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Macho V, Rodrigues R, Pinto D, Castro R, Silva CC, Silva CC, Soares SC. Importance of celiac disease oral manifestations in pediatric patients: A systematic review. World J Clin Pediatr 2025; 14:102002. [DOI: 10.5409/wjcp.v14.i2.102002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2024] [Revised: 02/06/2025] [Accepted: 02/20/2025] [Indexed: 03/18/2025] Open
Abstract
BACKGROUND Celiac disease (CD) is an autoimmune disease triggered by the ingestion of gluten in genetically predisposed individuals. It is more commonly diagnosed in children presenting typical clinical signs and symptoms but most of the CD patients diagnosed in the developed world are silent cases with no prominent gastrointestinal features. Thus, there are silent forms of the disease in which oral manifestations are the first sign. In the pediatric population oral health can affect growth and self-esteem and have a negative impact in their life quality.
AIM To assess the prevalence and types of oral manifestations in pediatric patients with CD.
METHODS We performed a comprehensive literature search in PubMed, Scielo, Cochrane Library and Lilacs databases from 2014-2024. Three independent researchers screened and extracted the information, applying the eligibility criteria and bias was assessed using Joanna Briggs Institute tools.
RESULTS Of the initial 241 articles, 14 studies fulfilled the proposed objectives and were included in the review. The main oral manifestations found were recurrent aphthous stomatitis and enamel defects. Additionally, delayed tooth eruption, angular cheilitis, glossodynia and xerostomia were also reported.
CONCLUSION Assessing oral manifestations is crucial, especially in underdiagnosed cases of children with CD. Recognizing these signs helps pediatricians or general practitioners identify them during routine exams, enabling early diagnosis and treatment to prevent negative impacts on the child’s and family’s quality of life.
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Affiliation(s)
- Viviana Macho
- Faculty of Health Sciences, University Fernando Pessoa, Porto 4249-004, Portugal
| | - Rita Rodrigues
- Faculty of Health Sciences, University Fernando Pessoa, Porto 4249-004, Portugal
| | - Diana Pinto
- Faculty of Health Sciences, University Fernando Pessoa, Porto 4249-004, Portugal
| | - Rita Castro
- Faculty of Health Sciences, University Fernando Pessoa, Porto 4249-004, Portugal
| | - Cátia Carvalho Silva
- Faculty of Health Sciences, University Fernando Pessoa, Porto 4249-004, Portugal
| | | | - Sandra Clara Soares
- Faculty of Health Sciences, University Fernando Pessoa, Porto 4249-004, Portugal
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Manninen J, Paavola S, Kurppa K, Huhtala H, Salmi T, Kaukinen K, Pasternack C. Prevalence of oral manifestations in coeliac disease and associated factors. BMC Gastroenterol 2025; 25:126. [PMID: 40033185 DOI: 10.1186/s12876-025-03699-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2024] [Accepted: 02/14/2025] [Indexed: 03/05/2025] Open
Abstract
BACKGROUND Various oral manifestations are associated with coeliac disease in children, whereas data on adults are scarce. Moreover, possible individual factors predisposing to these manifestations remain unresolved. The aim of this study was to investigate these issues in a large cohort of adult coeliac disease patients both at diagnosis and while on gluten-free diet (GFD). METHODS This population-based study involved 873 adult patients with coeliac disease and 563 non-coeliac controls. Patients and controls were interviewed and structured questionnaires were used to assess the severity of gastrointestinal symptoms and quality of life at the time of the study. All participants were systematically asked about oral manifestations, including dental enamel defects, recurrent aphthous ulceration and glossodynia. Coeliac disease-related data were collected from medical records. Possible individual factors associated with oral manifestations were studied using logistic regression analysis. RESULTS Dental enamel defects were more common among patients than among non-coeliac controls (27% vs. 4%, p < 0.001). Prior to the coeliac disease diagnosis, 56% of the patients had experienced recurrent aphthous ulceration and GFD brought relief to 69% of them. While on GFD, coeliac disease patients had higher prevalence of recurrent aphthous ulceration than did the controls (17% vs. 13%, p = 0.040), but this significance disappeared after adjusting for gender. Glossodynia on GFD was more prevalent in the coeliac cohort than in the controls (14% vs 6%, p < 0.001). Oral manifestations at diagnosis and on GFD were associated with the presence of abdominal symptoms at the time of coeliac disease diagnosis, long diagnostic delay and female gender. At the time of the study, patients with oral symptoms had more severe gastrointestinal symptoms and poorer quality of life than those without these symptoms. CONCLUSIONS Oral manifestations were more prevalent, at diagnosis and on GFD, in patients with coeliac disease than in the controls, and they were associated with long diagnostic delay, abdominal symptoms, female gender and impaired quality of life. A GFD was shown beneficial in relieving recurrent aphthous ulcerations in patients with coeliac disease.
