Oral microbiota and oral aspects in celiac disease before and after gluten free diet

Background: Celiac disease is an autoimmune disease. The immune reaction produces an inflammation that damages the lining of the small intestine, in particular the duodenal mucosa, leading to a general malabsorption of nutrients that causes intestinal symptoms and manifestations to the oral cavity. The aim of the work is to identify any dental or mucosal manifestations of celiac disease before and after the gluten-Free diet, in order to find a new diagnostic method for this disease. The oral examination could make a significant contribution to the revelation of celiac disease. Finding the connection between this disease and oral problems, the oral clinical examination could be considered an easy, non-invasive and effective method for the identification of autoimmune disease. Methods: 300 celiac patients will be examined before the gluten-free diet (T0) and then they will be reevaluated three months after the beginning of diet (T1). In T0 will be performed: anamnesis; DMFT / dmft (decayed, missing, filled teeth); evaluation of mucosal lesions such as recurrent aphthous stomatitis; collection of information related to the last professional oral hygiene and the brushing habits; pH through a saliva sample examined with pH meter; - quantitative analysis of basal salivary flow; identification of C-reactive protein that detects and controls an inflammation in the organism; FMPS (full mouth plaque score) and FMBS (full mouth bleeding score) considering six surface a tooth in order to exclude poor oral hygiene as a cause of inflammation; microbiological analysis (GENOMIC KIT for the extraction of bacterial DNA processed in PCR-Real-Time). The patients will be treated with professional oral hygiene to remove tartar and plaque. In the second visit (T1) the parameters considered in T0 will be re-evaluated using the initial methods. The data obtained will be compared with those observed in T0. Results: Comparing 300 patients' clinical exams, it will be possible to define if celiac patients have more oral manifestations than healthy people. Conclusions: The identification of oral signs caused by celiac disease will give more importance to clinical oral examination because this exam will be considered an easy, non-invasive and effective method to identify' the autoimmune disease.