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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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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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Personalized Nutrition in the Management of Female Infertility: New Insights on Chronic Low-Grade Inflammation. Nutrients 2022; 14:nu14091918. [PMID: 35565885 PMCID: PMC9105997 DOI: 10.3390/nu14091918] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2022] [Revised: 04/19/2022] [Accepted: 04/29/2022] [Indexed: 02/01/2023] Open
Abstract
Increasing evidence on the significance of nutrition in reproduction is emerging from both animal and human studies, suggesting a mutual association between nutrition and female fertility. Different “fertile” dietary patterns have been studied; however, in humans, conflicting results or weak correlations are often reported, probably because of the individual variations in genome, proteome, metabolome, and microbiome and the extent of exposure to different environmental conditions. In this scenario, “precision nutrition”, namely personalized dietary patterns based on deep phenotyping and on metabolomics, microbiome, and nutrigenetics of each case, might be more efficient for infertile patients than applying a generic nutritional approach. In this review, we report on new insights into the nutritional management of infertile patients, discussing the main nutrigenetic, nutrigenomic, and microbiomic aspects that should be investigated to achieve effective personalized nutritional interventions. Specifically, we will focus on the management of low-grade chronic inflammation, which is associated with several infertility-related diseases.
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Ludovichetti FS, Signoriello AG, Girotto L, Del Dot L, Piovan S, Mazzoleni S. Oro-dental Lesions in Paediatric Patients with Coeliac Disease: an Observatioanl Retrospective Clinical Study. REVISTA ESPANOLA DE ENFERMEDADES DIGESTIVAS 2022; 114:654-659. [DOI: 10.17235/reed.2022.8422/2021] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Nikniaz Z, Beheshti S, Abbasalizad Farhangi M, Nikniaz L. A systematic review and meta-analysis of the prevalence and odds of eating disorders in patients with celiac disease and vice-versa. Int J Eat Disord 2021; 54:1563-1574. [PMID: 34042201 DOI: 10.1002/eat.23561] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2021] [Revised: 05/15/2021] [Accepted: 05/15/2021] [Indexed: 12/25/2022]
Abstract
OBJECTIVES In the present systematic review and meta-analysis study, we aimed to review studies that assessed the prevalence and risk of eating disorders (EDs) in patients with celiac disease (CD) and vice-versa. METHOD We conducted a systematic search in PubMed, Embase, Scopus, and Web of Science for studies that assessed the prevalence and risk of AN in patients with CD and vice-versa. Joanna Briggs Institute tools were used for critical appraisal. The STATA software was used for the meta-analysis of the random-effect model. RESULTS In this study, 23 observational studies were included. The results of the meta-analysis indicated that the pooled prevalence of EDs and bulimia nervosa in patients with CD was 8.88% [95% CI: 6.4, 11.7] and 7.26% [95% CI: 0.23, 21.57], respectively. Moreover, the risk of anorexia nervosa in patients with CD was significantly higher than in the healthy population (relative risk [RR]: 1.48 [95% CI: 1.32, 1.64]). The rates of CD in patients with AN and EDs were 0.96% [95% CI: 0.15, 2.31] and 0.90% [95% CI: 0.56, 1.31], respectively. Moreover, the overall risk of CD in patients with AN was significantly higher compared with healthy adults (RR: 2.35 [95% CI: 1.27-3.44]). DISCUSSION The result of the present meta-analysis showed the high prevalence of EDs in patients with CD. Moreover, there was a significant bidirectional association between CD and EDs.
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Affiliation(s)
- Zeinab Nikniaz
- Liver and Gastrointestinal Diseases Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Samineh Beheshti
- Student Research Committee, Tabriz University of Medical Sciences, Tabriz, Iran
| | | | - Leila Nikniaz
- Research Center for Evidence-Based Medicine, Tabriz University of Medical Sciences, Tabriz, 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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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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Ciecierega T, Dweikat I, Awar M, Shahrour M, Libdeh BA, Sultan M. Severe persistent unremitting dermatitis, chronic diarrhea and hypoalbuminemia in a child; Hartnup disease in setting of celiac disease. BMC Pediatr 2014; 14:311. [PMID: 25526748 PMCID: PMC4308912 DOI: 10.1186/s12887-014-0311-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2014] [Accepted: 12/10/2014] [Indexed: 12/25/2022] Open
Abstract
Background Celiac disease (CD) is a complex autoimmune disorder that can lead to an inflammatory small intestinal villous atrophy and malabsorption. Hartnup disease is an autosomal recessive disorder caused by increased urinary excretion of neutral amino acids. Co-occurrence of Hartnup disease and CD is extremely rare with only a single case reported. Case presentation We report a 3-year girl with chronic diarrhea, Hypoalbuminemia and exfoliative erythema. She was diagnosed with celiac disease, which did not improve on gluten free diet. Hartnup disease was suspected and was confirmed by neutral aminoaciduria. Niacin was started and followed by dramatic improvement. Conclusion Presence of Celiac and Hartnup disease in single individual is very rare. Complete nutritional assessment of refractory celiac patient can reveal underlying nutritional deficiency.