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Affiliation(s)
- Jani Manninen
- Celiac Disease Research Center, Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
| | - Saana Paavola
- Celiac Disease Research Center, Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
- Department of Internal Medicine, Tampere University Hospital, Wellbeing Services County of Pirkanmaa, Tampere, Finland
| | - Kalle Kurppa
- Celiac Disease Research Center, Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
- Tampere Center for Child, Adolescent and Maternal Health Research, Tampere University and Tampere University Hospital, Wellbeing Services County of Pirkanmaa, Tampere, Finland
- The University Consortium of Seinäjoki, Seinäjoki, Finland
| | - Heini Huhtala
- Faculty of Social Sciences, Tampere University, Tampere, Finland
| | - Teea Salmi
- Celiac Disease Research Center, Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
- Department of Dermatology, Tampere University Hospital, Wellbeing Services County of Pirkanmaa, Tampere, Finland
| | - Katri Kaukinen
- Celiac Disease Research Center, Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
- Department of Internal Medicine, Tampere University Hospital, Wellbeing Services County of Pirkanmaa, Tampere, Finland
| | - Camilla Pasternack
- Celiac Disease Research Center, Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland.
- Department of Dermatology, Tampere University Hospital, Wellbeing Services County of Pirkanmaa, Tampere, Finland.
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Bianchi PI, Aronico N, Santacroce G, Broglio G, Lenti MV, Di Sabatino A. Nutritional Consequences of Celiac Disease and Gluten-Free Diet. GASTROENTEROLOGY INSIGHTS 2024; 15:878-894. [DOI: 10.3390/gastroent15040061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/05/2025] Open
Abstract
Celiac disease is an immune-mediated condition triggered by gluten ingestion in genetically predisposed individuals. The global prevalence of celiac disease is significant, affecting approximately 1.4% of women and 0.7% of men, with incidence rates of 17.4 and 7.8 per 100,000 person-years, respectively. The clinical presentation of celiac disease may range from overt diarrhea and malabsorption to more subtle features such as nutritional deficiencies and extraintestinal manifestations. It is the most common cause of global malabsorption in Western countries. A life-long gluten-free diet is the only available treatment for celiac disease. Moreover, a gluten-free diet is often adopted by individuals without celiac disease, either to address non-celiac gluten sensitivity or for other reasons. This review aims to explore the current understandings of the nutritional consequences of untreated celiac disease and the impact of the gluten-free diet itself. Physicians and dietitians specializing in celiac disease should focus on providing a well-rounded nutritional scheme to address deficiencies caused by the disease and prevent the instauration of new nutritional imbalances.
