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Oral Manifestations of Celiac Disease

Pastore, Luca DDS*; Carroccio, Antonio MD; Compilato, Domenico DDS; Panzarella, Vera DDS; Serpico, Rosario MD§; Muzio, Lorenzo Lo MD*

Journal of Clinical Gastroenterology: March 2008 - Volume 42 - Issue 3 - p 224-232
doi: 10.1097/MCG.0b013e318074dd98

Introduction Contrary to early beliefs, celiac disease (CD) is relatively common; however, it still remains underdiagnosed since most cases are atypical, with few or no gastrointestinal symptoms and predominance of extraintestinal manifestations. As a consequence, the diagnosis of the disorder often requires a multidisciplinary approach. Also some oral ailments have been described in celiac patients. In this study, we review the papers that have reported oral manifestations in subjects with CD.

Methods A comprehensive literature search was conducted in Medline and Embase databases using appropriate key words. Additional papers were selected by cross-referencing from the retrieved articles.

Results Dental enamel defects are the oral lesions most closely related to CD. There are conflicting data on the association between CD and recurrent aphthous stomatitis. A correlation of CD with atrophic glossitis has been reported, although robust evidence in support of it is lacking. Patients with CD have caries indexes seemingly lower than healthy individuals, but they may experience delay in tooth eruption. Occurrence of other oral mucosal lesions in CD subjects is likely occasional.

Conclusions Patients with systematic dental enamel defects should be screened for CD even in the absence of gastrointestinal symptoms. CD screening tests for patients with oral aphthae or idiopathic atrophic glossitis should be selectively considered during a medical evaluation that focuses on all aspects of the patient's status.

*Department of Surgical Sciences, University of Foggia

Departments of Internal Medicine

Oral Sciences, University of Palermo

§Department of Oral Disciplines, Second University of Naples, Italy

The authors declare no conflict of interest.

Supported in part by PRIN 2005 from Ministry of University and Research, Italy.

Reprints: Dr Luca Pastore, DDS, Dip. Scienze Chirurgiche, Università degli Studi di Foggia, c/o Ospedali Riuniti, viale Pinto, 71100 Foggia, Italy (e-mail:

© 2008 Lippincott Williams & Wilkins, Inc.