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  • Jefferson Adams
    Jefferson Adams

    Periodontists Get Certified on Impact of Celiac Disease on Dental Health

      With new training programs, periodontists could open new front for spotting celiac disease early.

    Caption: Image: CC--Germanna CC

    Celiac.com 03/15/2019 - A number of studies have shown a correlation between dental enamel defects and the presence of celiac disease. The connection opens up a possible avenue for dentists to help diagnose celiac disease by noticing dental symptoms and making a referral for celiac evaluation. Celiac.com has done a few articles on this subject over the years.

    Now, periodontal teams looking to remain on the cutting-edge of comprehensive dentistry are taking course-work on the impact of celiac disease on dental health.  

    One such team, board-certified periodontists, Drs. Sam Bakuri and Mark J. Weingarden of Pittsburgh, PA, recently completed a course on the impact of celiac disease and dental health with members of their team at Greater Pittsburgh Dental Implants & Periodontics. 

    Led by Cynthia Kupper, RD, celiac disease, CEO of the Gluten Intolerance Group (GIG), the training helped Drs. Bakuri and Weingarden to learn about dental issues commonly associated with celiac disease, such as enamel defects, cavities and frequent canker sores. 

    The training will help these dental professionals spot the dental effects of celiac disease early, before they can cause health or cosmetic issues later in life. It will also allow them to suggest appropriate dental options to improve the dental and general health of their patients.

    Anyone in the Pittsburgh area who wishes to discuss the dental health implications of celiac disease, along with possible treatment options, can contact Drs. Bakuri and Weingarden by phone at 412-201-0633. Learn more about the team at Greater Pittsburgh Dental Implants & Periodontics.

    Do you know of any other dentists or dental professionals who are up to speed on celiac disease and dental health? Please share your information below.

     



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    My Dentist is well aware of what Celiac Disease has done to my teeth and bone around the teeth...gums are great

    wish id of been diagnosed before the 30 years of needing to be gluten free and has never diagnosed 

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  • About Me

    Jefferson Adams 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 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.

  • Related Articles

    Jefferson Adams
    Celiac.com 08/23/2013 - Previous studies have noted the presence of dental enamel defects in people with celiac disease.
    A team of researchers recently set out to study the prevalence of dental enamel defects in adults with celiac disease, and to determine if there is in fact a connection between the grade of teeth lesion and clinical parameters present at the time of diagnosis of celiac disease.
    The research team included L.Trotta, F. Biagi, P.I. Bianchi, A. Marchese, C. Vattiato, D. Balduzzi, V. Collesano, and G.R. Corazza.
    They are affiliated with the Coeliac Centre/First Department of Internal Medicine at the Fondazione IRCCS Policlinico San Matteo at the University of Pavia in Italy.
    The team looked at 54 celiac disease patients who had undergone dental examination. The patients included 41 females and 13 males, with an average age of 37±13 years, and with an average age of 31±14years at the time of diagnosis.
    Symptoms leading to diagnosis were diarrhea/weight loss (32 pts.), anaemia (19 pts.), familiarity (3 pts.). None of the patients was diagnosed because of enamel defects.
    At the time of evaluation, all of the patients were following a gluten-free diet.
    The team classified enamel defects from grade 0 to 4 according to severity. They found dental enamel defects in 46 of the 54 patients (85.2%). They found grade 1 defects in 18 patients (33.3%), grade 2 defects in 16 patients (29.6%), grade 3 defects in 8 patients (14.8%), and grade 4 defects in 4 patients (7.4%).
    They also observed that grades 3 and 4 were more common in patients diagnosed with classical rather than non-classical coeliac disease (10/32 vs. 2/20). However, this was not statistically significant.
    From this study, the team concludes that enamel defects are common in adult celiac disease, and that the observation of enamel defects offers a way to diagnose celiac disease.
    Source:
     Eur J Intern Med. 2013 Apr 6. pii: S0953-6205(13)00091-5. doi: 10.1016/j.ejim.2013.03.007. [Epub ahead of print]