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Affiliation(s)
- Paola Ilaria Bianchi
- First Department of Internal Medicine, Fondazione IRCCS Policlinico San Matteo, Viale Golgi, 19, 27100 Pavia, Italy
| | - Nicola Aronico
- First Department of Internal Medicine, Fondazione IRCCS Policlinico San Matteo, Viale Golgi, 19, 27100 Pavia, Italy
| | - Giovanni Santacroce
- First Department of Internal Medicine, Fondazione IRCCS Policlinico San Matteo, Viale Golgi, 19, 27100 Pavia, Italy
- Department of Internal Medicine and Medical Therapeutics, University of Pavia, Corso Strada Nuova, 65, 27100 Pavia, Italy
| | - Giacomo Broglio
- First Department of Internal Medicine, Fondazione IRCCS Policlinico San Matteo, Viale Golgi, 19, 27100 Pavia, Italy
- Department of Internal Medicine and Medical Therapeutics, University of Pavia, Corso Strada Nuova, 65, 27100 Pavia, Italy
| | - Marco Vincenzo Lenti
- First Department of Internal Medicine, Fondazione IRCCS Policlinico San Matteo, Viale Golgi, 19, 27100 Pavia, Italy
- Department of Internal Medicine and Medical Therapeutics, University of Pavia, Corso Strada Nuova, 65, 27100 Pavia, Italy
| | - Antonio Di Sabatino
- First Department of Internal Medicine, Fondazione IRCCS Policlinico San Matteo, Viale Golgi, 19, 27100 Pavia, Italy
- Department of Internal Medicine and Medical Therapeutics, University of Pavia, Corso Strada Nuova, 65, 27100 Pavia, Italy
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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: 2] [Impact Index Per Article: 1.0] [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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Wieser H, Amato M, Caggiano M, Ciacci C. Dental Manifestations and Celiac Disease-An Overview. J Clin Med 2023; 12:jcm12082801. [PMID: 37109138 PMCID: PMC10144097 DOI: 10.3390/jcm12082801] [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: 02/25/2023] [Revised: 04/02/2023] [Accepted: 04/05/2023] [Indexed: 04/29/2023] Open
Abstract
This review summarizes recent investigations on dental manifestations in celiac disease. Particular attention is paid to delayed dental eruption and maturity, dental enamel defects, molar incisor hypomineralization, dental caries, dental plaque, and periodontitis. Most studies confirmed a higher frequency of delayed dental eruption and maturation in children and dental enamel defects in children and adults with celiac disease compared to healthy individuals. The malabsorption of various micronutrients, especially calcium and vitamin D, as well as immunity, is considered the main cause of these conditions. An early diagnosis of celiac disease and introducing a gluten-free diet might prevent the development of these conditions. Otherwise, the damage has already been established, and it is irreversible. Dentists can play an important role in identifying people who may have unrecognized celiac disease and may help prevent its progress and long-term complications. Investigations on dental caries, plaque, and periodontitis in celiac disease are rare and inconsistent; these complaints need further examination.
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Affiliation(s)
- Herbert Wieser
- Hamburg School of Food Science, Institute of Food Chemistry, University of Hamburg, 20146 Hamburg, Germany
| | - Massimo Amato
- Department of Medicine, Surgery, Dentistry Scuola Medica Salernitana, University of Salerno, 84081 Baronissi, Italy
| | - Mario Caggiano
- Department of Medicine, Surgery, Dentistry Scuola Medica Salernitana, University of Salerno, 84081 Baronissi, Italy
| | - Carolina Ciacci
- Department of Medicine, Surgery, Dentistry Scuola Medica Salernitana, University of Salerno, 84081 Baronissi, Italy
