by Jonathan Richter, DDS, FAGD
Celiac disease is a hereditary autoimmune disorder and is one of the most common gastrointestinal
disorders in the world. When gluten is consumed, it triggers the body’s immune response, which attacks the small intestine and damages the villa. Villa are small fingerlike projections that line the small intestine and promote nutrient absorption. When the villa are damaged, nutrients cannot be absorbed by the body properly, resulting in vitamin and mineral deficiencies and the onset of health conditions if left undiagnosed.
Gluten is a protein found in wheat, rye and barley, and, believe it or not, pops up in skin care products, shampoos, such dental wellness products as toothpaste, mouthwash, dental floss and fluoride, and even in gloves!
Diagnosis of celiac disease can be difficult since there are many symptoms associated with the condition, including, but not limited to, bloating, chronic diarrhea, constipation, gas, nausea, stomach pain and vomiting. Even asthma and skin conditions, like rosacea, eczema and psoriasis, have been linked to celiac disease or gluten sensitivity. Additionally, there are a multitude of dental complications that a patient with celiac disease might experience, but these symptoms are much less well known—even to dentists!
One of the biggest complications related to celiac disease are dental enamel defects—children being especially vulnerable because enamel defects can lead to lifelong oral health issues. If a child has celiac disease and he or she consumes gluten in any substantial quantity as the teeth are developing, the child can end up with a defect in the enamel leading into post-teeth formation.
Most enamel defects resulting from celiac disease place patients at very high risk for decay or other issues. Discoloration typically occurs, with patients noticing white, yellow or brown spots on the teeth. The enamel itself can be mottled and weak, sometimes exhibiting pitting, grooving or lines across the teeth.
Other common dental symptoms include delayed eruption of teeth, cheilosis (fissuring and dry scaling of the lips and angles of the mouth) and atrophic glossitis (also known as bald tongue). Many people also experience issues with frequent aphthous ulcers, otherwise known as cold sores. These sores can be especially painful and sometimes require prescribed medication to relieve them. In addition, a common problem is dry mouth syndrome, which, when coupled with dental enamel defects, puts patients at greater risk for tooth decay and cavity formation.
If you have celiac disease or gluten sensitivity, tell your dentist because several products—such as the prophy paste used in annual and biannual cleanings, some gloves, topical fluoride, polishing pastes, and even topical anesthetics—might have gluten as an ingredient. Also dental products that are a color typically have gluten in them. If any of these products are used on a patient with celiac disease, it will cause a very unpleasant response.
Source: Jonathan Richter, DDS, FAGD, of Cardiodontal (310 E. Shore Rd., Ste. 101, Great Neck). For more information or to schedule an appointment, call 516-282-0310 or visit Cardiodontal.com.