disease and oral manifestations. A structured questionnaire was administered to a group of 237 individuals with coeliac disease. 100% of the subjects fully completed the questionnaire. Among them, 182 (76.7%) were female, 64 patients (27%) were aged 15 to 24 years, 159 (67%) were aged 25 to 55 and 14 (6%) were aged 56 and over. Significant associations were observed in caries prevalence and dentin sensitivity; in addition, an inappropriate diet was related to oral manifestations; following a gluten-free diet could be important to control the gingival bleeding levels and to manage oral symptoms associated to coeliac disease. In general, the presence of inflammatory symptoms in the mouth seems to be associated with general symptoms of inflammation related to coeliac disease.
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12
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Kuklik HH, Cruz ITSA, Celli A, Fraiz FC, AssunÇÃo LRDS. MOLAR INCISOR HYPOMINERALIZATION AND CELIAC DISEASE. ARQUIVOS DE GASTROENTEROLOGIA 2020; 57:167-171. [PMID: 32490904 DOI: 10.1590/s0004-2803.202000000-31] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/12/2019] [Accepted: 02/06/2020] [Indexed: 11/22/2022]
Abstract
BACKGROUND Molar incisor hypomineralization (MIH) is a developmental enamel defect with multifactorial etiology. Although the relationship between celiac disease (CD) and developmental enamel defect was demonstrated, the association between CD and MIH is uncertain. OBJECTIVE The objective of this study was to analyze the occurrence of MIH in CD patients. METHODS Forty CD patients and a control group with 40 healthy individuals were selected. A calibrated examiner (k≥0.889) according to the European Academy of Pediatric Dentistry criteria performed the diagnosis of MIH. Data were analyzed by descriptive statistics and Fischer's exact test (α=0.05). RESULTS Of the 80 participants, ten presented MIH with eight individuals with CD. Celiac patients presented 4.75 times the chance of occurrence of MIH than the control group (95% CI: 2.22-10.18; P=0.044). In all the evaluated teeth (n=978), 22 had MIH: 20 teeth in individuals with CD and two in those without the disease. All CD participants with MIH presented the classic form of the disease. CD participants showed 17 teeth (85.0%) with demarcated opacities, two (10.0%) post-eruptive collapses and one (5.0%) atypical restoration. The control group presented only demarcated opacities. CONCLUSION CD increased the chance of MIH and associated with its clinical manifestations can assist in the diagnosis of CD.
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Affiliation(s)
| | | | - Adriane Celli
- Universidade Federal do Paraná, Curitiba, PR, Brasil
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13
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Khalaf ME, Akbar A, Alkhubaizi Q, Qudeimat M. Caries among adult patients with controlled celiac disease: A cross-sectional study. SPECIAL CARE IN DENTISTRY 2020; 40:457-463. [PMID: 32583903 DOI: 10.1111/scd.12491] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2020] [Revised: 06/01/2020] [Accepted: 06/05/2020] [Indexed: 12/01/2022]
Abstract
INTRODUCTION Celiac disease (CD) is one of the most common chronic gastrointestinal disorders in the world. Currently, the literature about the dental profiles of patients with celiac disease is sparse and no studies have reported on the oral conditions and caries status of CD patients in Kuwait. OBJECTIVE This study investigated the association between CD and caries experience. METHODS Two groups were examined; study and control. The study group consisted of controlled celiac disease patients. The control group consisted of subjects who were matched for age and gender to the study group participants. Both groups received clinical and radiographic examinations of their oral cavity. Parameters recorded for the study purposes were-dental caries index (decayed, missing, and filled teeth), salivary flow rates (stimulated and unstimulated), salivary buffering capacity and Lactobacilli and mutans Streptococci bacterial counts. RESULTS Patients with CD had statistically significant fewer missing teeth than the controls. There were no other significant differences. Measured stimulated and unstimulated salivary flow rates and salivary buffering capacity showed no statistical differences. Bacterial counts revealed no significant differences. CONCLUSION Adult patients with controlled CD showed fewer missing teeth than their counterparts. Other caries and salivary parameters showed no statistical differences between the two groups.