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Elbek-Cubukcu C, Arsoy HA, Ozkaya G. Assessment of oral manifestations in pediatric patients with celiac disease in relation to marsh types. Med Oral Patol Oral Cir Bucal 2023; 28:e9-e15. [PMID: 36565215 PMCID: PMC9805338 DOI: 10.4317/medoral.25490] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Accepted: 11/14/2022] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND To investigate the presence of molar-incisor hypoplasia and recurrent aphthous ulcers, the level of caries experience, and oral hygiene status, and to measure salivary flow rate, salivary buffer capacity, and salivary cariogenic microflora with Marsh types. MATERIAL AND METHODS A single-blind, prospective clinical study with 62 pediatric patients diagnosed with celiac disease with 64 controls. Clinical identification of molar-incisor hypomineralization (MIH) was followed according to the European Academy of Pediatric Dentistry criteria. DMFS and dfs index were used for the caries experience of each child. The clinical diagnosis of RAU was present or not. Oral hygiene was surveyed by recording the OHI-S and the CRT® Bacteria and Buffer Test was used to examine the cariogenic microflora of each child. RESULTS The prevalence of MIH was 61% and the number of recurrent aphthous ulcers were significantly higher in children with celiac disease. There was no statistically significant difference in the CD group, when DMFS, dfs, and MIH parameters were investigated according to dietary compliance. Higher dietary compliance resulted in better oral hygiene status. There was an inverse relationship between the duration of celiac diagnosis and the presence of MIH. A positive relation was found between the duration of the disease and the severity of MIH. In addition to the higher S. mutans counts, the salivary flow rate was very low in children with celiac disease, indicating a positive correlation between poor dietary compliance and poorer oral hygiene. CONCLUSIONS In children, enamel defects and recurrent mucosal lesions may be a sign of celiac disease. Higher numbers of dental caries in permanent teeth of children with celiac disease may be related to Marsh 2 type. The pediatricians and/or pediatric gastroenterologists should refer the chin with celiac disease to the pediatric dentist for the accurate treatment of intraoral manifestations of the disease itself.
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Affiliation(s)
- Cigdem Elbek-Cubukcu
- Assoc. Prof., Bursa Uludag University, Faculty of Dentistry, Department of Pedodontics, Bursa, Türkiye
| | - Hanife Aysegul Arsoy
- MD., Bursa Uludag University, Faculty of Medicine, Department of Pediatric Gastroenterology, Hepatology and Nutrition, Bursa, Türkiye
| | - Guven Ozkaya
- Prof., Bursa Uludag University, Faculty of Medicine, Department of Biostatistics, Bursa, Türkiye
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Durazzo M, Ferro A, Brascugli I, Mattivi S, Fagoonee S, Pellicano R. Extra-Intestinal Manifestations of Celiac Disease: What Should We Know in 2022? J Clin Med 2022; 11:258. [PMID: 35011999 PMCID: PMC8746138 DOI: 10.3390/jcm11010258] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2021] [Revised: 12/24/2021] [Accepted: 12/30/2021] [Indexed: 01/27/2023] Open
Abstract
Celiac disease (CD) is a chronic, small-intestinal, immune-mediated enteropathy due to gluten exposition in genetically predisposed individuals. It occurs in about 1% of the population and often remains an underdiagnosed condition. This could be due to the fact that the adult population often lacks the classical signs and symptoms of CD, manifesting only atypical symptoms. In this review we analyzed the main extra-intestinal manifestations of CD which include cutaneous and endocrinological disorders, abnormal liver function tests, and neuropsychiatric features. When CD is not diagnosed and therefore is not treated with a gluten-free diet (GFD), it can predispose to severe complications, not only gastrointestinal. Thus, it is important for clinicians to quickly recognize the atypical manifestations of CD, considering that an early diagnosis can significantly impact on a patient's prognosis.
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Affiliation(s)
- Marilena Durazzo
- Department of Medical Sciences, University of Turin, C.so A.M. Dogliotti 14, 10126 Turin, Italy; (A.F.); (I.B.); (S.M.)
| | - Arianna Ferro
- Department of Medical Sciences, University of Turin, C.so A.M. Dogliotti 14, 10126 Turin, Italy; (A.F.); (I.B.); (S.M.)
| | - Isabella Brascugli
- Department of Medical Sciences, University of Turin, C.so A.M. Dogliotti 14, 10126 Turin, Italy; (A.F.); (I.B.); (S.M.)
| | - Simone Mattivi
- Department of Medical Sciences, University of Turin, C.so A.M. Dogliotti 14, 10126 Turin, Italy; (A.F.); (I.B.); (S.M.)
