Oral Manifestations in Children with Celiac Disease- Part II: Salivary Changes, Immunological Markers and their Correlation with Oral Health Status

Objectives: Celiac disease (CD) is a systemic autoimmune disorder associated with various oral manifestations, including dental enamel defects (DED). This study aimed to investigate the correlation between enamel defects, other oral health-related factors, and salivary immunological markers in children with CD. Subject and Methods: A total of 128 children, comprising 97 patients diagnosed with CD and 31 healthy controls, were included in this cross-sectional study. All participants underwent a thorough oral examination to assess for dental enamel defects, caries experience, and recurrent aphthous stomatitis (RAS). Saliva samples were collected to measure stimulated salivary flow rate, buffer capacity, saliva pH, the levels of mutans Streptococci and Lactobacilli, anti-tissue transglutaminase (tTG) IgA and anti-gliadin antibody (AGA) IgA. Results: Children with CD showed a significantly higher prevalence of dental enamel defects and RAS compared to the healthy control group (p < 0.05). Serum IgA and tTG IgA levels positively correlated with salivary IgA and tTG IgA levels (p = 0.02, p = 0.00). A statistically significant positive correlation was found between the presence of enamel defects and the salivary levels of both tTG IgA and AGA IgA (p < 0.05). No significant difference was observed in caries experience between the groups. Conclusion: Celiac disease is associated with significant oral health disadvantages in children, including a higher prevalence of enamel defects. The correlation between these defects and salivary immunological markers suggests that saliva analysis could serve as a promising, non-invasive tool for monitoring disease-related oral manifestations in pediatric patients.