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Affiliation(s)
- Mai E Khalaf
- Faculty of Dentistry, Health Sciences Center, Faculty of Dentistry, Health Sciences Center, Kuwait University, Jabriya, Kuwait
| | - Aqdar Akbar
- Faculty of Dentistry, Health Sciences Center, Faculty of Dentistry, Health Sciences Center, Kuwait University, Jabriya, Kuwait
| | - Qoot Alkhubaizi
- Faculty of Dentistry, Health Sciences Center, Faculty of Dentistry, Health Sciences Center, Kuwait University, Jabriya, Kuwait
| | - Muawia Qudeimat
- Faculty of Dentistry, Health Sciences Center, Faculty of Dentistry, Health Sciences Center, Kuwait University, Jabriya, Kuwait
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14
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The difference in symmetry of the enamel defects in celiac disease versus non-celiac pediatric population. J Dent Sci 2020; 15:345-350. [PMID: 32952893 PMCID: PMC7486505 DOI: 10.1016/j.jds.2020.02.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2019] [Revised: 02/15/2020] [Indexed: 12/27/2022] Open
Abstract
Background/purpose Dental enamel defects are related to celiac disease and the dentists are in a perfect situation to identify and report suspected cases. The aim was to evaluate the symmetry of enamel defects in a pediatric Portuguese population with celiac disease and compare it with healthy controls. Materials and methods a case-control study was performed in 80 patients with celiac disease and 80 healthy individuals aged 6-18 years old as controls. Data was collected by a questionnaire and clinical observation. Colour, type, and site of enamel defects were recorded and classified according to Aine criteria. Data analysis was performed, and any p-value <0.05 was considered significant. Results Enamel defects were found in 55% of patients with celiac disease and 27.5% in the control individuals (p < 0.001). Grade I of Aine's classification was the most found in both groups, but it was higher in the celiac disease group, not only in the permanent dentition, but also in both dentitions with statistically significant difference (p = 0.002 and p = 0.001 respectively). Grade II was found only in the celiac disease group. It was observed that enamel defects in celiac disease were symmetric and the most affected teeth were the first permanent molars (p = 0.003) and the permanent incisors (p = 0.001). Conclusion Symmetric dental enamel defects in population with celiac disease are more predominant than in general population. Therefore, individuals with enamel defects, especially those with symmetric lesions, should be well evaluated and the possibility of having celiac disease in the clinical history must be taken into account.
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15
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Petronijevic S, Stig S, Halstensen TS. Epitope mapping of anti‐amelogenin IgA in coeliac disease. Eur J Oral Sci 2020; 128:27-36. [DOI: 10.1111/eos.12672] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/24/2019] [Indexed: 12/13/2022]
Affiliation(s)
- Sanja Petronijevic
- Institute of Oral Biology Faculty of Dentistry University of Oslo Oslo Norway
| | - Solveig Stig
- Institute of Oral Biology Faculty of Dentistry University of Oslo Oslo Norway
| | - Trond S. Halstensen
- Institute of Oral Biology Faculty of Dentistry University of Oslo Oslo Norway
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Oral Manifestations of Celiac Disease. SERBIAN JOURNAL OF EXPERIMENTAL AND CLINICAL RESEARCH 2019. [DOI: 10.2478/sjecr-2019-0009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Abstract
Celiac disease (CD) is chronic inflammatory disease of the proximal small intestine. It is caused by hypersensitivity to gluten proteins, rays and barley, which damage the intestinal mucous membrane, creating conditions for malabsorption. In addition to intestinal, classic forms of the disease, extraintestinal manifestations may occur. Aphthae in the oral cavity, defects of the enamel, caries, delayed tooth erupting, atrophic glossitis and angular cheilitis are some of them. Serological examination of patients with minimal symptoms and in patients with extraintestinal and atypical gastrointestinal symptoms would improve the timely diagnosis. By careful dental examination of the cavity with a special focus on these changes, we can contribute to early diagnosis of the CD. The education of patients about oral manifestations of CD can improve the quality of life of these patients.
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17
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da Fonseca MA. Oral and Dental Care of Local and Systemic Diseases. Pediatr Dent 2019. [DOI: 10.1016/b978-0-323-60826-8.00004-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
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18
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Cruz ITSA, Fraiz FC, Celli A, Amenabar JM, Assunção LRS. Dental and oral manifestations of celiac disease. Med Oral Patol Oral Cir Bucal 2018; 23:e639-e645. [PMID: 30341262 PMCID: PMC6260995 DOI: 10.4317/medoral.22506] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2018] [Accepted: 09/04/2018] [Indexed: 01/28/2023] Open
Abstract
Background The objective of this study was to evaluate the dental and oral manifestations in patients with celiac disease. Material and Methods The 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). Conclusions CD 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.
