Anam Ahmed
1. Department of Gastroenterology, AIIMS, New Delhi
Title: Dental Enamel defects and other Oral Manifestations in patients with celiac disease
Biography
Biography: Anam Ahmed
Abstract
Celiac disease (gluten sensitive enteropathy) is a chronic autoimmune disorder which affects 40-60 million people globally and 5-8 million people in India. Initially considered a disease found in children is now known to occur at any age group. Many patients lack gastrointestinal symptoms which causes delay in diagnosis, thus, dental enamel defects and recurrent aphthous ulcers, which may occur in patients with celiac disease (CeD), may be the only manifestation of this disorder. Others include Xerostomia, Cheilosis and Glossitis. To observe various oral manifestations in Indian population, known CeD patients (n=90) were screened from tertiary care unit of department of Gastroenterology, AIIMS, New Delhi (Celiac clinic) and relatives of patients from Otolaryngology department, AIIMS, New Delhi were taken as control subjects (n=30). Questionnaire was designed and filled by a dental surgeon and images of manifestations were captured. Various enamel defects were found in 69(76.7%) patients with CeD and 8(26.7%) controls. Enamel defects were more prominent in molars followed by incisors and canines. Xerostomia was complained by 58(64.4%) CeD patients and 10(33.3%) controls. Recurrence of aphthous ulcers was complained by 8(8.9%) CeD patients and 2(6.7%) controls. Glossitis and Lichen planus was found in 4(4.4%) and 2(2.2%) patients respectively but none of the controls had either of these manifestations. Cheilosis being another important oral manifestation was found in 10(11.1%) CeD patients and 1(3.3%) controls. Dental caries was found in 37(41.1%) CeD patients and 4(13.3%) controls, this might either be due to xerostomia or altered salivary content in CeD patients. Patients having such manifestations and with clinical suspicion of CeD should be advised to obtain serologic screening for CeD and, if positive, standard procedure should be followed for confirmation of diagnosis. Dentists here can play an important role in identifying people who may have unrecognized CeD. Appropriate referral and a timely diagnosis can help prevent serious complications of this disorder.