Journal Information
The European Journal of Oral Sciences (EJOS) is an international journal with a peer-reviewed nonprofit publication status. It has been published bi-monthly since 1893 and is a popular journal. EJOS aims at the survival of original scientific research in the medical field. The journal’s primary focus is on dental research, which distresses various aspects of problematic oral issues. It is significant to note that the journal produces not only articles but also short communications, letters, and focus reviews. Accordingly, this provides a comprehensive overview of the problems that exist in the field of dentistry (Wiley Online Library, n.d.). Publications in the journal are free (except for open access), and there is no limit on the number of pages.
Purpose of Choosing This Article
It is crucial to remark that celiac disease is an autoimmune condition that affects almost one in one hundred people worldwide. Patients with the disease cannot digest gluten and the protein found in cereal crops, such as wheat (Liu et al., 2022). It is important to establish whether the disease really affects the small intestine, which makes it difficult for the body to absorb many vital nutrients. Besides, it is essential to verify which symptoms the disorder is associated with, for example, whether it includes dental lesions, dry mouth, and aphthous stomatitis. It is also fundamental to establish whether the disease causes salivary gland lesions. In addition, the choice of the article relates to the need to apply its findings in professional activities.
Introduction of the Article
Celiac illness is a chronic autoimmune enteropathy that causes structural changes in the intestine. The dense lymphocytic infiltration and villous atrophy result in discomfort when chewing food. There is a genetic predisposition to such problems, but the main factors influencing the development of the problem are environmental issues. However, the situation is aggravated because the disease is diagnosed in progressive stages. Accordingly, this reduces the chances of curing a person’s oral cavity. Studies explain the effects of a gluten-free diet on the salivary glands. At the same time, gland lesions are associated with more discomfort in the mouth (Liu et al., 2022). Thus, the article “Salivary Gland Involvement and Oral Health in Patients With Coeliac Disease” should be analyzed.
Purpose of the Study
This article aims to establish in patients with signs of CD inflammation and structural changes of the mucosal glands. The paper accepts the hypothesis that inflammation of the small auditory glands reflects structural changes in the large mucosal glands (Liu et al., 2022). This is due to the rate of chewing and saliva flow. The consequence of the flow rate stimulation is through citric acid and impaired sIgA secretion (Liu et al., 2022). In addition, the article investigates whether salivary gland lesions are potentially associated with increased oral discomfort and dental deterioration. Another focus of the study is to specify the relationship between mucosal lesions in spores and Candida hyphae in patients with CD.
Materials and Method
Participants in the study were individuals who were continuously screened for health conditions and did not have abnormalities. Twenty-six people participated in the cross-sectional study, but six of them were not included in the dressage study because of comorbid factors (Liu et al., 2022). One of the methods of analysis was an interview. All participants answered questions about their general health, medication intake, medical history, and bad habits. Additionally, they responded to questions about symptoms that involved the oral cavity. Moreover, they had their saliva secretion rate measured for reliability. The participants took oral candidiasis swabs to confirm the clinical lesion (Liu et al., 2022). A lip salivary gland biopsy and histopathological analysis were also used as methods of investigation. Secretory IgA (sIgA) analysis was used to measure the salivary flow rate. Finally, statistical analysis in the research was applied to establish reliable results.
Results
When a diagnosis was created, all patients had problems with gastrointestinal symptoms. However, 70% had extraintestinal symptoms and other additional signs. All participants followed a gluten-free diet, but only half had persistent symptoms (Liu et al., 2022). Daily intake of dietary supplements was higher among patients with CD. Results of the serologic analysis show that patients had statistically significantly higher vitamin D levels than healthy controls (P = 0.02). Oral symptoms included xerostomia (60%), and more than half indicated recurrent aphthous stomatitis. Eight patients had impaired and altered taste perception, and three healthy control group participants reported impaired taste perception (Liu et al., 2022). Signs of mucosal dryness dominated the sample of participants, and mucosal erythema was observed among the patients. Only one CD patient was found to have grade 1 dental enamel defects on the lateral incisors. It is essential to mention that all participants’ mean salivation rate values were within normal limits. CD patients had higher rates of unstimulated and stimulated chewing saliva. The rate of stimulated parotid saliva was also higher (Liu et al., 2022). There were no significant correlations between age and salivary secretion rate. Lip salivary gland tissue biopsies in patients with CD demonstrated more changes in broader, diffuse chronic inflammation, focal lymphocytic infiltration, acinus atrophy, and glandular fibrosis than in healthy controls.
Discussion
The results suggest that minor salivary glands are associated with CD. Immunohistochemical analysis revealed more widespread inflammation and more focal lymphocytic infiltration in the labial salivary glands of CD patients than in healthy individuals. The small salivary glands of CD patients were characterized by acinar atrophy, fibrosis, and diffuse chronic inflammation. Relative focal lymphocytic infiltrations in the lip salivary glands of CD patients confirm the findings of patients with Sjogren’s syndrome. The study results indicate that the oral mucosa may be subject to an inflammatory response (Liu et al., 2022). In addition, patients who followed a gluten-free diet had the highest degree of inflammatory changes in the cheek mucosa. These outcomes may also explain the immune-mediated inflammatory changes in the lower small salivary glands. Therefore, unstimulated and promoted chewing saliva flow rates were significantly higher in patients with CD.
The study design does not determine whether the location of the salivary glands can contribute to explaining their different ways of being affected. Although adherence to a gluten-free diet reduces the degree of inflammation in the salivary glands and helps maintain normal salivary secretion (Liu et al., 2022). In addition, patients with CD also reported more oral problems, including taste disorders and eating problems. Patients had more rotten tooth surfaces than healthy participants. The healthy control group’s levels of potentially cariogenic bacteria did not differ between the two groups (Liu et al., 2022). It was found that the minor salivary glands were affected in patients with long-term CD despite following a gluten-free diet.
Conclusion of the Article
Thus, the article establishes that the salivary glands are affected in patients with long-term CD despite adherence to a gluten-free diet. However, further examinations are required to create inflammation in the lip salivary gland tissue. Significantly, the function of the major salivary glands was not altered in CD, and salivary sIgA did not differ among participants. The number of enamel defects was minimal, but this was due to the young age of the participants. Indeed, dental health and levels of potentially cariogenic bacteria did not appear to have varied among participants. Accordingly, the primary function of the salivary glands remains unchanged, promoting a balanced microbiota and oral health in CD individuals.
Take Home Message
It is essential to continue to investigate the specific secretion of the minor salivary glands and the composition of the secretions in order to elucidate the reasons for the high prevalence of oral mucosal lesions and symptoms in CD, as patients receive favorable treatment and adhere to the diet.
References
Liu, J., Lundemann, A. K. J., Reibel, J., & Pedersen, A. M. L. (2022). Salivary gland involvement and oral health in patients with coeliac disease. European Journal of Oral Sciences, 130(3), e12861.
Wiley Online Library. (n.d.). Author guidelines.