Celiac Disease and Its Impact on the Oral Health Status – Review of the Literature

Abstract

The paper presents the most recent reports on celiac disease, especially its manifestations within the oral cavity. Particular attention should be paid to typical dental enamel defects with a various degree of advancement: discolorations, horizontal groves and pits, and even significant structural destruction causing the change of the dental crown. Symmetric location of defects within all dentition sections, and within the same anatomic groups of teeth (the most frequently: incisors and first permanent molars), is specific for celiac disease. The changes described above may be the only manifestation of celiac disease; therefore, in the case of their occurrence further studies towards gluten intolerance are recommended even when other symptoms are not present. In celiac patients, recurrent aphthae and other disorders of the oral mucosa such as ulceration, erythema, atrophic glossitis, as well as dryness and a burning sensation (particularly of the tongue) may be present, which may be caused by malnutrition. Delayed tooth eruption may also be a consequence of alimentary deficiency in celiac disease (Adv Clin Exp Med 2014, 23, 5, 675-681).

At-Risk Screened Children with Celiac Disease are Comparable in Disease Severity and Dietary Adherence to Those Found because of Clinical Suspicion: A Large Cohort Study

“…37 Other possible complications which have been observed regardless of the clinical presentation of celiac disease are for instance low bone mineral density, dental enamel defects and elevated transaminases. 21,22,29,38 Further supporting the presence of advanced disease and risk of complications, the screen-detected children here had levels of celiac disease autoantibodies and severity of villous atrophy similar to those detected on clinical basis. It is possible that, despite equal severity of histological injury, the clinically detected group had longer length of small intestinal injury, which may explain their apparent gastrointestinal symptoms.…”

“…Then again, complications such as poor growth, dental enamel defects and low bone mass have been observed even in otherwise asymptomatic children with celiac disease, and these maladies may remain permanent if left untreated. [21][22][23] In order to further elucidate the potential benefits and detriments of celiac disease screening, we compared clinical, serological and histological features and follow-up results between children detected in the course of risk-group screening and those found due to clinical suspicion.…”

Diagnosis of Lingual Atrophic Conditions: Associations with Local and Systemic Factors. A Descriptive Review

“…The main target of this intolerance is represented by the mucosa of the small intestine, with the development of histological lesions characterized by various degrees of villous atrophy, crypt hyperplasia, damage to the surface epithelium, an increased number of lymphocytes and other inflammatory cells in the lamina propria [7, 32-34]. …”

The Effect of Celiac Disease on the Oral Cavity: A Review )

“…celiac disease is a complex disease associated with several extra intestinal signs and symptoms such as short stature, growth failure, weight loss, osteoporosis, anemia resistant to iron treatment, arthritis, increased liver enzymes, itchy skin rash (dermatitis herpetiformis), numbness, chronic fatigue, depression, delayed puberty, infertility, and schizophrenia [24,25]. Decreased bone density has been found in approximately 75% of newly diagnosed patients, with a 40% greater risk for bone fracture [26].…”

“…In addition to the systemic problems mentioned above, other pathological changes within the oral cavity, including enamel mineralization defects, oral aphtous ulcers, and malocclusion, have been identified [27][28][29]. Delayed tooth eruption, atrophic glossitis, geographic tongue, and burning sensation, particularly in the tongue, may also appear during the course of celiac disease [24][25][26][27][28][29][30].…”