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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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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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Kalvandi G, Shahramian I, Farmany A, Yadegari S, Parooie F. Serological study of celiac disease in children with dental caries. Hum Antibodies 2021; 29:237-241. [PMID: 34092626 DOI: 10.3233/hab-210445] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
BACKGROUND Celiac disease is a common gastrointestinal autoimmune disorder. Studies have shown that the prevalence of tooth decay is high in patients with celiac disease. This study was performed to evaluate the serology of celiac disease in children with dental caries. METHODS Children aged 3 to 12 years who referred to the dental clinic with enamel caries were included in the study. Celiac disease was assessed by measuring serum IgA levels and anti-TTG (Anti TTG (IgA)) antibodies. Then, by analyzing the collected data, the prevalence of celiac disease in children with dental caries and its relationship with various variables were investigated. RESULTS 120 children, 56 girls (46.7%) and 64 boys (53.3%) with dental caries were involved in this study. The positive celiac serology rate of studied population was 14 (11.6%). Based on the results of this study, a significant relationship was obtained between maternal education, sex and place of residence and celiac disease (p< 0.05). There were no significant relationships between celiac positive serology in children with dental caries, the number of decayed teeth, and breastfeeding (p> 0.05). CONCLUSION The present study showed that dental caries, might be a red flag indicating possible celiac disease and prevent its complications. On the other hand, pediatricians and dentists should be aware of the oral symptoms of celiac disease. Further studies are needed to plan screening for children with celiac disease.
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Affiliation(s)
| | - Iraj Shahramian
- Pediatric Gastroenterology and Hepatology Research Center, Zabol University of Medical Sciences, Zabol, Iran
| | - Abbas Farmany
- Hamadan University of Medical Sciences, Hamadan, Iran
| | | | - Fateme Parooie
- Pediatric Gastroenterology and Hepatology Research Center, Zabol University of Medical Sciences, Zabol, Iran
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Oral Health Impact Profile in Celiac Patients: Analysis of Recent Findings in a Literature Review. Gastroenterol Res Pract 2018; 2018:7848735. [PMID: 30473707 PMCID: PMC6220388 DOI: 10.1155/2018/7848735] [Citation(s) in RCA: 45] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2018] [Revised: 09/05/2018] [Accepted: 09/24/2018] [Indexed: 12/14/2022] Open
Abstract
The increment of recording atypical oral manifestation in young patients often related to systematic disease is today a challenge for the therapists. Sometime, the presence of tooth enamel lesions correlated with soft tissue lesions is just a symptom or a trigger sign for a deeper and undetermined disease. Recently, high impact has been developed toward the influence of the diet as a controlled and modifiable factor in patients affected by celiac pathologies. The celiac disease (CD) is a chronic immune-mediated disorder triggered by the ingestion of gluten that appears in genetically predisposed patients. Gluten is a proline-rich and glutamine-rich protein present in wheat (gliadin), barley (hordein), and rye (secalin). The gluten-free diet (GFD) seems to better influence the oral health status of the CD patients. For this reason, the main objective of this revision was to analyze the international data highlighting the relationship between celiac patients and the oral health impact profile. A comprehensive review of the current literature was conducted according to the PRISMA guidelines by accessing the NCBI PubMed database. Authors conducted the search of articles in the English language published from 2008 to 2018. The first analysis with filters recorded 67 manuscripts accordingly with the selected keywords. Finally, a number of 16 appropriate published papers were comprehended in the review. The studies were different in terms of the structure, findings, outcomes, and diet quality evaluation, and for this reason, it was not possible to accomplish a meta-analysis of the recorded data. This manuscript offers some observational evidence to justify the advantages of gluten-free diets related to a better oral health status in the patients involved.
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Bıçak DA, Urgancı N, Akyüz S, Usta M, Kızılkan NU, Alev B, Yarat A. Clinical evaluation of dental enamel defects and oral findings in coeliac children. Eur Oral Res 2018; 52:150-156. [PMID: 30775719 DOI: 10.26650/eor.2018.525] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2017] [Revised: 11/22/2017] [Accepted: 01/11/2018] [Indexed: 12/18/2022] Open
Abstract
Purpose To examine dental hard and soft tissue changes of coeliac children in order to increase the awareness of the pediatric dentists in prediagnosis of especially undiagnosed coeliac disease. Materials and methods Sixty children, 28 (46.7%) boys and 32 (53.3%) girls whose ages were between 6 to 16 years were included in the present study. Thirty children who had undergone endoscopy and diagnosed with the coeliac disease in the Şişli Hamidiye Etfal Hospital, İstanbul, Turkey, formed the study group. Also, thirty children clinically suspected of having the coeliac disease with the same gastrointestinal complaints had undergone endoscopy and proven not coeliac were chosen as the control group. Oral examination involved assessment of dentition and specific and unspecific dental enamel defects. Also, soft tissue lesions, clinical delay of the dental eruption, salivary flow rate, pH, and buffering capacity were examined. Results Twenty coeliac patients had enamel defects, however none in the control subjects. In the coeliac group, all enamel defects were diagnosed in permanent teeth and as specific in all children. Grade I dental enamel defects found mainly in the incisors. The clinical delayed eruption was observed in 10 (33.3%) of 30 coeliac children and none of the children in the control group. While the level of DMFT/S numbers and stimulated salivary flow rate were found significantly lower in the coeliac group, pH was found significantly higher. Conclusion Oral cavity may be involved in coeliac disease and pediatric dentists can play an important role in the early diagnosis of the coeliac disease.
