Oral Manifestations in Children with Celiac Disease: Part I - Prevalence of Dental Enamel Defects and Recurrent Aphthous Stomatitis and Their Association with Disease-Related Factors.

UNLABELLED: <p>

Objectives

Celiac disease (CD) is an immune-mediated disorder triggered by gluten, often presenting with oral manifestations: dental enamel defects (DEDs) and recurrent aphthous stomatitis (RAS). This study aimed to determine the prevalence of DEDs and RAS in children with CD and to identify the clinical, serological, and histopathological factors associated with their etiology.

MATERIALS AND

METHODS

Ninety-seven children (6-19 years) with biopsy-confirmed CD and 31 age-matched healthy controls were involved in the study. The CD cohort was stratified by age at diagnosis (<5 years and >5 years) and disease status (newly diagnosed). Data on clinical findings, human leukocyte antigen typing, and biochemical parameters were collected retrospectively. All intestinal biopsies were reevaluated according to the Marsh classification. A single, blinded examiner performed oral examinations to diagnose DEDs and RAS.

RESULTS

The prevalences of DEDs (63.9% vs. 16.1%) and RAS (27.8% vs. 22.5%) were significantly higher in the CD group than in controls (p < 0.05). The severity of DEDs was negatively correlated with serum calcium levels (p = 0.022) and positively correlated with the severity of intestinal damage (p < 0.05). A later age at diagnosis was also associated with a higher prevalence of DEDs. RAS was most prevalent in newly diagnosed, untreated patients (47%, p = 0.016) and showed significant remission following a gluten-free diet (p < 0.001).

CONCLUSION

DEDs and RAS are significant and common oral manifestations in children with CD. The strong association between DED severity and the degree of intestinal histopathology suggests shared pathogenic pathways. These oral findings can serve as important noninvasive clinical markers in the early detection of undiagnosed CD. </p>.