Dental Maturity in Children With Celiac Disease

A Case-control Study

Najlaa M. Alamoudi; Farah A. Alsadat; Azza A. El-Housseiny; Osama M. Felemban; Amani A. Al Tuwirqi; Rana H. Mosli; Omar I. Saadah


BMC Oral Health. 2020;20(311) 

In This Article


Celiac disease (CD) is an immune-mediated enteropathy targeting the mucosa of the small intestine and triggered by gluten ingestion in gentically susceptible individuals.[1] CD may present with intestinal or extraintestinal symptoms, or without any symptoms at all (silent).[2] Oral manifestations of CD have been reported, including apthous ulceration, delayed dental eruption (DE), and dental enamel defects.[3]

Dental age (DA) determination is useful for forensic and legal purposes; for example, it can be used for determining the age of an individual with an unknown or unrecorded chronological age (CA). It can also help in the treatment of orthodontic cases. DA could be estimated by either the number of erupted teeth within the oral cavity, or the degree of tooth calcification assessed by radiography.[4] Dental eruption is affected by child's socioeconomic status or individual characteristics, such as weight, height, gender, or culture,[4,5] although DE has been related to the general metabolism and growth of the body. Malnutrition has been reported in association with delayed DE;[6] children with a poor nutritional status may present with delayed DE. By contrast, children with a good nutritional status can have an advanced stage of DE.[7] Thus, delayed DA can be used as a clue for clinical diagnosis of patients with silent CD, in association with delayed growth and development.[8] A pediatric dentist should be aware of the various clinical features of CD in children for early diagnosis, since early intervention contributes to improved quality of life.

Several studies that examine the association between CD and DA have been published.[9–12] These show that CD patients tend to have delayed DE in comparison with healthy controls, attributable to the general delay in growth and development found in CD patients.[8] Some authors relate delayed DE to the effect of poor nutritional status often observed in CD patients.[9]

Dental maturity (DM) reflects the difference between the dental age (DA) and chronological age (CA). Its determination provides more information on the eruption of teeth and dental development, focusing on the developmental process rather than local or environmental factors,[6] enabling, for example, the development of an orthodontic treatment plan.[10] However, to the best of our knowledge, there is a limited number of published studies on children with CD related to their DM. Thus, we aim to examine the DM in children with CD and to compare this with healthy controls to look for possible predictors of DM.