Importance of celiac disease oral manifestations in pediatric patients: A systematic review.

Viviana Macho, Rita Rodrigues, Diana Pinto, Rita Castro, Cátia Carvalho Silva, Cristina Cardoso Silva, Sandra Clara Soares
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Abstract

Background: Celiac disease (CD) is an autoimmune disease triggered by the ingestion of gluten in genetically predisposed individuals. It is more commonly diagnosed in children presenting typical clinical signs and symptoms but most of the CD patients diagnosed in the developed world are silent cases with no prominent gastrointestinal features. Thus, there are silent forms of the disease in which oral manifestations are the first sign. In the pediatric population oral health can affect growth and self-esteem and have a negative impact in their life quality.

Aim: To assess the prevalence and types of oral manifestations in pediatric patients with CD.

Methods: We performed a comprehensive literature search in PubMed, Scielo, Cochrane Library and Lilacs databases from 2014-2024. Three independent researchers screened and extracted the information, applying the eligibility criteria and bias was assessed using Joanna Briggs Institute tools.

Results: Of the initial 241 articles, 14 studies fulfilled the proposed objectives and were included in the review. The main oral manifestations found were recurrent aphthous stomatitis and enamel defects. Additionally, delayed tooth eruption, angular cheilitis, glossodynia and xerostomia were also reported.

Conclusion: Assessing oral manifestations is crucial, especially in underdiagnosed cases of children with CD. Recognizing these signs helps pediatricians or general practitioners identify them during routine exams, enabling early diagnosis and treatment to prevent negative impacts on the child's and family's quality of life.

Abstract Image

儿科患者乳糜泻口腔表现的重要性:一项系统综述。
背景:乳糜泻(CD)是一种由遗传易感个体摄入麸质引发的自身免疫性疾病。它更常见于表现出典型临床体征和症状的儿童但发达国家诊断出的大多数乳糜泻患者都是无症状病例,没有明显的胃肠道特征。因此,有沉默形式的疾病,其中口腔表现是第一个迹象。在儿科人群中,口腔健康会影响成长和自尊,并对他们的生活质量产生负面影响。目的:评估小儿cd患者口腔表现的患病率和类型。方法:对2014-2024年PubMed、Scielo、Cochrane Library和Lilacs数据库进行综合文献检索。三位独立研究人员筛选和提取信息,应用资格标准,并使用乔安娜布里格斯研究所的工具评估偏见。结果:在最初的241篇文章中,有14篇研究达到了预定的目标,并被纳入了综述。口腔主要表现为复发性口疮性口炎和牙釉质缺损。此外,延迟出牙,角唇炎,舌痛和口干症也有报道。结论:评估口腔表现是至关重要的,特别是在未被诊断的乳糜泻儿童病例中。识别这些症状有助于儿科医生或全科医生在常规检查中发现它们,从而实现早期诊断和治疗,以防止对儿童和家庭生活质量的负面影响。
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