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Dental enamel defects and oral cavity manifestations in Asian patients with celiac disease

  • Original Article
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Indian Journal of Gastroenterology Aims and scope Submit manuscript

Abstract

Background

While the small intestine is the main site of disease, many other organs are affected by celiac disease (CeD). Dental enamel defects (DED) are common in patients with CeD, and these are one of the indicators of CeD, even when no other symptom of CeD is present. Data on dental and oral cavity manifestations in Asian patients with CeD are scanty. The purpose of the current study was to evaluate dental and oral manifestations in Asian patients with CeD.

Methods

We recruited 118 patients with biopsy-confirmed CeD (36 treatment naïve and 82 on follow-up for at least 1 year on gluten-free diet [GFD]) and 40 controls. Diagnosis was made as per the standard criteria. Oral and dental manifestations were evaluated by a dental surgeon. The DED were evaluated according to Aine’s criteria.

Results

Overall higher number of patients with CeD (66.9%), both treatment naïve (69.4%) and those on GFD (65.8%) had DED in comparison to controls (20%) (odds ratio, 8.1, 95% confidence interval [CI] 3.4–19.2; p<0.001). Specific/bilaterally symmetrical DED were significantly higher in patients with CeD than controls. Recurrent aphthous ulcers were also significantly higher in patients with CeD. Approximately 80.6% and 63.4% treatment-naïve patients and those on GFD, respectively reported dry mouth sensation, which was significantly higher than the controls.

Conclusion

Almost two-third of patients with CeD had DED. Physicians and dietitians caring for patients with CeD should be trained in identification of DED and other oral manifestations of CeD.

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Acknowledgements

We acknowledge the support of study subjects for their kind participation in this study. We also acknowledge Wajiha Mehtab, Mona Pathak, Samagra Agarwal, Akhilesh Gaur, Ashu Miyan, and Sachin Rajput for their kind help.

Funding

The financial grant for this study was provided by the Department of Biotechnology, Government of India (Ref No. BT/MED/12/SP17783/2016).

Author information

Authors and Affiliations

  1. Department of Gastroenterology and Human Nutrition, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, 110 029, India

    Anam Ahmed, Alka Singh, Ashish Chauhan, Mahendra S. Rajput, Vikas Banyal, Vineet Ahuja & Govind K. Makharia

  2. Department of Otorhinolaryngology and Head - Neck Surgery, All India Institute of Medical Sciences, New Delhi 110 029, India

    Smile Kajal

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  1. Anam Ahmed
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Contributions

Conceptualization: Anam Ahmed, Govind K Makharia; methodology: Anam Ahmed, Smile Kajal, Alka Singh; formal analysis and investigation: Anam Ahmed, Smile Kajal, Ashish Chauhan; writing–original draft preparation: Anam Ahmed, Alka Singh, Mahendra S Rajput; writing–review and editing: Anam Ahmed, Alka Singh, Vikas Banyal, Govind K Makharia; funding acquisition: Govind K Makharia; supervision: Vineet Ahuja, Govind K Makharia

Corresponding author

Correspondence to Govind K. Makharia.

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Conflict of interest

AA, AS, SK, AC, MSR, VB, VA, and GKM declare that they have no conflict of interest.

Ethics statement

The study was performed conforming to the Helsinki declaration of 1975, as revised in 2000 and 2008 concerning human and animal rights, and the authors followed the policy concerning informed consent as shown on Springer.com.

The study was approved by Institute Ethics Committee of All Indian Institute of Medical Sciences (AIIMS), New Delhi (Ref No – IEC-324/01.07.2016).

Consent to participate

Informed consent was obtained from all individual participants included in the study.

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The authors affirm that human research participants provided informed consent for publication of the images in Fig. 1a, b, c, and d.

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The authors are solely responsible for the data and the contents of the paper. In no way, the Honorary Editor-in-Chief, Editorial Board Members, the Indian Society of Gastroenterology or the printer/publishers are responsible for the results/findings and content of this article.

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Guarantor of the article: Prof. Govind K Makharia, Professor, AIIMS, New Delhi

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Cite this article

Ahmed, A., Singh, A., Kajal, S. et al. Dental enamel defects and oral cavity manifestations in Asian patients with celiac disease. Indian J Gastroenterol 40, 402–409 (2021). https://doi.org/10.1007/s12664-021-01175-7

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  • DOI: https://doi.org/10.1007/s12664-021-01175-7

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