ORAL MANIFESTATIONS OF THE CELIAC DISEASE PART I. A SYSTEMATIC REVIEW OF CASE-CONTROLLED STUDIES

Celiac disease (CD) is responsible for digestive and systemic manifestations leading to moderate-to-severe health disparities and impaired quality of life for the affected patients. Several oral manifestations have been described, including mainly dental enamel defects (DEDs) and recurrent aphthous stomatitis (RAS). Nevertheless, publications on the topic reveal visible reporting discrepancies. Therefore, the aim of our study was to perform a systematic-review of case-controlled observational studies on CD oral manifestations. The searching protocol was applied to EMBASE, OVID and PubMed. Both pediatric and adult cohorts were included. The main oral manifestation in children was represented by DEDs, while RAS was rather reported in adults. Despite the relatively constant prevalence reported for such oral manifestations, publications are characterized by high publication and outcome bias. Moreover, oral manifestations are influenced by concurring the oral conditions possibly generated by diet and healthcare disparities. Thus, CD should be searched in patients with DEDs and aphthous ulcers or RAS, yet the concurring conditions should be ruled out, and a thorough CD diagnosis algorithm should be implemented.