Dental enamel defects in adult coeliac disease: Prevalence and correlation with symptoms and age at diagnosis

Published:April 08, 2013DOI:https://doi.org/10.1016/j.ejim.2013.03.007

      Abstract

      Background

      Coeliac disease is a condition characterized by a wide spectrum of clinical manifestations. Any organ can be affected and, among others, dental enamel defects have been described. Our aims were to study the prevalence of dental enamel defects in adults with coeliac disease and to investigate a correlation between the grade of teeth lesion and clinical parameters present at the time of diagnosis of coeliac disease.

      Methods

      A dental examination was performed in 54 coeliac disease patients (41 F, mean age 37 ± 13 years, mean age at diagnosis 31 ± 14 years). Symptoms leading to diagnosis were diarrhoea/weight loss (32 pts.), anaemia (19 pts.), familiarity (3 pts.); none of the patients was diagnosed because of enamel defects. At the time of evaluation, they were all on a gluten-free diet. Enamel defects were classified from grade 0 to 4 according to its severity.

      Results

      Enamel defects were observed in 46/54 patients (85.2%): grade 1 defects were seen in 18 patients (33.3%) grade 2 in 16 (29.6%), grade 3 in 8 (14.8%), and grade 4 in 4 (7.4%). We also observed that grades 3 and 4 were more frequent in patients diagnosed with classical rather than non-classical coeliac disease (10/32 vs. 2/20). However, this was not statistically significant.

      Conclusion

      This study confirms that enamel defects are common in adult coeliac disease. Observation of enamel defects is an opportunity to diagnose coeliac disease.

      Keywords

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      References

        • Corrao G.
        • Corazza G.R.
        • Bagnardi V.
        • Brusco G.
        • Ciacci C.
        • Cottone M.
        • et al.
        Mortality in patients with coeliac disease and their relatives: a cohort study.
        Lancet. 2001; 358: 356-361
        • Biagi F.
        • Klersy C.
        • Balduzzi D.
        • Corazza G.R.
        Are we not over-estimating the prevalence of coeliac disease in the general population?.
        Ann Med. 2010; 42: 557-561
        • Biagi F.
        • Lorenzini P.
        • Corazza G.R.
        Literature review on the clinical relationship between ulcerative jejunoileitis, coeliac disease and enteropathy associated T cell lymphoma.
        Scand J Gastroenterol. 2000; 35: 785-790
        • Ludvigsson J.F.
        • Leffler D.A.
        • Bai J.
        • Biagi F.
        • Fasano A.
        • Green P.H.R.
        • et al.
        The Oslo definitions for coeliac disease and related terms.
        Gut. 2013; 62 ([2]): 43-52
        • Aine L.
        • Mäki M.
        • Collin P.
        • Keyriläinen O.
        Dental enamel defects in celiac disease.
        J Oral Pathol Med. 1990; 19: 241-245
        • Pastore L.
        • Carroccio A.
        • Compilato D.
        • Panzarella V.
        • Serpico R.
        • Lo Muzio L.
        Oral manifestations of celiac disease.
        J Clin Gastroenterol. 2008; 42: 224-232
        • Aguirre J.M.
        • Rodriguez R.
        • Oribe D.
        • Vitoria J.C.
        Dental enamel defects in celiac patients.
        Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 1997; 84: 646-650
        • Cheng J.
        • Malahias T.
        • Brar P.
        • Minaya M.T.
        • Green P.H.
        The association between celiac disease, dental enamel defects, and aphthous ulcers in a United States cohort.
        J Clin Gastroenterol. 2010; 44: 191-194
        • Mariani P.
        • Mazzilli M.C.
        • Margutti G.
        • Lionetti P.
        • Triglione P.
        • Petronzelli F.
        • et al.
        Coeliac disease, enamel defects and HLA typing.
        Acta Paediatr. 1994; 83: 1272-1275
        • Aine L.
        Permanent tooth dental enamel defects leading to the diagnosis of coeliac disease.
        Br Dent J. 1994; 177: 253-254
        • Biagi F.
        • Pezzimenti D.
        • Campanella J.
        • Vadacca G.B.
        • Corazza G.R.
        Endomysial and tissue transglutaminase antibodies in coeliac sera. A comparison not influenced by previous serological testing.
        Scand J Gastroenterol. 2001; 36: 955-958
        • Macdonald W.C.
        • Brandborg L.L.
        • Flick A.L.
        • Trier J.S.
        • Rubin C.E.
        Studies of celiac sprue. IV. The response of the whole length of the small bowel to a gluten-free diet.
        Gastroenterology. 1964; 47: 573-589
        • Ralph P.M.
        • Troutman K.C.
        The oral manifestations of intestinal lymphangiectasia: case report.
        Pediatr Dent. 1996; 18: 461-464