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 her complete dental story.
Dental manifestations of Celiac
Celiac disease is an autoimmune digestive disorder. People who have celiac disease cannot tolerate a protein called gluten, found in wheat, rye, and barley. Gluten is found mainly in foods but may also be found in products we use every day, such as stamp and envelope adhesive, certain medicines, and vitamins. When people with celiac disease eat foods containing gluten, their immune system responds by damaging the finger-like villi of the small intestine. 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. Celiac disease is a genetic condition that can be triggered by events such as surgery, pregnancy, childbirth, viral infection, or severe emotional stress. The only treatment for celiac disease is a lifelong gluten-free diet.
This disease can cause the improper development of enamel on adult teeth. A fairly common oral manifestation of celiac disease is abnormal tooth shape and/or appearance. 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.