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Affiliation(s)
- I-T-S-A Cruz
- Department of Stomatology, Universidade Federal do Paraná, Avenida Prefeito Lothário Meissner 632, Curitiba, Paraná, Brazil. Zip code: 80210-170,
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Bhattarai KR, Junjappa R, Handigund M, Kim HR, Chae HJ. The imprint of salivary secretion in autoimmune disorders and related pathological conditions. Autoimmun Rev 2018; 17:376-390. [DOI: 10.1016/j.autrev.2017.11.031] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2017] [Accepted: 11/16/2017] [Indexed: 12/11/2022]
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OLIVEIRA GN, MOHAN R, FAGBEMI A. REVIEW OF CELIAC DISEASE PRESENTATION IN A PEDIATRIC TERTIARY CENTRE. ARQUIVOS DE GASTROENTEROLOGIA 2018; 55:86-93. [DOI: 10.1590/s0004-2803.201800000-17] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/10/2017] [Accepted: 10/09/2017] [Indexed: 12/11/2022]
Abstract
ABSTRACT BACKGROUND: Celiac disease is an immune-mediated disorder with a multiform presentation and therefore a challenging diagnosis. OBJECTIVE: Our purpose is to identify the epidemiological, clinical, laboratory and histologic characteristics of children with celiac disease at diagnosis and on follow-up. METHODS: Children with previously established or newly diagnosed celiac disease, admitted in a tertiary centre in a two-year period (2014-2016) were recruited. Data was collected retrospectively from electronic medical records and clinical notes, and subsequently analysed with SPSS version 20.0. RESULTS: A total of 159 patients, out of 312, were included. Age ranged from 1 to 17 years (mean ± SD: 8.5±4.5 years, 69% girls). Disease presentation was classical in 60%, non-classical in 25%, subclinical in 10% and 5% classified as potential celiac disease. Non-classical and subclinical profiles had a higher mean age at presentation but not statistically significant (P-value 0.24). The most frequent gastrointestinal features at presentation were abdominal pain (58%), diarrhea (43%) and bloating (27%). A positive family history for celiac disease was present in 24% (n=35). We found anaemia in 23%, low ferritin in 63% and a moderate to severe deficiency of 25-hydroxyvitamin D in 62%. celiac disease -specific serologic testing and esophagogastroduodenoscopy were performed in 99%. Histology revealed modified Marsh 2 or 3 enteropathy in 94%, the remaining had normal histology but positive human leukocyte antigen typing. Clinical improvement at 12 months of gluten-free diet was complete in 51% and partial in 49%. IgA tTG normalized after 12-30 months of gluten-free diet in 45%. On growth assessment at diagnosis and after 12-28 months of gluten-free diet, 100% had height increase (mean ±SD: 7.11±4.43 cm) and 96% weight gain (mean ±SD: 5.60±4.91 kg). CONCLUSION: Our findings outline the diverse clinical presentations of pediatric celiac disease that should be considered irrespective of age. Increased clinician’s awareness will enable an early diagnosis and treatment, with subsequent symptom and nutritional status improvement.
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Affiliation(s)
| | - Rajiv MOHAN
- Royal Manchester Children’s Hospital, United Kingdom
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21
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Souto-Souza D, da Consolação Soares ME, Rezende VS, de Lacerda Dantas PC, Galvão EL, Falci SGM. Association between developmental defects of enamel and celiac disease: A meta-analysis. Arch Oral Biol 2017; 87:180-190. [PMID: 29306074 DOI: 10.1016/j.archoralbio.2017.12.025] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2017] [Revised: 12/19/2017] [Accepted: 12/23/2017] [Indexed: 12/14/2022]
Abstract
OBJECTIVES Studies have observed the presence of extra-intestinal manifestations of celiac disease (CD), including involvement of the oral cavity, such that developmental defects of enamel (DDE) occur. Thus, the aim of this review was to access the polled prevalence of DDE in individuals with CD, and to establish the strength of the association between these two variables. METHODS To carry out the systematic review, four electronic databases and the Grey Literature were searched, complemented by a manual search of reference lists within the selected articles. Two pairs of independent reviewers selected the articles, and perform the data extractions and bias risk assessment Studies evaluating the presence of DDE in individuals with CD as well as in healthy individuals and which performed the DDE diagnosis by direct visualization of tooth enamel changes and the CD diagnosis were included. Meta-analyses were performed using the software R. RESULTS Of 557 studies, 45 were selected for review, encompassing 2840 patients. The prevalence of DDE in people with CD was 50% (95% CI 0.44-0.57, I2 = 88%). In a general analysis, it was observed that patients with CD had a significantly higher prevalence of enamel defects compared to healthy people (RR: 2.31, 95% CI: 1.71-3.12, I2 = 98%). Only developmental defects of enamel diagnosed using Aine's method were associated with the disease (RR: 3.30, 95% CI 2.39-4.56, I2 = 75%). In a sensitivity analysis involving the deciduous, mixed and permanent dentitions, only individuals with deciduous dentition were observed to have association with the disease (RR: 2.34, 95% CI 1.25-4.39, I2 = 39%). CONCLUSIONS Patients with enamel developmental defects should be screened for the possibility of their having celiac disease.
