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  • Jefferson Adams
    Jefferson Adams

    Dental Enamel Defects in Children Strong Indicators of Celiac Disease

    Reviewed and edited by a celiac disease expert.

    Celiac.com 10/12/2007 - A team of Dutch dentists recently conducted a study to determine if Dutch children with proven celiac disease exhibit corresponding defects in dental enamel and to gauge whether children without proven celiac disease, but showing celiac-associated gastro-intestinal complaints lack any such defects in their dental enamel.

    The research team included CLAAR D. WIERINK, General dentist, DENISE E. VAN DIERMEN, Department of Oral and Maxillofacial Surgery, Academic Centre for Dentistry, Amsterdam, The Netherlands, IRENE H. A. AARTMAN, Department of Social Dentistry and Behavioral Sciences, Academic Centre for Dentistry, Amsterdam, The Netherlands, HUGO S. A. HEYMANS Emma Children’s Hospital, Academic Medical Centre, Amsterdam, The Netherlands

    The team was led by Claar D. Wierink, and looked at a group of 81 children, 53 who were known to have celiac disease, and 28 of whom served as a control group.

    The children underwent examinations from 2003-2004 and the Oral Surgery Outpatient Clinic of the Academic Medical Center in Amsterdam. 29 (55%) of the 53 children with celiac disease showed enamel defects, compared with 5 (18%) of the 28 non-celiac control subjects.

    Enamel defects were diagnosed as being specific in 20 of the 53 children with celiac disease, compared with only 1 (4%) of the 28 control subjects. Overall, children with celiac disease showed more specific enamel defects than did the control subjects.

    From these results, the researchers concluded that dentists might have a significant role to play in the early screening of patients who have undiagnosed celiac disease.

    International Journal of Paediatric Dentistry 2007

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    Nice article but please provide clinical references of specific enamel defects. As a dental professional with celiac disease I have never in 30 years seen a picture or heard of an enamel defect that was suggested it was related to celiac disease. This is new news. High fevers, medications, injury during tooth development have always been suggested of poor enamel. And when all else fails you blame it on genetics.

    Just FYI:



    Eur J Paediatr Dent. 2007 Mar;8(1):31-7.

    Enamel hypoplasia in coeliac children: a potential clinical marker of early diagnosis.

    Bossù M, Bartoli A, Orsini G, Luppino E, Polimeni A.


    Department of Pediatric Dentistry, University La Sapienza, Rome, Italy.




    International Journal of Paediatric Dentistry

    Volume 17 Issue 3, Pages 163 - 168

    Published Online: 7 Feb 2007


    Dental enamel defects in children with coeliac disease




    Objective. The aim of this study was to investigate whether Dutch children with proven coeliac disease show specific dental enamel defects, and to asses whether children with the same gastrointestinal complaints, but proved no-coeliac disease, lack these specific dental enamel defects.


    Materials and methods. Eighty-one children (53 coeliac patients and 28 control subjects) were examined during the period 2003–2004 in the Oral Surgery Outpatient Clinic of the Academic Medical Centre in Amsterdam.


    Result. Twenty-nine (55%) coeliac patients had enamel defects against 5 (18%) control subjects. In the coeliac disease group, the enamel defects were diagnosed as specific in 20 (38%) children, compared with 1 (4%) in the control group. Statistical analysis showed significantly more specific enamel defects in children with coeliac disease than in children in the control group (χ 2 = 12.62, d.f. = 2, P = 0.002).

    Conclusion. This study showed significantly more specific enamel defects in Dutch children with coeliac disease as compared with children in the control group. Dentists could play an important role in recognizing patients with coeliac disease.




    3) From the National Digestive Diseases Information Clearinghouse

    A service of the National Institute of Diabetes and Digestive and Kidney Diseases, NIH


    Dental Enamel Defects and Celiac Disease


    Celiac disease manifestations can extend beyond the classic gastrointestinal problems, affecting any organ or body system. One of these manifestations—dental enamel defects—can help dentists and other health care providers identify people who may have celiac disease and refer them to a gastroenterologist. Ironically, for some people with celiac disease, a dental visit, rather than a trip to the gastroenterologist, was the first step toward discovering their illness.


    Not all dental enamel defects are caused by celiac disease, although the problem is fairly common among people with the condition, particularly children, according to Alessio Fasano, M.D., medical director at the University of Maryland Center for Celiac Research. And dental enamel defects might be the only presenting manifestations of celiac disease, Fasano said.


    Dental enamel problems stemming from celiac disease involve permanent dentition and include tooth discoloration—white, yellow, or brown spots on the teeth—poor enamel formation, pitting or banding of teeth, and mottled or translucent-looking teeth. The imperfections are symmetrical and often appear on the incisors and molars.


    Tooth defects resulting from celiac disease are permanent and do not improve once a diagnosed patient adopts a gluten-free diet—the only treatment available for celiac disease. But dentists may use bonding, veneers, and other cosmetic solutions to cover enamel defects in older children and adults.




    4) More resources:


    The following studies discuss celiac disease and dental enamel defects:


    Aguirre JM, Rodriguez R, et al. Dental enamel defects in celiac patients. Oral Surgery Oral Medicine Oral Pathology. 1997;84:646–650.


    Bossu M, Bartoli A, et al. Enamel hypoplasia in celiac children: a potential clinical marker of early diagnosis. European Journal of Pediatric Dentistry. 2007;8:31–37.


    Procaccini M, Campisi G, et al. Lack of association between celiac disease and dental enamel hypoplasia in a case-control study from an Italian central region. Head and Face Medicine. 2007;3:25.


    Wierink celiac disease, Van Diermen DE, et al. Dental enamel defects in children with celiac disease. International Journal of Pediatric Dentistry. 2007;17:163–168.

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  • About Me

    Jefferson Adams is Celiac.com's senior writer and Digital Content Director. He earned his B.A. and M.F.A. at Arizona State University, and has authored more than 2,000 articles on celiac disease. His coursework includes studies in biology, anatomy, medicine, science, and advanced research, and scientific methods. He previously served as SF Health News Examiner for Examiner.com, and devised health and medical content for Sharecare.com. Jefferson has spoken about celiac disease to the media, including an appearance on the KQED radio show Forum, and is the editor of the book "Cereal Killers" by Scott Adams and Ron Hoggan, Ed.D.

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