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Screening for celiac disease in children with dental enamel defects.

El-Hodhod MA, El-Agouza IA, Abdel-Al H, Kabil NS, Bayomi KA - ISRN Pediatr (2012)

Bottom Line: After 1 year on GFD, DED improved better in CD compared to nonceliac patients.Lower serum calcium significantly predicted CD in this cohort.Conclusion.

View Article: PubMed Central - PubMed

Affiliation: Department of Pediatrics, Faculty of Medicine, Ain Shams University, Cairo 11566, Egypt.

ABSTRACT
Background. Dental enamel defects (DEDs) are seen in celiac disease (CD). Aim was to detect frequency of CD among such patients. Methods. This study included 140 children with DED. They were tested for CD. Gluten-free diet (GFD) was instituted for CD patients. A cohort of 720, age and sex-matched, normal children represented a control group. Both groups were evaluated clinically. Serum calcium, phosphorus, alkaline phosphatase, serum IgA, and tissue transglutaminase (tTG) IgG and IgA types were measured. Results. CD was more diagnosed in patients with DEDs (17.86%) compared to controls (0.97%) (P < 0.0001). Majority of nonceliac patients showed grade 1 DED compared to grades 1, 2, and 3 DED in CD. Five children had DED of deciduous teeth and remaining in permanent ones. After 1 year on GFD, DED improved better in CD compared to nonceliac patients. Gastrointestinal symptoms did not vary between celiac and nonceliac DED patients. Lower serum calcium significantly predicted CD in this cohort. Conclusion. CD is more prevalent among children with DED than in the general population. These DEDs might be the only manifestation of CD; therefore, screening for CD is highly recommended among those patients especially in presence of underweight and hypocalcemia.

No MeSH data available.


Related in: MedlinePlus

Comparison between the degrees of improvement of grade of DED in patients with CD versus patients with non-CD. (DIFF_CD: degree of improvement in CD, DIFNONCD: degree of improvement in non-CD).
© Copyright Policy - open-access
Related In: Results  -  Collection


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fig1: Comparison between the degrees of improvement of grade of DED in patients with CD versus patients with non-CD. (DIFF_CD: degree of improvement in CD, DIFNONCD: degree of improvement in non-CD).

Mentions: After 1-year followup with routine dental care for all patients in addition to GFD in CD, the frequency of improvement of DED was significantly higher in CD compared to non-CD patients (P = 0.0003). Grade 1 pathology was more seen in nonceliac compared to celiac both at start and after 1 year of care (P = 0.0001 and P = 0.0091, resp.). Grade 2 and 3 pathology were significantly more frequent in CD more than nonceliac patients at the start of study (P = 0.0243 and P = 0.0452, resp.). However, the difference became insignificant after 1 year of care. Frequency of grade 4 was not different between celiac and nonceliac patients. Moreover, grade 1 was not different in same group before and after 1 year of care (Table 3). Figure 1 showed that the degree of improvement of grade of DED in celiac patients was significantly higher than that of nonceliac patients. The maximum shift of DED grade was one level. Deciduous teeth showed no improvement at all.


Screening for celiac disease in children with dental enamel defects.

El-Hodhod MA, El-Agouza IA, Abdel-Al H, Kabil NS, Bayomi KA - ISRN Pediatr (2012)

Comparison between the degrees of improvement of grade of DED in patients with CD versus patients with non-CD. (DIFF_CD: degree of improvement in CD, DIFNONCD: degree of improvement in non-CD).
© Copyright Policy - open-access
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC3376764&req=5

fig1: Comparison between the degrees of improvement of grade of DED in patients with CD versus patients with non-CD. (DIFF_CD: degree of improvement in CD, DIFNONCD: degree of improvement in non-CD).
Mentions: After 1-year followup with routine dental care for all patients in addition to GFD in CD, the frequency of improvement of DED was significantly higher in CD compared to non-CD patients (P = 0.0003). Grade 1 pathology was more seen in nonceliac compared to celiac both at start and after 1 year of care (P = 0.0001 and P = 0.0091, resp.). Grade 2 and 3 pathology were significantly more frequent in CD more than nonceliac patients at the start of study (P = 0.0243 and P = 0.0452, resp.). However, the difference became insignificant after 1 year of care. Frequency of grade 4 was not different between celiac and nonceliac patients. Moreover, grade 1 was not different in same group before and after 1 year of care (Table 3). Figure 1 showed that the degree of improvement of grade of DED in celiac patients was significantly higher than that of nonceliac patients. The maximum shift of DED grade was one level. Deciduous teeth showed no improvement at all.

Bottom Line: After 1 year on GFD, DED improved better in CD compared to nonceliac patients.Lower serum calcium significantly predicted CD in this cohort.Conclusion.

View Article: PubMed Central - PubMed

Affiliation: Department of Pediatrics, Faculty of Medicine, Ain Shams University, Cairo 11566, Egypt.

ABSTRACT
Background. Dental enamel defects (DEDs) are seen in celiac disease (CD). Aim was to detect frequency of CD among such patients. Methods. This study included 140 children with DED. They were tested for CD. Gluten-free diet (GFD) was instituted for CD patients. A cohort of 720, age and sex-matched, normal children represented a control group. Both groups were evaluated clinically. Serum calcium, phosphorus, alkaline phosphatase, serum IgA, and tissue transglutaminase (tTG) IgG and IgA types were measured. Results. CD was more diagnosed in patients with DEDs (17.86%) compared to controls (0.97%) (P < 0.0001). Majority of nonceliac patients showed grade 1 DED compared to grades 1, 2, and 3 DED in CD. Five children had DED of deciduous teeth and remaining in permanent ones. After 1 year on GFD, DED improved better in CD compared to nonceliac patients. Gastrointestinal symptoms did not vary between celiac and nonceliac DED patients. Lower serum calcium significantly predicted CD in this cohort. Conclusion. CD is more prevalent among children with DED than in the general population. These DEDs might be the only manifestation of CD; therefore, screening for CD is highly recommended among those patients especially in presence of underweight and hypocalcemia.

No MeSH data available.


Related in: MedlinePlus