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Affiliation(s)
- Débora Souto-Souza
- Department of Pediatric Dentistry, Federal University of the Jequitinhonha and Mucuri Valleys, Diamantina, Minas Gerais, Brazil
| | | | - Vanessa Silva Rezende
- Department of Pediatric Dentistry, Federal University of the Jequitinhonha and Mucuri Valleys, Diamantina, Minas Gerais, Brazil
| | - Paulo César de Lacerda Dantas
- Department of Oral and Maxillofacial Surgery, Federal University of the Jequitinhonha and Mucuri Valleys, Diamantina, Minas Gerais, Brazil
| | - Endi Lanza Galvão
- Clinical Research and Public Policy in Infectious and Parasitic Diseases, Centro de Pesquisas René Rachou, Fundação Oswaldo Cruz, Fiocruz, Belo Horizonte, Minas Gerais, Brazil
| | - Saulo Gabriel Moreira Falci
- Department of Oral and Maxillofacial Surgery, Federal University of the Jequitinhonha and Mucuri Valleys, Diamantina, Minas Gerais, Brazil.
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Amato M, Zingone F, Caggiano M, Iovino P, Bucci C, Ciacci C. Tooth Wear Is Frequent in Adult Patients with Celiac Disease. Nutrients 2017; 9:nu9121321. [PMID: 29207559 PMCID: PMC5748771 DOI: 10.3390/nu9121321] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2017] [Revised: 11/29/2017] [Accepted: 11/30/2017] [Indexed: 02/07/2023] Open
Abstract
(1) Background: Celiac disease (CD) patients can be affected by mouth and tooth disorders, which are influenced by their gluten-free diet. The aim of our research was to evaluate the pathological conditions of the stomatognathic system observed in celiac patients on a gluten-free diet. (2) Methods: we consecutively recruited celiac patients on a gluten-free diet at our celiac center, as well as healthy volunteers. Two dentists examined all patients/controls and checked them for any mouth disorder. (3) Results: Forty-nine patients affected by celiac disease (age at test 31.8 ± 11.58, time on GFD 8.73 ± 7.7) and 51 healthy volunteers (age at test 30.5 ± 8.7) were included. Recurrent aphthous stomatitis was reported in 26 patients (53.0%) and in 13 (25.5%) controls (p = 0.005). Dental enamel disorders were reported in 7 patients (14.3%) and in 0 controls (p = 0.002), with none having geographic tongue. We found non-specific tooth wear, characterized by loss of the mineralized tissue of the teeth, in 9 patients (18.3%) and in 3 (5.9%) controls (p = 0.05). (4) Conclusion: Recurrent aphthous stomatitis and enamel hypoplasia are "risk indicators" that may suggest that an individual has CD. We detected a high prevalence of non-specific tooth wear that can be caused by several factors such as malocclusion, sleep bruxism, parafunctional activity, and age.