| | - Sharmila Fagoonee
- Institute for Biostructure and Bioimaging, National Research Council, Molecular Biotechnology Centre, 10126 Turin, Italy;
| | - Rinaldo Pellicano
- Unit of Gastroenterology, Città della Salute e della Scienza Hospital, C.so Bramante 88, 10126 Turin, Italy;
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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: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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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: 1.0] [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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12
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Oral manifestations of celiac disease in French children. Arch Pediatr 2020; 28:105-110. [PMID: 33341334 DOI: 10.1016/j.arcped.2020.11.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2019] [Revised: 07/16/2020] [Accepted: 11/15/2020] [Indexed: 12/22/2022]
Abstract
Celiac disease (CD) is an immune-mediated systemic disorder caused by ingestion of the gluten found in wheat, rye, and barley. The currently estimated prevalence in children is about 1%. CD is a chronic enteropathy with gastrointestinal manifestations including diarrhea, abdominal distension and weight loss, but extra-intestinal features are increasingly being reported. Dental and oral manifestations such as dental enamel defects (ED), delay in dental eruption, and recurrent aphthous stomatitis (RAS) are well-recognized manifestations of CD. The aim of this study was to compare the frequency of oral manifestations (ED, RAS and delay in dental eruption) on deciduous and permanent teeth between children with CD and a control population. An oral examination was performed on 28 CD children and 59 control children. All children were younger than 12 years old and had deciduous or mixed dentition. CD children had significantly more ED and RAS than the control group (67.9% vs. 33.9% P=0.004 and 50.0% vs. 21.8% P=0.011, respectively). No delay in dental eruption was observed in CD children. ED were mainly grade I and II of Aine's classification (color defects and slight structural defects). ED were more often seen on CD children's deciduous teeth than on permanent teeth (57.1% and 13.6%, respectively; P<0.001). The main teeth affected by ED are the second molar and canines of the deciduous teeth, and the first molar, central incisor, and lateral incisors of the permanent teeth. RAS and ED that were symmetrical in all quadrants and occurred firstly in teeth that mineralize during the first year of life both seem to be signs of CD. Thus, more information for dentists and pediatricians on these oral manifestations should help improve detection of CD.
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Alawsi F, Sawbridge D, Fitzgerald R. Orthodontics in patients with significant medical co-morbidities. J Orthod 2020; 47:4-24. [PMID: 32985344 DOI: 10.1177/1465312520949881] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
A wide variety of patients with medical co-morbidities may present to general orthodontic practice. It is important for the treating clinician to have a general understanding of key medical conditions that may impact upon the treatment and management options. This clinical supplement provides a treatment-focused summative update for the orthodontist regarding significant medical co-morbidities, their general prevalence and an exploration of potential impacts upon orthodontic treatment. This review also discusses the significance of key medications and provides suggestions for the safe provision of orthodontic treatment.
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Affiliation(s)
- Fahad Alawsi
- Orthodontic Department, Royal Preston Hospital, Preston, UK
| | - David Sawbridge
- Intestinal Failure Unit, Salford Royal NHS Foundation Trust, Salford, UK
| | - Rhian Fitzgerald
- Orthodontic Department, Royal Preston Hospital, Preston, UK.,Alder Hey Children's Hospital, Liverpool, UK
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Alamoudi NM, Alsadat FA, El-Housseiny AA, Felemban OM, Al Tuwirqi AA, Mosli RH, Saadah OI. Dental maturity in children with celiac disease: a case-control study. BMC Oral Health 2020; 20:311. [PMID: 33167944 PMCID: PMC7654167 DOI: 10.1186/s12903-020-01316-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Accepted: 10/29/2020] [Indexed: 12/31/2022] Open
Abstract
Background Celiac disease (CD) is an immune-related enteropathy triggered by gluten ingestion in susceptible individuals. Oral manifestations of CD have been frequently described, although reports on dental maturity (DM) are scant. Thus, the aim of this study is to assess the prevalence of DM in CD patients and to test for possible predictors. Methods This is a case–control study of children with CD and healthy controls between 2017 and 2020. A panoramic radiograph and comprehensive oral examination were performed for each participant. Dental age (DA) was measured according to Demirjian’s method and DM was calculated by subtracting the chronological age (CA) from the DA. Statistical analysis was performed to compare the DM between CD patients and controls, and a multivariate analysis was utilized to look for predictors of DM. Results Two-hundred and eight participants (104 children with CD, and 104 healthy controls) were incorporated. The mean age for CD patients was 10.67 ± 2.40 years, and 10.69 ± 2.37 years for healthy controls (P = 0.971). CD patients had a higher prevalence of delayed DM than controls (62.5% vs. 3%, respectively). They also had a greater delay in DM than controls (− 7.94 ± 10.94 vs. 6.99 ± 8.77, P < 0.001). A multivariate analysis identified age between 6 and 7 years (β ± SE = 16.21 ± 2.58, P < 0.001), as the only predictor for DM. Conclusions CD patients had a greater prevalence of delayed DM than controls. No predictors for DM could be found, except young age.
