title: Oral aspects in celiac disease children: clinical and dental enamel chemical evaluation.
abstract: OBJECTIVE
  The aim of this study was to evaluate the oral manifestations of celiac disease (CD), the chemical composition of dental enamel, and the occurrence of CD in children with dental enamel defects (DEDs).
  
  
  METHODS
  In the study, 52 children with CD and 52 controls were examined for DEDs, recurrent aphthous stomatitis (RAS), dental caries experience, and salivary parameters. In addition, 10 exfoliated primary enamel molars from each group were analyzed by energy dispersive x-ray spectroscopy and Fourier transform infrared spectroscopy. Fifty children with DEDs were submitted to CD diagnosis.
  
  
  RESULTS
  Among the children with CD, a higher prevalence of DEDs (P = .00001) and RAS (P = .0052), lower caries experience (P = .0024), and reduction of salivary flow (P = .0060) were observed. Dental enamel from the children with CD demonstrated a lower calcium-to-phosphorus ratio (P = .0136), but no difference in the carbonate-to-phosphate ratio (P = .5862) was observed. In the multivariate analysis, CD was a protective factor for caries (OR = 0.74) and a risk factor for RAS (OR3.23).
  
  
  CONCLUSIONS
  The children with CD presented with more RAS, DEDs, reduction of salivary flow, and chemical alterations in the enamel.
authors.affiliation: Professor, Department of Pediatric Dentistry, University of São Paulo - School of Dentistry of Ribeirão Preto, Ribeirão Preto, São Paulo, Brazil. Electronic address: Fabricio@hotmail.com.
authors.forename: Fabrício Kitazono
authors.initials: FK
authors.lastname: de Carvalho
authors.affiliation: Professor, Department of Pediatric Dentistry, University of São Paulo - School of Dentistry of Ribeirão Preto, Ribeirão Preto, São Paulo, Brazil.
authors.forename: Alexandra Mussolino
authors.initials: AM
authors.lastname: de Queiroz
authors.affiliation: Professor, Department of Pediatric Dentistry, University of São Paulo - School of Dentistry of Ribeirão Preto, Ribeirão Preto, São Paulo, Brazil.
authors.forename: Raquel Assed
authors.initials: RA
authors.lastname: Bezerra da Silva
authors.affiliation: Professor, Department of Childcare and Pediatrics, University of São Paulo - School of Medicine of Ribeirão Preto, Ribeirão Preto, São Paulo, Brazil.
authors.forename: Regina
authors.initials: R
authors.lastname: Sawamura
authors.affiliation: Professor, Department of Physics, University of São Paulo - School of Philosophy, Sciences and Letters of Ribeirão Preto, Ribeirão Preto, São Paulo, Brazil.
authors.forename: Luciano
authors.initials: L
authors.lastname: Bachmann
authors.affiliation: Full Professor, Department of Pediatric Dentistry, University of São Paulo - School of Dentistry of Ribeirão Preto, Ribeirão Preto, São Paulo, Brazil.
authors.forename: Léa Assed
authors.initials: LA
authors.lastname: Bezerra da Silva
authors.affiliation: Full Professor, Department of Pediatric Dentistry, University of São Paulo - School of Dentistry of Ribeirão Preto, Ribeirão Preto, São Paulo, Brazil.
authors.forename: Paulo
authors.initials: P
authors.lastname: Nelson-Filho
mesh_terms: D000293:Adolescent; D016022:Case-Control Studies; D002446:Celiac Disease / Q000150:complications*; D002648:Child; D002675:Child, Preschool; D003731:Dental Caries / Q000209:etiology; D003743:Dental Enamel / Q000737:chemistry*; D006801:Humans; D007223:Infant; D008855:Microscopy, Electron, Scanning; D008963:Molar; D012463:Saliva / Q000737:chemistry; D012472:Salivation; D013052:Spectrometry, X-Ray Emission; D013281:Stomatitis, Aphthous / Q000209:etiology