Celiac Disease and Your Oral Health

According to the Mayo Clinic, one in 141 Americans living in the U.S. has celiac disease. However, it is believed that as many as an additional two million people have it, but remain undiagnosed. Living with Celiac disease traditionally means a wheat-free diet, but it may require you to alter your oral care habits as well. People with this condition are more prone to gastrointestinal problems, and as a result, their teeth (often referred to as “Celiac teeth”) are more prone to decay. This means those with Celiac disease need to take extra steps to protect their enamel. Other dental issues associated with Celiac disease include dry mouth, canker sores and even oral cancer. We take a look at what Celiac Disease is and offer some tips to ease your symptoms and protect your mouth.

What is Celiac Disease?

Celiac disease is a type of chronic digestive disorder in which a person’s body is unable to tolerate a protein called gluten. Gluten is a protein is found in wheat, oats, rye, and barley. When ingested, the gluten causes an immune response that results in the destruction of small protrusions that are located in the small intestine. The protrusions, called villi, allow the intestine to absorb nutrients that the body needs from the foods that are being digested. Because of the destruction of the villi, nutrients are unable to be successfully digested and a person can suffer from malnutrition. Celiac disease can appear at any time in a person’s life. In adults, the disease can be triggered for the first time after surgery, viral infection, severe emotional stress, pregnancy or childbirth. CD is a multi-system, multi-symptom disorder. Symptoms vary and are not always gastrointestinal. GI symptoms can often mimic other bowel disorders. Infants, toddlers and young children with CD may often exhibit growth failure, vomiting, bloated abdomen, behavioral changes and failure to thrive.

How do I know if I have Celiac Disease?

Although celiac disease is a condition that affects both children and adults, the symptoms often manifest differently according to which category a person falls into. Young children often experience symptoms associated with digestive difficulties, such as vomiting, abdominal bloating, and weight loss. Bowel-related symptoms include stools with a strong, foul odor, chronic diarrhea or constipation, and fatty stools. Additionally, sufferers may seem more irritable as a result. Signs of malnutrition due to celiac disease in infants and young children may include stunted or delayed growth, late puberty, and dental defects in permanent teeth.

As adults, people who develop celiac disease will tend to have fewer digestive symptoms. Common symptoms for adults include feelings of depression, fatigue, and anxiety. They may suffer from iron-deficiency anemia that cannot be easily explained, arthritis, osteoporosis, itchy skin, and canker sores. Women may experience missed periods or infertility or may be more susceptible to miscarriage. Dermatitis herpetiformis is a skin rash that is also associated with the disease.

How does Celiac Disease affect oral health?

  • Dental Enamel Damage: It’s common for people with Celiac disease to experience white, yellow or brown spots on the enamel of their teeth. The enamel may even develop poorly, incur pitting or banding and appear translucent. Dental enamel defects appear as bilateral, symmetrical, and chronologic white or yellow opacities with or without rough horizontal lines or grooves; the enamel is without glaze and enamel structural defects could be present. This is caused by an immune-mediated reaction affecting the cells, which form enamel and a nutritional disturbance. Sometimes, a dentist will be able to pinpoint Celiac disease as the root cause of your dental issues before you’re even diagnosed with the condition. Although the dental effects of Celiac are irreversible, early diagnosis of celiac disease while enamel is still forming may decrease the amount of future enamel defects. Adults who have dental enamel defects usually seek cosmetic dental options to improve the look of the affected teeth, like veneers or other cosmetic restoration.
  • Chronic Canker Sores: Recurrent canker sores or mouth ulcers are another nuisance for those with Celiac disease. These painful breakouts appear on the inside of your lips or cheeks, on your tongue, at the base of your gums or on the roof of your mouth. Research hasn’t yet proven what causes them in every case, though it may have something to do with the body’s immune system. No matter what the cause, avoid spicy and acidic foods that can irritate your mouth, instead eating simple, plain-flavored meals until your canker sores aren’t a bother to you anymore. If the sores are especially large or painful, ask your dentist about treating it with a prescribed medication.
  • Dry Mouth Syndrome:  Celiac disease can also lead to dry mouth. Dry mouth makes you more susceptible to tooth decay and cavities because you have less saliva to wash away bacteria and food debris. Drink plenty of water during the day to keep your mouth hydrated and keep a humidifier in your room while you sleep to prevent your mouth from drying out. Consider the use of a saliva substitute, as well as a prescription toothpaste, both of which are made especially for dry mouth so they won’t aggravate your condition.

Follow these tips and work with a knowledgeable dental professional to keep your overall health in excellent shape despite this dietary limitation.

Do you have any questions about Celiac Disease and your oral health? Call Westermeier Martin Dental care to schedule an appointment with your dentist 716-508-4547.