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

Abstract

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

The impact of histopathological celiac disease activity on dental enamel defects and dental caries

“…This comes in agreement with a study by Shahraki et al when studying wider range of sample age (3-16 years) and larger sample size (65) of CD patients. (14) Structural abnormalities were also present at lesser extent as Aine's II was in 10% of the sample which contained no Ain's III or IV and this comes in an agreement with a Turkish study that reported no Aine's III or IV in 60 CD patients' ages 6-16 years. (21) The present study revealed that the least intestinal damage (Marsh II) came with no CD specific DED while the more intestinal damage (Marsh III-a and III-b) came with more CD specific DED and this comes in contrast with what Aine et al showed by studying adults enamel defects in relation to the degree of histological damage although children cannot be compared to adults.…”

“…Early diagnosis of CD patients by dentists can be performed by DED since most CD patients are atypical. (14,20) In the present study almost half of the sample had no CD specific enamel defects, however, most of the defects were enamel opacities (Aine's I). This comes in agreement with a study by Shahraki et al when studying wider range of sample age (3-16 years) and larger sample size (65) of CD patients.…”

“…(11) A study by Abdul-Wahid et al (12) revealed an increase in the presence of unspecific dental enamel defects by the application of the Modified Developmental Defects of Enamel Index for 102 CD patients aged 2-35 years compared to the control group in primary and permanent dentitions while dental caries was experienced at higher extent in the primary teeth only. Higher DED in CD children was observed as compared to children devoid from the disease (10,13,14) in contrast to dental caries that was experienced at lesser extent in CD children. (13) Another study showed no significant difference in prevalence of DED between CD children and others without the disease.…”

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

“…6,8 Increased risk of dental caries is suggested to be associated with CD. While this statement is supported by the results of certain studies 24,39 other authors report opposing findings. Dental decay is a common disorder in children and is multifactorial in aetiology, so it might not be a particularly useful means of identifying CD, although retrospectively, it can be noted.…”

Prevalence of Molar-incisor hypomineralization in Iranian children – A systematic review and narrative synthesis

“…Providing the prevalence rate of MIH could be extracted, studies with a primary outcome rather than prevalence of MIH in random population were also included. Only one study was excluded because of small sample size [ 17 ]. Fifteen studies met the final inclusion criteria for the review [ 18 – 32 ].…”