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Affiliation(s)
- Massimo Amato
- Department of Medicine, Surgery and Dentistry, Medical School of Salerno, 84131 Salerno, Italy.
| | - Fabiana Zingone
- Department of Medicine, Surgery and Dentistry, Medical School of Salerno, 84131 Salerno, Italy.
| | - Mario Caggiano
- Department of Medicine, Surgery and Dentistry, Medical School of Salerno, 84131 Salerno, Italy.
| | - Paola Iovino
- Department of Medicine, Surgery and Dentistry, Medical School of Salerno, 84131 Salerno, Italy.
| | - Cristina Bucci
- Department of Medicine, Surgery and Dentistry, Medical School of Salerno, 84131 Salerno, Italy.
| | - Carolina Ciacci
- Department of Medicine, Surgery and Dentistry, Medical School of Salerno, 84131 Salerno, Italy.
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Macho VMP, Coelho AS, Veloso E Silva DM, de Andrade DJC. Oral Manifestations in Pediatric Patients with Coeliac Disease - A Review Article. Open Dent J 2017; 11:539-545. [PMID: 29238414 PMCID: PMC5712645 DOI: 10.2174/1874210601711010539] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2017] [Revised: 08/29/2017] [Accepted: 09/19/2017] [Indexed: 12/26/2022] Open
Abstract
Background: Coeliac disease is a chronic enteropathy that remains a challenge for the clinician, due to its atypical manifestations and etiopathogenic complexity. Objective: This article intends to describe the oral characteristics of Coeliac Disease in children in order to facilitate their management in the dental office. Methods: A review of the literature was performed electronically in PubMed (PubMed Central, and MEDLINE) for articles published in English from 2000 to April of 2017. The article is also based on the authors' clinical experience with children with coeliac disease. The searched keywords were “coeliac disease “,”oral manifestations “, “dental enamel defects”, “recurrent aphthous stomatitis” and “oral aphthous ulcers”. Results: There are some oral manifestations which are strictly related to coeliac disease: dental enamel defects, recurrent aphthous stomatitis, delayed tooth eruption, multiple caries, angular cheilitis, atrophic glossitis, dry mouth and burning tongue. Conclusion: The complete knowledge of the oral manifestations of coeliac disease can trigger an effective change in the quality of life of the patients with this disease.
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Nieri M, Tofani E, Defraia E, Giuntini V, Franchi L. Enamel defects and aphthous stomatitis in celiac and healthy subjects: Systematic review and meta-analysis of controlled studies. J Dent 2017; 65:1-10. [DOI: 10.1016/j.jdent.2017.07.001] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2017] [Revised: 06/22/2017] [Accepted: 07/01/2017] [Indexed: 12/14/2022] Open
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de Queiroz AM, Arid J, de Carvalho FK, da Silva RAB, Küchler EC, Sawamura R, da Silva LAB, Nelson-Filho P. Assessing the proposed association between DED and gluten-free diet introduction in celiac children. SPECIAL CARE IN DENTISTRY 2017; 37:194-198. [DOI: 10.1111/scd.12227] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Affiliation(s)
- Alexandra Mussolino de Queiroz
- Department of Pediatric Dentistry; University of São Paulo - School of Dentistry of Ribeirão Preto; Ribeirão Preto SP Brazil
| | - Juliana Arid
- Department of Pediatric Dentistry; University of São Paulo - School of Dentistry of Ribeirão Preto; Ribeirão Preto SP Brazil
| | - Fabrício Kitazono de Carvalho
- Department of Pediatric Dentistry; University of São Paulo - School of Dentistry of Ribeirão Preto; Ribeirão Preto SP Brazil
| | - Raquel Assed Bezerra da Silva
- Department of Pediatric Dentistry; University of São Paulo - School of Dentistry of Ribeirão Preto; Ribeirão Preto SP Brazil
| | - Erika Calvano Küchler
- Department of Pediatric Dentistry; University of São Paulo - School of Dentistry of Ribeirão Preto; Ribeirão Preto SP Brazil
| | - Regina Sawamura
- Department of Childcare and Pediatrics; University of São Paulo - School of Medicine of Ribeirão Preto; Ribeirão Preto SP Brazil
| | - Lea Assed Bezerra da Silva
- Department of Pediatric Dentistry; University of São Paulo - School of Dentistry of Ribeirão Preto; Ribeirão Preto SP Brazil
| | - Paulo Nelson-Filho
- Department of Pediatric Dentistry; University of São Paulo - School of Dentistry of Ribeirão Preto; Ribeirão Preto SP Brazil
