Salivary gland involvement and oral health in patients with coeliac disease

Liu, Jason; Lundemann, Ann-Kristine Juncker; Reibel, Jesper; Pedersen, Anne Marie Lynge

doi:10.1111/eos.12861

Cited by 8 publications

(15 citation statements)

References 47 publications

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“…[ 147 , 149 ]. The enteropathy triggered by the ingestion of gluten is correlated with various oral manifestations such as xerostomia, dry lips, mucosal ulcerations, and sialadenitis [ 150 ]. A recent pediatric study confirmed that children with CD have a higher rate of recurrent aphthous stomatitis and dental enamel defects than the healthy population [ 151 ].…”

Section: Methodsmentioning

confidence: 99%

New Approach to Addison Disease: Oral Manifestations Due to Endocrine Dysfunction and Comorbidity Burden

et al. 2022

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This review highlights oral anomalies with major clinical impact in Addison disease (AD), including dental health and dermatologic features, through a dual perspective: pigmentation issues and AD comorbidities with oral manifestations. Affecting 92% of AD patients, cutaneomucosal hyperpigmentation is synchronous with or precedes general manifestations by up to a decade, underlying melanocytic infiltration of the basal epidermal layer; melanophages in the superficial dermis; and, rarely, acanthosis, perivascular lymphocytic infiltrate, and hyperkeratosis. Intraoral pigmentation might be the only sign of AD; thus, early recognition is mandatory, and biopsy is helpful in selected cases. The buccal area is the most affected location; other sites are palatine arches, lips, gums, and tongue. Pigmented oral lesions are patchy or diffuse; mostly asymptomatic; and occasionally accompanied by pain, itchiness, and burn-like lesions. Pigmented lingual patches are isolated or multiple, located on dorsal and lateral areas; fungiform pigmented papillae are also reported in AD individuals. Dermoscopy examination is particularly indicated for fungal etiology; yet, it is not routinely performed. AD’s comorbidity burden includes the cluster of autoimmune polyglandular syndrome (APS) type 1 underlying AIRE gene malfunction. Chronic cutaneomucosal candidiasis (CMC), including oral CMC, represents the first sign of APS1 in 70–80% of cases, displaying autoantibodies against interleukin (IL)-17A, IL-17F ± IL-22, and probably a high mucosal concentration of interferon (IFN)-γ. CMC is prone to systemic candidiasis, representing a procarcinogenic status due to Th17 cell anomalies. In APS1, the first cause of mortality is infections (24%), followed by oral and esophageal cancers (15%). Autoimmune hypoparathyroidism (HyP) is the earliest endocrine element in APS1; a combination of CMC by the age of 5 years and dental enamel hypoplasia (the most frequent dental complication of pediatric HyP) by the age of 15 is an indication for HyP assessment. Children with HyP might experience short dental roots, enamel opacities, hypodontia, and eruption dysfunctions. Copresence of APS-related type 1 diabetes mellitus (DM) enhances the risk of CMC, as well as periodontal disease (PD). Anemia-related mucosal pallor is related to DM, hypothyroidism, hypogonadism, corresponding gastroenterological diseases (Crohn’s disease also presents oral ulceration (OU), mucogingivitis, and a 2-3 times higher risk of PD; Biermer anemia might cause hyperpigmentation by itself), and rheumatologic diseases (lupus induces OU, honeycomb plaques, keratotic plaques, angular cheilitis, buccal petechial lesions, and PD). In more than half of the patients, associated vitiligo involves depigmentation of oral mucosa at different levels (palatal, gingival, alveolar, buccal mucosa, and lips). Celiac disease may manifest xerostomia, dry lips, OU, sialadenitis, recurrent aphthous stomatitis and dental enamel defects in children, a higher prevalence of caries and dentin sensitivity, and gingival bleeding. Oral pigmented lesions might provide a useful index of suspicion for AD in apparently healthy individuals, and thus an adrenocorticotropic hormone (ACTH) stimulation is useful. The spectrum of autoimmune AD comorbidities massively complicates the overall picture of oral manifestations.

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Section: Methodsmentioning

confidence: 99%

New Approach to Addison Disease: Oral Manifestations Due to Endocrine Dysfunction and Comorbidity Burden

et al. 2022

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“…Conversely, the other seventeen studies [11,[20][21][22][23][24]26,30,31,33,34,36,[39][40][41][42]44] presented data indicating that the occurrence of RAS in the study group was statistically significantly higher when compared to the control group.…”

Section: Recurrent Aphthous Stomatitis (Ras)mentioning

confidence: 99%

Beyond the Gut: A Systematic Review of Oral Manifestations in Celiac Disease

Lucchese

Stasio

Stefano

et al. 2023

JCM

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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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“…Niekonsekwentne jej przestrzeganie może prowadzić do osteoporozy, bezpłodności oraz nowotworów złośliwych, w tym chłoniaka T-komórkowego. Ponadto może występować z innymi chorobami autoimmunologicznymi, zwłaszcza cukrzycą typu 1, chorobami tarczycy i zespołem Sjögrena [7]. Celiakia może dotyczyć osób obu płci w każdym wieku, natomiast średni wiek rozpoznania to 45 lat, a do 20% wszystkich pacjentów diagnozowanych jest powyżej 60 roku życia [8].…”

Section: Wprowadzenieunclassified

“…Zmniejszone wydzielanie śliny jest możliwym objawem celiakii [2].Obniżenie wilgotności błony śluzowej jamy ustnej zwiększa ryzyko infekcji oraz próchnicy oraz wiąże się tez z zaburzeniami smaku. [2,7]. Badania wykazują, że mniejsze gruczoły śluzowe u pacjentów chorujących na celiakie charakteryzują się atrofią, włóknieniem i rozlanym przewlekłym zapaleniem.…”

Section: Iiif Zmniejszone Wydzielanie śLinyunclassified

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Dental and oral manifestations of coeliac disease - a literature review

Jakubowska,

Łazicka,

Tuczyńska

et al. 2023

J Educ Health Sport

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Introduction Coeliac disease is a genetic autoimmune disease of the digestive system. It is caused by permanent intolerance to gluten (a protein contained in wheat, rye, barley), which results in the atrophy of the intestinal villi in the small intestine and deficiency of nutrients in the body. It can also manifest itself with various pathologies within the teeth and oral mucosa. Aim of the study The purpose of the study is to present the symptoms of coeliac disease in oral cavity. Materials and methods PubMed and Google Scholar medical databases were analyzed, operating with the following keywords: coeliac disease, oral cavity, manifestations, lesions, symptoms, oral health in as many configurations as needed. Twenty-eight related articles published during the last five years (2018-2023) were selected. Results In addition to the classic intestinal symptomatology, coeliac disease can also manifest itself in the oral cavity in the form of delayed tooth eruption, enamel defects, MIH, recurrent aphthous stomatitis or xerostomia. The etiology of the changes is still not clear, but studies show that they most likely arise as a result of impaired absorption of vitamins and minerals in the small intestine. Conclusion The variety of symptoms of celiac disease makes it a significant diagnostic challenge. It is important to raise awareness among dentists about the symptoms of the disease because a quick diagnosis can prevent many complications.

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Salivary gland involvement and oral health in patients with coeliac disease

Cited by 8 publications

References 47 publications

New Approach to Addison Disease: Oral Manifestations Due to Endocrine Dysfunction and Comorbidity Burden

New Approach to Addison Disease: Oral Manifestations Due to Endocrine Dysfunction and Comorbidity Burden

Beyond the Gut: A Systematic Review of Oral Manifestations in Celiac Disease

Dental and oral manifestations of coeliac disease - a literature review

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