Patinen P, Aine L, Collin P, Hietanen J, Korpela M, Enckell G, Kautiainen H, Konttinen Y T, Reunala T
Department of Oral and Maxillofacial Surgery, Helsinki University Central Hospital, Helsinki, Finland.
Oral Dis. 2004 Nov;10(6):330-4. doi: 10.1111/j.1601-0825.2004.01048.x.
Both coeliac disease (CD) and Sjogren's syndrome (SS) have an autoimmune background and increased risk of oral mucosal and dental abnormalities. Individuals suffering concomitantly from CD and SS could even be at a higher risk.
Oral mucosal and dental abnormalities were examined in 20 patients with CD + SS (mean age 61 years) and compared with age- and sex-matched controls with either CD or SS.
Oral mucosal changes were most common in SS (80%), followed by CD + SS (65%) and CD (40%). Coeliac-type dental enamel defects were found in 89% in CD + SS and in 88% in CD compared with only 25% in SS (P < 0.001). The median number of teeth was six in the CD + SS, 24 in the CD and 22 in the SS group. The DMF index was higher (P < 0.005) in the CD + SS than in the CD group. CD + SS was characterized by higher salivary flow rate (P < 0.001) and lower inflammatory focus score in the salivary glands (P < 0.01) than SS.
The co-occurrence of CD and SS should be recognized because of its effects on dental and oral mucosal health. A lower salivary gland inflammatory focus score and higher salivary flow rate in CD + SS than in SS suggests that a gluten-free diet treatment may alleviate autoimmune inflammation.
乳糜泻（CD）和干燥综合征（SS）均具有自身免疫背景，且口腔黏膜和牙齿异常的风险增加。同时患有CD和SS的个体甚至可能面临更高的风险。
对20例CD + SS患者（平均年龄61岁）的口腔黏膜和牙齿异常进行检查，并与年龄和性别匹配的单纯CD或SS对照组进行比较。
口腔黏膜变化在SS中最为常见（80%），其次是CD + SS（65%）和CD（40%）。CD + SS中89%发现乳糜泻型牙釉质缺陷，CD中为88%，而SS中仅为25%（P < 0.001）。CD + SS组的牙齿中位数为6颗，CD组为24颗，SS组为22颗。CD + SS组的DMF指数高于CD组（P < 0.005）。与SS相比，CD + SS的特点是唾液流速更高（P < 0.001），唾液腺炎症焦点评分更低（P < 0.01）。
应认识到CD和SS的同时存在，因为其对牙齿和口腔黏膜健康有影响。与SS相比，CD + SS的唾液腺炎症焦点评分更低，唾液流速更高，这表明无麸质饮食治疗可能减轻自身免疫炎症。
