Association of oral manifestations with celiac disease in Syrian patients: A case-control study

Introduction: Celiac disease is an autoimmune condition that is primarily elicited by the ingestion of gluten from wheat, barley and oats. Celiac disease may present with extra-intestinal symptoms despite the absence of gastrointestinal complaints, complicating timely diagnosis and leading to underrecognition. Oral manifestations are valuable indicators for identifying patients with celiac disease. In this context, dentists are pivotal in the early detection of celiac disease by recognizing characteristic oral signs and referring patients for definitive diagnostic evaluation. The objective of this study was to explore the oral manifestations associated with celiac disease. Materials and Methods: A case-control study was conducted involving 70 participants grouped as follows: 35 individuals diagnosed with celiac disease and 35 individuals representing the control group. Oral findings-recurrent aphthous ulcers (RAU), pallor and fissured lips, angular cheilitis, atrophic glossitis, and geographic tongue-were examined under halogen illumination using a sterile dental mirror. Results: The study employed chi-square analysis to identify significant differences between the celiac disease group and the control groups. Significant associations were detected between celiac disease and recurrent aphthous ulcerations (p = 0.000), atrophic glossitis (p = 0.041), and geographic tongue (p = 0.000). However, no significant difference was observed in the incidence of pallor and fissured lips (p = 0.066) and angular cheilitis (p = 0.779) between the two groups. Conclusion: The outcomes of this cross-sectional study provide valuable insights into the oral manifestations associated with celiac disease. The study underscores the significance of routine dental examinations and the early identification of oral manifestations in individuals diagnosed with celiac disease, as they may serve as crucial clinical indicators of the underlying autoimmune disorder.