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Affiliation(s)
- Najlaa M Alamoudi
- Pediatric Dentistry Department, Faculty of Dentistry, King Abdulaziz University Hospital, Jeddah, Saudi Arabia
| | - Farah A Alsadat
- Pediatric Dentistry Department, Faculty of Dentistry, King Abdulaziz University Hospital, Jeddah, Saudi Arabia
| | - Azza A El-Housseiny
- Pediatric Dentistry Department, Faculty of Dentistry, King Abdulaziz University Hospital, 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 Hospital, Jeddah, Saudi Arabia
| | - Amani A Al Tuwirqi
- Pediatric Dentistry Department, Faculty of Dentistry, King Abdulaziz University Hospital, Jeddah, Saudi Arabia
| | - Rana H Mosli
- Clinical Nutrition Department, Faculty of Applied Medical Sciences, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Omar I Saadah
- Pediatric Gastroenterology Unit, Department of Pediatrics, Faculty of Medicine, King Abdulaziz University, P.O Box 80205, Jeddah, 21589, Saudi Arabia.
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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: 0.4] [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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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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Neves FS, Barros AS, Cerqueira GA, Cruz GA, Reis AA, Alves LB, Crusoé-Rebello I. Assessment of fractal dimension and panoramic radiomorphometric indices in women with celiac disease. Oral Radiol 2019; 36:141-147. [DOI: 10.1007/s11282-019-00388-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2019] [Accepted: 04/20/2019] [Indexed: 12/11/2022]
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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: 48] [Impact Index Per Article: 6.9] [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: 1.0] [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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Cutaneous and Mucosal Manifestations Associated with Celiac Disease. Nutrients 2018; 10:nu10070800. [PMID: 29933630 PMCID: PMC6073559 DOI: 10.3390/nu10070800] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2018] [Revised: 06/15/2018] [Accepted: 06/18/2018] [Indexed: 12/12/2022] Open
Abstract
Celiac disease (CD) is an immune-mediated, gluten-induced enteropathy that affects predisposed individuals of all ages. Many patients with CD do not report gastrointestinal symptoms making it difficult to reach an early diagnosis. On the other hand, CD is related to a wide spectrum of extra-intestinal manifestations, with dermatitis herpetiformis (DH) being the best characterized. These associated conditions may be the clue to reaching the diagnosis of CD. Over the last few years, there have been multiple reports of the association between CD and several cutaneous manifestations that may improve with a gluten-free diet (GFD). The presence of some of these skin diseases, even in the absence of gastrointestinal symptoms, should give rise to an appropriate screening method for CD. The aim of this paper is to describe the different cutaneous manifestations that have been associated with CD and the possible mechanisms involved.
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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: 2.4] [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: 2.0] [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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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: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/22/2016] [Indexed: 12/20/2022]
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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: 0.2] [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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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: 0.3] [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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