Gluten Intolerance - Celiac Disease
This patient has Celiac disease, a more extreme type of gluten intolerance. The tooth enamel of all of her teeth failed to develop correctly and was soft and very susceptible to wear and stains. Her teeth had been covered over by her former dentist with composite bonding to make them look better. The bonded composite was leaking and staining around the edges and did not have natural tooth shapes. This patient wanted to have symmetrically shaped, bright white but still translucent teeth.
Dental Treatment for enamel hypoplasia caused by Celiac
Due to the poor bonding characteristics of this patient's enamel, crowns had to be placed on every tooth in her mouth to stop the wear and erosion and to restore a healthy occlusal (bite) relationship. Empress crowns were placed on her front teeth and porcelain fused to gold crowns were placed on her posterior teeth. See the case report of her complete dental story.
What is Celiac Disease?
Celiac disease is an autoimmune digestive disorder. Those with this condition are unable to tolerate gluten, which is commonly found in rye, barley, and wheat products. If these foods are ingested, an adverse immune response occurs in which the small intestine is damaged. This interferes with absorption of nutrients such as calcium from food into the bloodstream which can lead to malnourishment. Failure to thrive during childhood development is a common indicator of celiac. Common signs of celiac disease include anemia, delayed growth, weight loss, and joint problems; and the bones become weak, brittle, and prone to fracture.
Frequent and severe outbreaks of apthous ulcers or canker sores occur in sufferers of all ages. Those not on a gluten-free diet have a greater risk for cancers of the mouth, esophagus, and pharynx.
Celiac disease has a genetic component that doesn’t always manifest itself. In other words, some people that have the genes don’t seem to have any symptoms or issues. The condition that can be triggered by events such as pregnancy, childbirth, surgery, severe emotional trauma, or a viral infection. The only treatment for celiac disease is a lifelong gluten-free diet.
Dental problems with Celiac Disease
Celiac disease is a condition that affects the digestive system. If you have Celiac disease you may have dental enamel defects. This disease can cause the improper development of enamel on adult teeth. Delayed dental development in the form of slow eruption of adult teeth is also possible. The enamel defects often cause more cavities in children.
A fairly common oral manifestation of celiac disease is abnormal tooth shape and/or appearance (see case report of Celiac patient). The teeth can be slightly small, widely spaced, and discolored with hypo-calcified enamel. When combined with bruxism, weak and poorly developed enamel can cause significant loss of tooth structure for patients. Bonded composite often will not serve well on functional occlusal surfaces.
Patients with dental enamel defects of the entire secondary dentition should be screened for celiac disease even in the absence of gastrointestinal symptoms. There can also be recurrent aphthous stomatitis. This disease affects one in 100 individuals, and 97% of those affected are undiagnosed.
Reasons Behind Enamel Defects in Celiac Disease | Enamel hypoplasia
The exact reason that kids with Celiac have enamel defects. Research is continuing on three most likely theories. The nutritional deficiencies often occur due to damage to the lining of the small intestine with Celiac. These nutritional issues may indirectly cause weakening of the enamel. Another theory is that it is an auto-immune issue. Just as the bodies immune system attacks the lining of the small intestine, it also attacks the developing tooth buds of teeth. the third possibility is a genetic link which is associated with Celiac. It has been shown that relatives of patients diagnosed with Celiac often have similar enamel defects even though they themselves have not be diagnosed with the condition.
Celiac Disease and Dry Mouth
Dental problems are compounded when salivary flow is reduced. A dry mouth is a common complaint with celiac. Saliva has a major role in preventing cavities. If the enamel is weak already, then major dental problems can advance quickly. Interestingly, a major cause of chronic dry mouth—Sjögren’s syndrome—is also weakly linked to celiac disease. Sjögren’s syndrome is another autoimmune condition that can cause the immune system to attack the saliva glands. Saliva controls the growth of bacteria that lead to tooth decay, people with Sjögren’s syndrome are also vulnerable to catastrophic tooth decay and tooth loss.
Contact Lake Forest Dental Arts
If you suffer from celiac, and are starting to see symptoms of dental damage, reach out to Dr. Fondriest at Lake Forest Dental Arts. Contact us online or give us a call at 847-234-0517.
Dr Fondriest is a Nationally recognized and highly sought after cosmetic dentist serving clients from throughout the United States