Maintain Good Dental Health with Celiac Disease

Most common symptoms for celiac disease include gastrointestinal problems, such as abdominal pain and discomfort. However, diagnosing this condition is certainly not straightforward.  Sometimes it manifests itself in unexpected places. One of these places may be your mouth.  It is, therefore, necessary to maintain good dental health with celiac disease. Recent studies report 85-90% of all individuals with CD suffer from some type of dental defect.

If you find yourself making constant trips to the dentist, ask your health care provider about celiac disease. Sometimes teeth problems are the only subtle sign that points to an undiagnosed case of this condition.

Are oral problems more frequent in celiac disease patients?

Yes, celiac disease patients are at a higher risk of developing oral health problems. These can  include teeth defects and other disturbances in the mouth. It is estimated this may affect over 80% -90% of celiac disease patients. Interestingly, defects associated with this condition tend to affect incisors and first molars in a symmetrical and sequential pattern (the same on one side as on the other). Single, random and asymmetrical changes are seldom markers for celiac disease. Particularly in children, these problems may be the only manifestation of the disease.  Your dentist may recommended further testing to rule out the possibility of celiac disease.

What are the most common problems?

For celiac disease patients, most common problems include:

Defects in teeth enamel Include:

• thinning of the enamel
• yellow or darker coloration
• rough teeth surface with horizontal or vertical grooves
• changes in the shape of the teeth.
• mottled or translucent-looking teeth (discolored or almost “see through”)
• Disturbances with mucosa include: 
•  recurrent aphthae, erythema (red spots) and sore or painful tongue,
• a burning sensation and dryness.
•  ulcers inside the mouth (called aphthous ulcers).
•  cracking at the corners of the mouth or cracking lips (called cheilosis).
•  lesions, sores or rashes on the mouth, lips or tongue (called oral lichen planus).
•  a smooth, glossy tongue that is painful and tender to the touch (called atrophic glossitis)
• Caries:
• Scientists are yet to determine if caries (tooth decay) are more common in celiac disease patients. Some studies seem to suggest this is the case but, in practical terms, patients following a gluten-free diet and consuming less sugar, may naturally develop a better oral hygiene and avoid these cavities.
• Delay in tooth eruption:
• In children, a delay in tooth eruption can be one of the first signs of celiac disease and should be investigated. This is most likely a consequence of malnutrition and failure to thrive caused by celiac disease.
• Malocclusion of the mandible:
• Again caused by short stature and slow growth, many children with celiac disease present a misalignment between the upper and lower jaw when they close their mouth. For some, this may be severe enough to need corrective treatment.

Children vs. adults

Teeth problems, in particular relating to the formation of enamel, are more prevalent if celiac disease is diagnosed in children than in adults. It’s generally accepted that this is because the development of symptoms in adults takes place after the process of mineralization of teeth.

• For milk teeth, this happens during the prenatal period, making children suffering from celiac disease more likely to develop problems with their teeth from a very early age.
• Issues with the arrangement of teeth as they come in
• For permanent teeth, the first ones to undergo mineralization include molars, incisors and canines, typically completed up to the age of 8 years old. In practical terms, if symptoms start to develop after this age, patients are less likely to develop teeth problems.

What is the mechanism behind these challenges?

Researchers know there is a strong correlation between teeth problems and celiac disease, but an explanation remains elusive. There are certainly  nutritional influences, and it is believed that low calcium in particular caused by malabsorption may disturb the process of teeth formation. Similarly, deficiencies in iron, folic acid, and vitamin B12 can cause aphthae, but a gluten-free diet accompanied with proper nutritional supplementation are usually enough to decrease their incidence.

For celiac disease patients, however, there may be another reason, which is totally unrelated to nutritional deficiencies. Researchers have observed that anti-gliadin antibodies – present in celiac disease patients – may react with enamel proteins as these are incredibly similar to gliadin. Further studies are still needed to clarify this mechanism.

Conclusion

There is no running away from the fact that celiac disease patients are more likely to experience problems with their teeth. For children, in particular, even if no other symptoms are present, any teeth problems – especially if they appear symmetrically and chronologically in incisors and first molars – should be reason for further investigations. Therefore, a meticulous examination of the mouth, looking in particular for enamel defects, aphthae or delayed teeth eruption, may allow an early diagnosis and prevent further complications.

This original article is made possible by Gluten Free Therapeutics. Our mission is to educate, inform, and provide the most effective nutritional products possible to allow those with celiac disease and severe gluten intolerances to heal their bodies. CeliVites complete line of superior gluten free supplements includes multivitamin supplements, iron supplements, and calcium supplements for people living with celiac disease.

All CeliVites products are designed to help you heal, restore and rebuild your body, because going gluten-free isn’t enough!