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Affiliation(s)
- Thomas Ciecierega
- New York Presbyterian, Weill Cornell Medical College, New York, USA.
| | - Imad Dweikat
- An-Najah National University, P.O. BOX 7, Nablus, West Bank, Palestine.
| | - Mohammad Awar
- Makassed Hospital, Alquds University, Medical College, Jerusalem, Palestine.
| | - Maher Shahrour
- Makassed Hospital, Alquds University, Medical College, Jerusalem, Palestine.
| | - Bassam Abu Libdeh
- Makassed Hospital, Alquds University, Medical College, Jerusalem, Palestine.
| | - Mutaz Sultan
- Makassed Hospital, Alquds University, Medical College, Jerusalem, Palestine.
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Barbero EM, McNally SL, Donohue MC, Kagnoff MF, Arrese M, Uribe M, Méndez-Sánchez N. Barriers impeding serologic screening for celiac disease in clinically high-prevalence populations. BMC Gastroenterol 2014; 14:42. [PMID: 24592899 PMCID: PMC4016507 DOI: 10.1186/1471-230x-14-42] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/24/2013] [Accepted: 02/28/2014] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND Celiac disease is present in ~1% of the general population in the United States and Europe. Despite the availability of inexpensive serologic screening tests, ~85% of individuals with celiac disease remain undiagnosed and there is an average delay in diagnosis of symptomatic individuals with celiac disease that ranges from ~5.8-11 years. This delay is often attributed to the use of a case-based approach for detection rather than general population screening for celiac disease, and deficiencies at the level of health care professionals. This study aimed to assess if patient-centered barriers have a role in impeding serologic screening for celiac disease in individuals from populations that are clinically at an increased risk for celiac disease. METHODS 119 adults meeting study inclusion criteria for being at a higher risk for celiac disease were recruited from the general population. Participants completed a survey/questionnaire at the William K. Warren Medical Research Center for Celiac Disease that addressed demographic information, celiac disease related symptoms (gastrointestinal and extraintestinal), family history, co-morbid diseases and conditions associated with celiac disease, and patient-centered barriers to screening for celiac disease. All participants underwent serologic screening for celiac disease using the IgA tissue transglutaminase antibody (IgA tTG) and, if positive, testing for IgA anti-endomysial antibody (IgA EMA) as a confirmatory test. RESULTS Two barriers to serologic testing were significant across the participant pool. These were participants not knowing they were at risk for celiac disease before learning of the study, and participants not knowing where to get tested for celiac disease. Among participants with incomes less than $25,000/year and those less than the median age, not having a doctor to order the test was a significant barrier, and this strongly correlated with not having health insurance. Symptoms and co-morbid conditions were similar among those whose IgA tTG were negative and those who tested positive. CONCLUSION There are significant patient-centered barriers that impede serologic screening and contribute to the delayed detection and diagnosis of celiac disease. These barriers may be lessened by greater education of the public and health care professionals about celiac disease symptoms, risk factors, and serologic testing.
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Affiliation(s)
- Erika M Barbero
- Department of Medicine, Division of Gastroenterology, University of California San Diego, 9500 Gilman Drive, La Jolla, CA 92093 MC 0623D, USA
| | - Shawna L McNally
- Department of Medicine, Division of Gastroenterology, University of California San Diego, 9500 Gilman Drive, La Jolla, CA 92093 MC 0623D, USA,Current Address: Nutrition Research Consultant, Harvard Center for Population and Development Studies, Providence, RI, USA
| | - Michael C Donohue
- Department of Family and Preventive Medicine, Division of Biostatistics and Bioinformatics, University of California San Diego, La Jolla, CA, USA
| | - Martin F Kagnoff
- Department of Medicine, Division of Gastroenterology, University of California San Diego, 9500 Gilman Drive, La Jolla, CA 92093 MC 0623D, USA,Department of Pediatrics, Division of Gastroenterology, University of California San Diego, La Jolla, CA, USA
| | - Marco Arrese
- Departamento de Gastroenterología, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Misael Uribe
- Liver Research Unit, Medica Sur Clinic & Foundation, Mexico City, Mexico
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Radočaj O, Dimić E, Tsao R. Effects of Hemp (Cannabis sativaL.) Seed Oil Press-Cake and Decaffeinated Green Tea Leaves (Camellia sinensis) on Functional Characteristics of Gluten-Free Crackers. J Food Sci 2014; 79:C318-25. [DOI: 10.1111/1750-3841.12370] [Citation(s) in RCA: 60] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2013] [Accepted: 12/29/2013] [Indexed: 12/21/2022]
Affiliation(s)
- Olga Radočaj
- Faculty of Technology; Univ. of Novi Sad; Bulevar cara Lazara 1 21000 Novi Sad Serbia
| | - Etelka Dimić
- Faculty of Technology; Univ. of Novi Sad; Bulevar cara Lazara 1 21000 Novi Sad Serbia
| | - Rong Tsao
- Guelph Food Research Centre; Agriculture and Agri-Food Canada; 93 Stone Road West Guelph Ontario N1G 5C9 Canada
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