Prevalence of dental findings of children with celiac disease in Libya: a comparative study

Abstract

Background and objectives: Celiac disease is a disease affecting the digestive system whereby the patient is unable to tolerate gluten-containing food. The aims of this study were to study the prevalence of dental defects and oral hygiene status of a group of celiac disease patients in Benghazi. Materials and methods: A group of celiac disease patients (n = 40 & Male: Female ratio is 1: 2.4 & age range 3-19 years, mean 10 years, SD ± 4.8) were recruited from Benghazi Pediatric Hospital where they had already been diagnosed in gastroenterology units at private clinics. The patient's dental status was assessed through measuring their Decayed, Missing and Filled Teeth index (DMFT), oral hygiene index (OHI) and CPITN using disposable mouth mirrors, explorers and periodontal probes. Descriptive statistics was applied to give a picture about the oral hard and soft tissue prevalence this group of patients. Results: Descriptive statistics of the celiac sample showed that 29 (72.5%) had enamel hypoplastic defects. The mean and SD values for DMFT, CPITN and OHI were measured (DMFT: 4.5 SD ± 4.7 & CPITN: 0.8 SD ± 0.5; and OHI: 1.1 SD ± 0.7). Besides, only two patients (6.4%) reported a history of oral ulceration during the course of their therapy. Healthy controls showed comparative values, being less in only OHI, while they were slightly more in DMFT and CPITN. Conclusion: This is a cross-sectional clinical survey showing that patients with celiac disorder should be expected to have higher prevalence of defective incisor teeth, which makes their front teeth liable to traumatic fracture. The presence of frequent soft tissue ulcers in their mouths might indicate a warning sign of the possibility to develop the disease and thus urge the child's parents or guardians to consult a physician to confirm or negate the suspicion.

Review of Celiac Disease Presentation in a Pediatric Tertiary Centre

“…There is strong evidence confirming an increased risk of dental enamel defects (DED) in children with CD and it may be the only presenting symptom (1,77) . The incisors and molars are the most frequently affected (77)(78)(79) . We report a 2.5% prevalence of DED, but three case-control studies have reported estimates of 55%, 62% and 73% (as compared with 18%, 21% and 0% in the corresponding control groups), indicating higher prevalence of DED among children with CD (77)(78)(79) .…”

“…The incisors and molars are the most frequently affected (77)(78)(79) . We report a 2.5% prevalence of DED, but three case-control studies have reported estimates of 55%, 62% and 73% (as compared with 18%, 21% and 0% in the corresponding control groups), indicating higher prevalence of DED among children with CD (77)(78)(79) . A significant improvement on GFD in children with DED and CD is reported, so screening for CD is highly recommended, particularly in the presence of hypocalcemia (78,80) .…”