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Affiliation(s)
- Damla Akşit Bıçak
- Department of Pediatric Dentistry, Near East University, Faculty of Dentistry, KKTC
| | - Nafiye Urgancı
- Clinic of Pediatric Gastroenterology, Şişli Hamidiye Etfal Training and Research Hospital, İstanbul, Turkey
| | - Serap Akyüz
- Department of Pediatric Dentistry, Marmara University, Faculty of Dentistry, İstanbul, Turkey
| | - Merve Usta
- Clinic of Pediatric Gastroenterology, Şişli Hamidiye Etfal Training and Research Hospital, İstanbul, Turkey
| | - Nuray Uslu Kızılkan
- Clinic of Pediatric Gastroenterology, Şişli Hamidiye Etfal Training and Research Hospital, İstanbul, Turkey.,Clinic of Pediatric Gastroenterology, Koç University Hospital, İstanbul, Turkey
| | - Burçin Alev
- Department of Basic Medical Sciences, Division of Biochemistry, Marmara University, Faculty of Dentistry, İstanbul, Turkey
| | - Ayşen Yarat
- Department of Basic Medical Sciences, Division of Biochemistry, Marmara University, Faculty of Dentistry, İstanbul, Turkey
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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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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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Gastrointestinal diseases and their oro-dental manifestations: Part 3: Coeliac disease. Br Dent J 2017; 222:126-129. [DOI: 10.1038/sj.bdj.2017.80] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/22/2016] [Indexed: 12/20/2022]
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Beth SA, Jansen MAE, Elfrink MEC, Kiefte-de Jong JC, Wolvius EB, Jaddoe VWV, van Zelm MC, Moll HA. Generation R birth cohort study shows that specific enamel defects were not associated with elevated serum transglutaminase type 2 antibodies. Acta Paediatr 2016; 105:e485-91. [PMID: 27439586 DOI: 10.1111/apa.13533] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/19/2015] [Revised: 06/23/2016] [Accepted: 07/18/2016] [Indexed: 12/21/2022]
Abstract
AIM Coeliac disease can induce specific enamel defects (SED), but little is known about the consequences of antitissue transglutaminase (TG2A) autoimmunity. We investigated whether TG2A positivity in children and their mothers was associated with SED in the primary dentition. METHODS Maternal and child serum immunoglobulin A-TG2A levels were measured as part of the Generation R prospective cohort study. Clinical oral photographs of the primary dentition were taken, and SED and caries were recorded. We performed logistic regression analysis. RESULTS We analysed data on 4775 mothers and 4233 children (median age of 6.2 ± 0.5 years). SED and caries were not associated with maternal TG2A levels. The 59 TG2A-positive children tended to have more SED, particularly the 31 in the strongly positive subgroup, with odds ratio of 1.72 and 2.29, respectively. A positive linear trend was observed between higher TG2A levels and paediatric SED (p = 0.04), but this became nonsignificant after adjusting for ethnic and socio-economic background. No difference in caries was found between the groups. CONCLUSION TG2A did not play an independent role on SED in the primary dentition during pregnancy and childhood, and the relationship may be explained by ethnic and socio-economic background.
