Dental enamel defects in celiac patients

Area of Science:

• Oral Medicine
• Gastroenterology
• Genetics

Background:

• Celiac disease is an autoimmune disorder triggered by gluten ingestion.
• Enamel defects are a known, yet often overlooked, extraintestinal manifestation of celiac disease.

Purpose of the Study:

• To determine the prevalence and patterns of enamel defects in pediatric and adult celiac disease patients.
• To compare enamel defect characteristics between celiac disease patients and a healthy control group.
• To investigate the association of specific human leukocyte antigens (HLAs) with enamel defects in celiac disease.

Main Methods:

• Oral examinations were conducted on 137 celiac disease patients and 52 controls.
• Permanent dentition enamel defects were recorded for type, number, and location.
• Decayed, Missing, and Filled Teeth (DMFT) index and HLA typing were performed on celiac disease patients.

Main Results:

• Enamel defects were found in 52.5% of celiac disease patients versus 42.3% of controls, with systematic defects being significantly more prevalent in the celiac group.
• Defects were more frequently bilateral and symmetrical in celiac patients (72.2%) compared to controls (40.9%).
• Incisors and molars were most affected, with significantly greater involvement in the celiac group. DR7, DR3, and DQ2 were common HLAs in celiac patients.

Conclusions:

• Enamel defects are a frequent finding in individuals with celiac disease.
• The characteristic bilateral, symmetrical, and chronological distribution of defects, particularly on incisors and molars, should prompt screening for celiac disease.
• These oral findings can serve as a clinical indicator for further diagnostic evaluation of celiac disease.