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Celiac diseaseand
Oral healthTrey L. Petty, DDS, FADI, FAGD
Holy Cross Hospital CentreCalgary Alberta Canada
• Oral Manifestations:• Recurrent aphthous stomatitis, canker sores
celiac Disease & Oral health
Atrophic glossitis
Xerostomia - dry mouth
Squamous cell carcinoma
Enamel defects
celiac Disease & Oral health
Oral Manifestations:
celiac Disease & Oral health
• Oral Manifestations:• Enamel defectsRange:•Symmetrical spots of hypocalcification on incisors•Severe structural defects
celiac Disease & Oral health
• Oral Manifestations:• Enamel defects
• North American Society for Pediatric Gastroenterology, Hepatology & Nutrition (NASPGHAN) - 2006Jan
• Included as symptom of Celiac Disease
• Oral Manifestations:• Enamel defects
celiac Disease & Oral health
Due to malabsorption during formation of teethTooth calcification:
• Primary teeth: 14wk - 11mo in utero• Adult teeth: 3mo - 25yrs
celiac Disease & Oral health
• Oral Manifestations:• Enamel defects
Often first step to diagnosis of CDMay be only presenting manifestation
• Oral Manifestations:• Enamel defects
celiac Disease & Oral health
Differential diagnoses:• Dental fluorosis• Amelogenesis imperfecta• Dentinogenesis imperfecta• Osteogenesis imperfecta
• Oral Manifestations:• Enamel defects
celiac Disease & Oral health
NEGLECT... ABUSE ...
Differential diagnoses:
• Oral Manifestations:• Enamel defects
celiac Disease & Oral health
Permanent; requires restoration• Bonding, veneers, crowns
celiac Disease & Oral health
Dental Materials
Do they contain gluten?• Some do...• Some don’t...
www.withoutthewheat.com/Dental_Products.html
celiac Disease & Oral health
Dental Materials
Do they contain gluten?Problem is: SORBITOL• Artificial sweetener• Typically corn derived• MAYBE wheat derived
celiac Disease & Oral health
Dental Materials
Do they contain gluten?Most companies are willing to make a clear Yes/No statementOthers cannot rule-out presence
• Do not control raw materials
celiac Disease & Oral health
Dental Materials
Do they contain gluten?
In general, dental filling materials do NOT contain gluten
celiac Disease & Oral health
Dental Materials
Do they contain gluten?
In general, toothpaste does NOT contain gluten
celiac Disease & Oral health
Dental Materials
Do they contain gluten?In general, denture adhesives MIGHT contain gluten, butDenture cleaners do NOT
celiac Disease & Oral health
Dental Materials
Do they contain gluten?
In general, local anesthetics & topical anesthetics do NOT contain gluten
celiac Disease & Oral health
Dental Materials
Do they contain gluten?
In general, SOME mouth rinses MAY contain gluten
• Caregivers:• Educate the local dental community on CD
• Dentists, Dental Hygienists
• Common oral conditions
• Referral pathways
celiac Disease & Oral health
- Pediatric- Hospital-based- Oral Medicine
Caregivers:• Identify Dental Champions in your area
• Referral of frustrated people living with CD
• Knowledge base of gluten-free dental materials
celiac Disease & Oral health
People living with Celiac Disease:• Find a dentist aware of CD
• Awareness; lack of stigmatization
• Gluten-free dental materials
• You may have to educate about CD...
celiac Disease & Oral health
Oral ulcerations
Dry mouth
Enamel defects
People living with Celiac Disease:Find a dentist to manage symptoms
celiac Disease & Oral health
- caution: $$$
Celiac diseaseand
Oral health
Trey L. Petty, DDS, FADI, FAGD
Holy Cross Hospital CentreCalgary Alberta Canada
Primum non Primum non nocere...nocere...