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Affiliation(s)
- Sytske A. Beth
- The Generation R Study Group; Erasmus University Medical Center; Rotterdam The Netherlands
- Department of Pediatrics; Erasmus University Medical Center; Rotterdam The Netherlands
- Department of Immunology; Erasmus University Medical Center; Rotterdam The Netherlands
| | - Michelle A. E. Jansen
- The Generation R Study Group; Erasmus University Medical Center; Rotterdam The Netherlands
- Department of Pediatrics; Erasmus University Medical Center; Rotterdam The Netherlands
- Department of Immunology; Erasmus University Medical Center; Rotterdam The Netherlands
| | - Maria E. C. Elfrink
- The Generation R Study Group; Erasmus University Medical Center; Rotterdam The Netherlands
- Department of Cariology, Endodontology and Pedodontology; Academic Center for Dentistry Amsterdam (ACTA); Amsterdam The Netherlands
| | - Jessica C. Kiefte-de Jong
- Department of Epidemiology; Erasmus University Medical Center; Rotterdam The Netherlands
- Department of Global Public Health; Leiden University College; The Hague The Netherlands
| | - Eppo B. Wolvius
- The Dutch Cranofacial Centre; Department of Oral and Maxillofacial Surgery; Sophia's Children's Hospital; Erasmus University Medical Center; Rotterdam The Netherlands
| | - Vincent W. V. Jaddoe
- The Generation R Study Group; Erasmus University Medical Center; Rotterdam The Netherlands
- Department of Pediatrics; Erasmus University Medical Center; Rotterdam The Netherlands
| | - Menno C. van Zelm
- Department of Immunology and Pathology; Monash University; Melbourne Vic. Australia
| | - Henriëtte A. Moll
- Department of Pediatrics; Erasmus University Medical Center; Rotterdam The Netherlands
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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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13
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Seow WK. Developmental defects of enamel and dentine: challenges for basic science research and clinical management. Aust Dent J 2013; 59 Suppl 1:143-54. [PMID: 24164394 DOI: 10.1111/adj.12104] [Citation(s) in RCA: 106] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Abnormalities of enamel and dentine are caused by a variety of interacting factors ranging from genetic defects to environmental insults. The genetic changes associated with some types of enamel and dentine defects have been mapped, and many environmental influences, including medical illnesses that can damage enamel and dentine have been identified. Developmental enamel defects may present as enamel hypoplasia or hypomineralization while dentine defects frequently demonstrate aberrant calcifications and abnormalities of the dentine-pulp complex. Clinically, developmental enamel defects often present with problems of discolouration and aesthetics, tooth sensitivity, and susceptibility to caries, wear and erosion. In contrast, dentine defects are a risk for endodontic complications resulting from dentine hypomineralization and pulpal abnormalities. The main goals of managing developmental abnormalities of enamel and dentine are early diagnosis and improvement of appearance and function by preserving the dentition and preventing complications. However, despite major advances in scientific knowledge regarding the causes of enamel and dentine defects, further research is required in order to translate the knowledge gained in the basic sciences research to accurate clinical diagnosis and successful treatment of the defects.
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Affiliation(s)
- W K Seow
- Centre for Paediatric Dentistry, School of Dentistry, The University of Queensland, Brisbane, Australia
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Salanitri S, Seow WK. Developmental enamel defects in the primary dentition: aetiology and clinical management. Aust Dent J 2013; 58:133-40; quiz 266. [PMID: 23713631 DOI: 10.1111/adj.12039] [Citation(s) in RCA: 73] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/16/2013] [Indexed: 11/30/2022]
Abstract
Developmental enamel defects, presenting as enamel hypoplasia or opacities are caused by damage or disruption to the developing enamel organ as a result of inherited and acquired systemic conditions. The high prevalence of these defects in the primary dentition demonstrates the vulnerability of the teeth to changes in the pre- and postnatal environment. The presence of enamel hypoplasia increases the risk of primary teeth to early childhood caries and tooth wear as the defective enamel is thinner, more plaque retentive and less resistant to dissolution in acid compared to normal enamel. The purpose of this paper was to critically review the aetiology and clinical complications of developmental enamel defects in the primary dentition and propose recommendations for the clinical management of affected teeth.
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Affiliation(s)
- S Salanitri
- Centre for Paediatric Dentistry, School of Dentistry, The University of Queensland, Brisbane, Queensland
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Robles MJ, Ruiz M, Bravo-Perez M, González E, Peñalver MA. Prevalence of enamel defects in primary and permanent teeth in a group of schoolchildren from Granada (Spain). Med Oral Patol Oral Cir Bucal 2013; 18:e187-93. [PMID: 23229271 PMCID: PMC3613868 DOI: 10.4317/medoral.18580] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2012] [Accepted: 08/20/2012] [Indexed: 11/09/2022] Open
Abstract
Objective: The purpose of this study was to determine and compare the prevalence and presentations of developmental defects of the enamel (DDE) in the primary and permanent dentitions of a group of healthy schoolchildren residing in Granada (Spain).
Study Design: A total of 1,414 healthy schoolchildren were examined using modified DDE criteria for recording enamel defects.
Results: The prevalence of DDE of any type was 40.2% in primary dentition and 52% in permanent dentition (p<0.033). Of the 31,820 primary and permanent teeth examined in the study, 699 (4.1%) primary and 1,232 (8.3%) permanent teeth had some form of DDE. Diffuse opacity was the most common type of DDE observed in primary teeth, and demarcated opacity in the permanent teeth. Enamel hypoplasia was the least prevalent defect in both dentition types.
