ORAL HEALTH EVIDENCE-BASED PRACTICE PROGRAM
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Title Strong Evidence of Correlation Between Enamel Defects with Celiac Disease
Clinical Question Does Celiac Disease have an effect on the development of enamel?
Clinical Bottom Line There is a strong correlation between enamel defects and Celiac Disease.
Best Evidence (you may view more info by clicking on the PubMed ID link)
PubMed ID Author / Year Patient Group Study type
(level of evidence)
#1) 20212408Giuca/2010varied groupsLiterature Review
Key resultsEvidence collected from 1972 to 2009 showed that there was a correlation between oral defects and Celiac Disease.
#2) 21507289Rashid/2011varied groupsClinical Review
Key resultsEnamel defects in Celiac Disease present in permanent dentition ranged from 9.5% - 95.9% with a mean of 51.1%. Enamel defects present in deciduous dentition ranged from 5.8% to 13.3% with a mean of 9.6%.
#3) 19687752Cheng/201067 patients with CD, 69 control patientsCase Control Study
Key resultsPatients with celiac disease presented more enamel defects than the patients in the control group: (51% vs. 30%, P=0.016, OR 2.4, 95% CI 1.2-4.8). In children this correlation was also evident: (87% vs. 33%, P = 0.003, OR 13.3, 95% CI 3.0-58.6). The correlation was present in mixed dentition vs. permanent dentition (68.4% vs. 29.6%, P<0.0001). In adults this correlation was not seen (32% vs. 29%, P=0.76, OR 1.2, 95% CI 0.5-2.8).
Evidence Search ("Celiac Disease"[Mesh]) AND "Dental Enamel"[Mesh] ("Dental Enamel Hypoplasia"[Mesh]) AND "Celiac Disease"[Mesh]
Comments on
The Evidence
The Giuca review was conducted using Medline database that consisted of articles from 1979 to 2009. Of the 382 published articles found, 29 articles were selected as relevant. From these 29 articles an additional 17 articles were found to supplement the data. Per literature review evidence does in fact exist between certain types of oral defects and celiac disease. Additionally this information validates dental screening for signs of celiac disease as part of the clinical exam. The Rashid clincial review discussed the different manifesations that can occur orally in a patient with Celiac Disease. The prevalence of these intraoral manifestations was reported. The Cheng article was a case control study that included 67 people recruited from a Celiac Disease support group with Celiac Disease and 69 controls. The controls were on a regular diet while the people with Celiac Disease were on a gluten free diet. Dental examination was conducted. Teeth were dried with light air and wiped with a 2X2 gauze. Photographs were then taken of the patients teeth and they were questioned on the prevalance of apthous ulcers. The same dentist examined all the patients and a second dentist re-examined the photographs taken of the patients. When evaluating the enamel, patients were either determined to have a presence of enamel defect or not.
Applicability In order to detect Celiac Disease at an early stage, dental patients that present with enamel hypoplasia should be screened for the possibility of having Celiac Disease.
Specialty/Discipline (Oral Medicine/Pathology/Radiology) (General Dentistry) (Pediatric Dentistry) (Restorative Dentistry)
Keywords Enamel, Celiac Disease, Dental Enamel Hypoplasia
ID# 2293
Date of submission: 05/02/2012spacer
E-mail torresla@livemail.uthscsa.edu
Author Luciana Torres
Co-author(s)
Co-author(s) e-mail
Faculty mentor/Co-author Georgiana Gross, MPH
Faculty mentor/Co-author e-mail GROSSG@uthscsa.edu
Basic Science Rationale
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