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Can Gluten in Orthodontic Retainers Trigger Ongoing Celiac Symptoms?

Celiac.com 08/22/2014 - It is often hard to tell if isolated case reports have anything to contribute to the larger understanding of celiac disease. However, some case reports are enough in themselves to cause reflection, whatever their contribution to the larger scientific understanding may be.

Photo: Wikimedia Commons--clockfaceFor most people with celiac disease, symptoms disappear and healing begins with the adoption of a gluten-free diet. For one 9-year-old girl, however, the battle to beat her symptoms and feel better did not end with a gluten-free diet.

The girl had initially complained of non-specific abdominal discomfort, and showed positive blood tests for celiac disease. Duodenal biopsies revealed Marsh 3B histopathology. So, she definitely had celiac disease with corresponding symptoms. Despite following a strict gluten-free diet, the girl continued to have symptoms and show positive blood tests for active disease.

Gluten is a common additive in plastics. After some detective work, the team discovered that the child was being exposed to gluten from her orthodontic retainer that contained a plasticized methacrylate polymer.

She discontinued its use and her symptoms disappeared and her celiac blood tests returned to normal.

This case illustrates that, even for patients on the strictest gluten-free diet, exposure to non-dietary sources of gluten, such as those used to make plastics, dental equipment, and cosmetics, can trigger or exacerbate celiac disease symptoms. This case also emphasizes the importance of ferreting out and removing all possible sources of gluten, including non-dietary, when managing celiac disease.

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17 Responses:

 
Kelly

said this on
25 Aug 2014 10:05:30 AM PST
Can you please provide more information on what to ask my doctor about this potential gluten containing mater? I think I have this issue, but my appliance is not optional.

 
PKN
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said this on
25 Aug 2014 7:53:02 PM PST
You should read "Do parents of children with celiac disease really have to worry that their children’s retainers contain gluten?" by Amy Jones, MS, RD and Tricia Thompson, MS, RD, at the Gluten Free Dietitian.

They conclude that the one case mentioned in this presentation gives insufficient data to draw definite conclusions or cause concerns for wearers of dental appliances.

 
Diana Bliffert
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said this on
25 Aug 2014 2:46:06 PM PST
New information, thank you. Diagnosed celiac since 1983.

 
Heather
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said this on
25 Aug 2014 6:36:09 PM PST
What about white fillings used for cavities?

 
Al
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said this on
25 Aug 2014 7:20:15 PM PST
I am in the dental field and heavily involved in research in materials in the dental field.
It is my strong opinion, that the retainer has nothing to do with the celiac symptoms. Even if at one point of time, there was gluten in the resin (but there was not), it would be bound in the resin and there is no way that 20ppm (the upper limit of gluten in a substance to be safe) would go through the stomach and ever reach the small intestine. It is my strong opinion that the retainer was not the source of the problem. Something else was the problem and whatever it was, happened to coincide with the retainer. Anecdotal reports like these cause unnecessary fear.
I can not post a link but I suggest to search the glutenfreedietician site and this topic is discussed there also.

 
MJ Billmann
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said this on
01 Sep 2014 7:35:42 AM PST
It's negative close-minded thinking like this that keep celiac disease cloaked in 'mystery'. Someday all pediatricians will test all children for gluten issues BEFORE they prescribe pharmaceuticals that merely mask symptoms.

 
jill
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said this on
18 Mar 2016 5:32:10 PM PST
Hello AI-
I've been watching for more information about this article saying that my night guard could be a source of gluten contamination. My dentist can't find it. You said that you are in "dental field and heavily involved in research in materials in the dental field." Great! I am so glad you took the time to write a response. I take it you are a chemist or bio-chemist and you have links to studies about leaching of substances. So, what I want to know is if you are following this topic any further? One can perhaps conjecture that the girl might have been accidentally getting glutened from a grain or a baked good, incorrectly deemed 20/million GF (although I've seen studies and inferences saying that is the top # and there are many Celiacs that have damage/reactions at lower parts/million.) I just wondered if you have made a study of how resins hold up in the mouth overnight and can shed any more light on this topic?

 
Donnie
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said this on
25 Aug 2014 7:36:05 PM PST
I didn't know plastics could contain gluten. Does anyone know if plastic water bottles and food containers contain gluten? Such as: #1, 2, 4 and 5? I have to drink bottled spring water, that is in plastic gallon jugs.

 
MJ Billmann
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said this on
01 Sep 2014 7:38:06 AM PST
Don't forget envelopes and many forms of glue.

 
Brian

said this on
25 Aug 2014 8:18:56 PM PST
Please do be more specific - if you know what types. I'm an adult but wear a retainer (only once a week). I've been GF for 8 months and still do not feel good. Wondering if it is the retainer. My retainer does not look like the picture above but is more of a mouthpiece that a fighter might wear - clear plastic

 
Amanda
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said this on
26 Aug 2014 11:13:35 AM PST
Oh my goodness, this is scary! I wonder if this is why I'm still bothered sometimes when wearing my retainers... Like the above person noted, how can we find out what materials are used in the retainers?

 
Marci
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said this on
26 Aug 2014 4:53:11 PM PST
Does anyone know where you can get retainers without plasticized methacrylate polymer?

 
Lisa
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said this on
27 Aug 2014 4:52:30 PM PST
Excellent article my son just got a retainer and I knew about the possible contamination from the product I informed my sons orthodontist I made sure from the lab that there was not any product in my sons material . I work in a GI office in buffalo
NY and I feel I know more about the possibilities of cross contamination then the general public I wish people were more educated about this.

 
Tanja
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said this on
02 Sep 2014 6:38:52 AM PST
I recently started wearing Nightguard. I contacted my dentist but it looks like she can only tell me that it is consistent of methyl methacrylate (which is if I am not mistaken the above mentioned plasticized methacrylate polymer) which can contain gluten. So I have to go to detect who is a manufacturer and can they answer me. Is anybody familiar with the exact manufacturers and products of that sort that contain gluten? I mean it is a whole range of all sorts of dental products and no one is giving names of where is this gluten present. And don't get me started on how much confusion all of these opposite opinions cause. At the end I really do not know what to make of it.

 
jill
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said this on
18 Mar 2016 4:59:32 PM PST
Tanya- Did you or anyone ever get to the bottom of this? As I'm chipping my expensive dental work by grinding at night without wearing my nice custom made methyl plasticized methacrylate polymer night guard, I'm wondering if it is ascertained- as AI above says that any gluten in it would be -"bound in the resin" and unable to leach the 20ppm into your g.i. tract or not.

 
Heather

said this on
03 Sep 2014 2:02:29 AM PST
Wow! POWERFUL KNOWLEDGE!!
I now believe this gives me a thought of why my retainer "May" not have worked correctly. Most of all my parents are so upset to pay $400 for a piece of plastic!!
That may also be a reason why my body disgusts the dentists...no idea why!
NO PROBLEMS... WITH HOSPITAL EVEN ER!! I Usually need IV after IV cause they can
never find my vein the first, second, sometimes, third or more times... so this could be
a possible cause. THANKS FOR THE INFO!!!

 
Sharon
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said this on
05 Sep 2014 10:50:06 AM PST
For those with celiac and NSGS who have an issue with seaweed and seaweed products like carrageenan (red seaweed species) and now the alginates-sodium or calcium alginate/align/alginic acid (from kelp/kombu, brown seaweeds) the dental office can be a concern as many of the molds used contain seaweed substances.




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