Alterations of the oral ecosystem in children with celiac disease.

UNLABELLED The aim of this work is to evaluate the alterations of the oral ecosystem in symptomatic children with celiac disease (CD), to establish a particular pattern of oral markers that can be used as presumptive diagnosis of CD. MATERIAL & METHODS A sample of n=52 children with CD diagnosis according to the modified criteria of the European Society of Pediatric Gastroenterology and Nutrition (ESPGAN), 1990, was studied. A dental clinical evaluation of soft and hard tissues was performed. Saliva samples were obtained; in which buffer capacity, total proteins, calcium and phosphate were measured and SDS PAGE 12% electrophoretic profiles were performed. In addition, oral mucosa smears were collected by brushing. RESULTS Low frequency of enamel structural alterations was found, particularly in the permanent teeth of children with CD. These alterations had characteristics of chronological coherence (31.7%), bilateralism (26.8%) and symmetry (29.23%). The celiac smears in the celiac group (20%) showed signifcant presence of polymorphic nuclei and free nuclei. The celiac group had significant differences in buffer capacity, IgA levels, minute volume, calcium and Ca/P ratio (p<0.05). The protein profiles of CD children showed the absence of bands of low, medium and high molecular weight. CONCLUSION Our results enable us to develop an alteration pattern corresponding to the oral ecosystem of CD children. In the CD patients, the most relevant variables were tooth enamel alterations, oral mucosa morphology, and modifications of salivary parameters, which would enable the dentist to refer these patients to specialist physician.