    Jefferson Adams
    Celiac.com 02/08/2017 - Celiac disease is a chronic autoimmune-mediated enteropathy, triggered by exposure to dietary gluten in genetically prone individuals. Celiac disease is also one of many gastrointestinal diseases that can have dental manifestations. In fact, distinct dental enamel defects are strong indicators of celiac disease, and may lead to a role for dentists in better celiac screening.
    While the disease often manifests in early childhood, a large number of patients are diagnosed over the age of 50. Despite increased awareness, the majority of patients still remain undiagnosed. Dentists should consider celiac disease when they observe certain symmetric enamel defects.
    Symptoms of celiac disease vary widely and are certainly not restricted to the intestine. They may include, among others, dental and oral manifestations.
    A team of researchers recently published an update in the British Dental Journal regarding the role of such defects in the timely diagnosis of celiac disease, which is requires a gluten-free diet to prevent complications.
    The research team included T. van Gils, H. S. Brand, N. K. H. de Boer, C. J. J. Mulder & G. Bouma. They are variously affiliated with the Department of Gastroenterology and Hepatology, VU University Medical Centre, Amsterdam, The Netherlands, and the Departments of Oral Biochemistry, Academic Centre for Dentistry Amsterdam (ACTA) in Amsterdam, The Netherlands.
    They note that most of the enamel defects are nonspecific, but symmetric in a way that is very specific to celiac disease. They also note the importance of recognizing this relationship, as it offers an easy way to help to identify unrecognized celiac sufferers, and to promote better screening and diagnosis. They encourage dental practitioners to take note.
    Source:
    British Dental Journal 222, 126 - 129 (2017). Published online: 27 January 2017 | doi:10.1038/sj.bdj.2017.80

    Jefferson Adams
    Celiac.com 08/09/2017 - There have been a number of studies showing a strong connection between celiac disease and dental enamel defects (DEDs), however, the exact relationship is still unclear.
    To get a better understanding, a team of researchers recently set out to evaluate DEDs in people with celiac disease by looking at how long it took them to begin a gluten-free diet (GFD).
    The research team included AM de Queiroz, J Arid, FK de Carvalho, RAB da Silva, EC Küchler, R Sawamura, LAB da Silva, and P Nelson-Filho.
    They are variously affiliated with the Department of Pediatric Dentistry, University of São Paulo - School of Dentistry of Ribeirão Preto, Ribeirão Preto, SP, Brazil, and the Department of Childcare and Pediatrics, University of São Paulo School of Medicine of Ribeirão Preto, Ribeirão Preto, SP, Brazil.
    For their study, the team had a pediatric dentist examine forty-five children with celiac disease. The dentist then classified DEDs by the type of teeth affected. The study team divided celiac disease patients into two groups, those with and those without DEDs. They then tested the differences between these groups using chi-square or Fisher´s exact tests and t-test to compare differences between means.
    They used the Pearson coefficient test to determine the correlation between the age at gluten-free diet introduction and number of teeth with defects. They found that patients with Molar Incisor Hypomineralisation (MIH), a condition affecting the enamel of permanent teeth, were more often introduced earlier to the GFD (p = 0.038). They also saw a connection with molar DED (p = 0.013).
    Their study suggests that enamel defects in the molar are connected with the time that celiac disease patients were introduced to a gluten-free diet. What this means for patients with celiac disease remains to be seen.
    Source:
    Spec Care Dentist. 2017 Jul;37(4):194-198. doi: 10.1111/sceliac disease.12227.

    Jefferson Adams
    Celiac.com 07/05/2018 - We’ve known for a while that dental enamel defects can be an indicator of celiac disease. Now, a new study has evaluated the pathological conditions of the stomatognathic system observed in celiac patients on a gluten-free diet, and found that non-specific tooth wear can be seen nearly 20% of celiac patients, while such wear is seen in just under 6% of non-celiac control subjects. 
    The data come from a team of researchers that recently set out to evaluate the pathological conditions of the stomatognathic system observed in celiac patients on a gluten-free diet. The research team included Massimo Amato, Fabiana Zingone, Mario Caggiano Orcid, Paola Iovino, Cristina Bucci and Carolina Ciacci. They are variously affiliated with the Department of Medicine, Surgery and Dentistry, Medical School of Salerno in Salerno, Italy.
    For their study, the team consecutively recruited celiac patients on a gluten-free diet, along with healthy control volunteers, from the team’s celiac clinic. Two dentists examined all patients and controls and examined them for mouth disorders. 
    The study included forty-nine patients with celiac disease, and 51 healthy volunteer subjects. The team found recurrent aphthous stomatitis in 26 patients (53.0%) and in 13 (25.5%) controls. They found dental enamel disorders in 7 patients (14.3%) and in 0 controls (p = 0.002), with no cases of geographic tongue. 
    They found non-specific tooth wear, characterized by loss of the mineralized tissue of the teeth, in 9 patients (18.3%) and in 3 (5.9%) controls. From this data, the team notes that recurrent aphthous stomatitis and enamel hypoplasia are “risk indicators” that indicate the possible presence of celiac disease. 
    Among patients with celiac disease, the team found high rates of non-specific tooth wear that can be caused by several factors such as malocclusion, sleep bruxism, parafunctional activity, and age.
    This study, and previous studies on dental enamel defects, confirms that non-specific tooth wear and enamel defects can be strong indications of celiac disease, and may lead to a more active role for dentists in helping to spot and diagnose celiac disease.
    Source:
    mdpi.com

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