Conclusions: The study population showed a high prevalence of DDE in primary as well as in permanent dentition, reflecting the current increasing trend of this condition, which should be considered as a significant public health problem.
Key words:Developmental enamel defects, enamel hypoplasia, demarcated opacity, diffuse opacity.
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Affiliation(s)
- Maria-Jesús Robles
- University of Granada, Campus de Cartuja, Colegio Máximo s/n, Granada, Spain
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El-Hodhod MAA, El-Agouza IA, Abdel-Al H, Kabil NS, Bayomi KAEM. Screening for celiac disease in children with dental enamel defects. ISRN PEDIATRICS 2012; 2012:763783. [PMID: 22720168 PMCID: PMC3376764 DOI: 10.5402/2012/763783] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/21/2012] [Accepted: 04/17/2012] [Indexed: 12/20/2022]
Abstract
Background. Dental enamel defects (DEDs) are seen in celiac disease (CD). Aim was to detect frequency of CD among such patients. Methods. This study included 140 children with DED. They were tested for CD. Gluten-free diet (GFD) was instituted for CD patients. A cohort of 720, age and sex-matched, normal children represented a control group. Both groups were evaluated clinically. Serum calcium, phosphorus, alkaline phosphatase, serum IgA, and tissue transglutaminase (tTG) IgG and IgA types were measured. Results. CD was more diagnosed in patients with DEDs (17.86%) compared to controls (0.97%) (P < 0.0001). Majority of nonceliac patients showed grade 1 DED compared to grades 1, 2, and 3 DED in CD. Five children had DED of deciduous teeth and remaining in permanent ones. After 1 year on GFD, DED improved better in CD compared to nonceliac patients. Gastrointestinal symptoms did not vary between celiac and nonceliac DED patients. Lower serum calcium significantly predicted CD in this cohort. Conclusion. CD is more prevalent among children with DED than in the general population. These DEDs might be the only manifestation of CD; therefore, screening for CD is highly recommended among those patients especially in presence of underweight and hypocalcemia.
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Muñoz F, Del Río N, Sóñora C, Tiscornia I, Marco A, Hernández A. Enamel defects associated with coeliac disease: putative role of antibodies against gliadin in pathogenesis. Eur J Oral Sci 2012; 120:104-12. [DOI: 10.1111/j.1600-0722.2012.00949.x] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
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Acar S, Yetkıner AA, Ersın N, Oncag O, Aydogdu S, Arıkan C. Oral findings and salivary parameters in children with celiac disease: a preliminary study. Med Princ Pract 2012; 21:129-33. [PMID: 22024774 DOI: 10.1159/000331794] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/06/2010] [Accepted: 06/28/2011] [Indexed: 11/19/2022] Open
Abstract
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.
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Affiliation(s)
- Sibel Acar
- Department of Pediatric Dentistry, Hepatology and Nutrition, Ege University, Izmir, Turkey.
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Gentile A, Bossù M, Sfasciotti G, Polimeni A. La patologia odontostomatologica associata alla malattia celiaca: revisione della letteratura. DENTAL CADMOS 2011. [DOI: 10.1016/j.cadmos.2010.11.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Majorana A, Bardellini E, Ravelli A, Plebani A, Polimeni A, Campus G. 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. Int J Paediatr Dent 2010; 20:119-24. [PMID: 20384826 DOI: 10.1111/j.1365-263x.2009.01028.x] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
BACKGROUND The association between coeliac disease (CD) and dental enamel defects (DED) is well known. AIM 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. DESIGN 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. RESULTS 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. CONCLUSIONS Our results confirmed a possible correlation between HLA antigens and DED.
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Abstract
PURPOSE OF REVIEW To summarize recent advances in celiac disease published between August 2008 and July 2009. RECENT FINDINGS Celiac disease affects nearly 1% of most populations but remains largely unrecognized. In the last year, work has shown that the prevalence of celiac disease has increased dramatically, not simply due to increased detection. Also, undiagnosed celiac disease may be associated with increased mortality. Significant progress has been made in understanding how gliadin peptides can cross the intestinal border and access the immune system. New genetic loci and candidate genes that may contribute to the risk of celiac disease and its overlap with type 1 diabetes mellitus have been identified. Novel deamidated gliadin peptides antibodies have better diagnostic accuracy over native gliadin-based tests. The inclusion of duodenal bulb biopsy specimens may increase the rate of celiac disease detection. The spectrum of celiac disease likely includes a minority of patients with mild enteropathy. A practical seven-item instrument may facilitate standardized evaluation of gluten-free diet adherence. Finally, refractory celiac disease, although rare, is associated with a poor prognosis. SUMMARY Celiac disease is a global health problem that requires a multidisciplinary and increasingly cooperative multinational research effort.
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