Oral manifestations and dental precautions of celiac disease

Celiac disease (gluten-sensitive enteropathy) is a common chronic gastrointestinal disorder affecting both children and adults، resulting in small intestine mucosal disruption via an autoimmune mechanism in patients with genetic predilection. Classic signs of the disease are chronic abdominal signs (diarrhea، flatus)، amnesia، weight loss، malnutrition and anemia. However، many of the patients have atypical signs without gastrointestinal signs. Delay in diagnosis and treatment could lead to complications. This review article summarizes the common oral manifestation of celiac disease. In addition، it evaluates oral signs of atypical cases which are the only approach for dentists to diagnose the disease. Review report: A search was run for the key word “celiac”، combined with “oral manifestation” in Iran medical databases (medlib. ir) and in library sources، including reference books، PubMed، Scopus and Google search engine from 1982 to 2012. Articles were selected based on inclusion and exclusion criteria and evaluated. Since many people with celiac disease do not present with the classic malabsorptive syndrome and delays in the diagnosis are common، oral manifestation such as dental enamel defects and recurrent aphthous ulcers may be the only manifestations of this disorder. Dentists can play an important role in identifying people who may have unrecognized celiac disease. Appropriate referral and a timely diagnosis can help prevent serious complications of this disorder.