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Petronijevic S, Stig S, Gao J, Halstensen TS. Amelogenin specific IgA and IgG in children with untreated coeliac disease. Eur J Oral Sci 2016; 124:526-533. [DOI: 10.1111/eos.12314] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/26/2016] [Indexed: 11/27/2022]
Affiliation(s)
- Sanja Petronijevic
- Department of Oral Biology; Faculty of Dentistry; University of Oslo; Oslo Norway
| | - Solveig Stig
- Department of Oral Biology; Faculty of Dentistry; University of Oslo; Oslo Norway
| | - Jian Gao
- Department of Oral Biology; Faculty of Dentistry; University of Oslo; Oslo Norway
| | - Trond S. Halstensen
- Department of Oral Biology; Faculty of Dentistry; University of Oslo; Oslo Norway
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Paul SP, Kirkham EN, John R, Staines K, Basude D. Coeliac disease in children - an update for general dental practitioners. Br Dent J 2016; 220:481-5. [PMID: 27173708 DOI: 10.1038/sj.bdj.2016.336] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/04/2015] [Indexed: 01/10/2023]
Abstract
Coeliac disease (CD) is an immune-mediated systemic disorder caused by ingestion of gluten found in wheat, rye and barley. It affects around 1% of children, but 90% of cases are considered to remain undiagnosed. CD classically presents with gastrointestinal manifestations including diarrhoea, bloating, weight loss and abdominal pain, but extra-intestinal features (including oral and dental manifestations) are increasingly being reported. Dental and oral manifestations such as dental enamel defects, delayed eruption of teeth, recurrent aphthous ulcers are well-recognised manifestations of CD. In patients with yet undiagnosed CD, these can sometimes be the only presenting features. Dentists have regular contact with well children, and therefore the visit to the dentist is an opportunity to suspect CD. When CD is suspected, Dental practitioners can liaise with the general medical practitioner to organise screening for coeliac disease. Positive serology will prompt onward referral to a paediatric gastroenterologist to confirm the diagnosis. The recent European Paediatric Gastroenterology Hepatology and Nutrition (ESPGHAN) guidelines revised in 2012 have streamlined the diagnostic pathway for faster diagnosis of CD. Management involves strict adherence to a gluten free diet, which should lead to resolution of symptoms, recovery of intestinal mucosa and prevention of long-term complications associated with it. This article aims to describe CD, inform of recent changes to the diagnostic pathway and highlight the dental manifestations of the condition to equip dental practitioners to aid early diagnosis and initiation of treatment for children with CD.
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Affiliation(s)
| | | | - R John
- School of Oral &Dental Sciences, University of Bristol
| | - K Staines
- School of Oral &Dental Sciences, University of Bristol
| | - D Basude
- Bristol Royal Hospital for Children, Bristol
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Sóñora C, Arbildi P, Rodríguez-Camejo C, Beovide V, Marco A, Hernández A. Enamel organ proteins as targets for antibodies in celiac disease: implications for oral health. Eur J Oral Sci 2015; 124:11-6. [DOI: 10.1111/eos.12241] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/18/2015] [Indexed: 12/25/2022]
Affiliation(s)
- Cecilia Sóñora
- Cátedra de Inmunología; Instituto de Química Biológica; Facultad de Ciencias -Departamento de Biociencias; Facultad de Química; Universidad de la República; Montevideo Uruguay
- Escuela Universitaria de Tecnología Médica; Facultad de Medicina. Universidad de la República; Montevideo Uruguay
| | - Paula Arbildi
- Cátedra de Inmunología; Instituto de Química Biológica; Facultad de Ciencias -Departamento de Biociencias; Facultad de Química; Universidad de la República; Montevideo Uruguay
| | - Claudio Rodríguez-Camejo
- Cátedra de Inmunología; Instituto de Química Biológica; Facultad de Ciencias -Departamento de Biociencias; Facultad de Química; Universidad de la República; Montevideo Uruguay
| | - Verónica Beovide
- Servicio y Cátedra de Anatomía Patológica General y Bucomaxilofacial; Facultad de Odontología; Universidad de la República; Montevideo Uruguay
| | - Alicia Marco
- Cátedra de Inmunología; Instituto de Química Biológica; Facultad de Ciencias -Departamento de Biociencias; Facultad de Química; Universidad de la República; Montevideo Uruguay
| | - Ana Hernández
- Cátedra de Inmunología; Instituto de Química Biológica; Facultad de Ciencias -Departamento de Biociencias; Facultad de Química; Universidad de la República; Montevideo Uruguay
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