celiac disease and braces

[Anne G]

Hello,

My 17 yr old daughter was diagnosed with celiac disease 2 yrs ago. She does not have gum disease and no history of cavities.

Her dentist is recommending braces for her lower teeth but I read it may worsen gum recession or possibly increase cavity risk which I know are already issues for patients with celiac. Has anyone here had braces and did it cause any problems or issues with gum recession?  Her dentist seemed oblivious that celiac patients are at higher risk of gum disease /cavities. Her bottom teeth are crooked but are pretty hidden even when she smiles.

Thank you!!

[Scott Adams]

You are right to be proactive, as research does indicate that individuals with celiac disease can have a higher predisposition to enamel defects, cavities, and periodontal issues, even with excellent oral hygiene. While many people with celiac successfully undergo orthodontic treatment without complication, your caution is valid. It may be beneficial to seek a consultation with an orthodontist who is familiar with managing patients with autoimmune conditions or who is willing to collaborate with your daughter's gastroenterologist or a periodontist. They can perform a thorough assessment of her current oral health, discuss your specific concerns about recession and decay, and create a tailored hygiene plan. This second opinion could provide a clearer risk-benefit analysis, helping you decide if addressing the cosmetic concern of the lower teeth is worth the potential risks for your daughter, especially if they are not currently affecting function or her confidence. 

[Aretaeus Cappadocia]

Your concerns are reasonable about the celiac risk aspect, and getting additional medical input is a good idea.

Obviously I don't know the extent of your child's misalignment, but please don't think of it as just a cosmetic issue.

Braces improve bite alignment and typically provide long term health benefits.

[knitty kitty]

@Anne G,

I came across an article that I thought would be of interest.  Malabsorption of vitamins can be a big issue with Celiac disease.  The Gluten Free diet can be low in vitamins, too.  Supplementing with a B Complex is a good idea.  B vitamins and Vitamin C are water soluble and easily excreted if not needed.  Has you doctor checked for nutritional deficiencies beyond B12 and Vitamin D?

The Role of Vitamin B Complex in Periodontal Disease: A Systematic Review Examining Supplementation Outcomes, Age Differences in Children and Adults, and Aesthetic Changes

https://pmc.ncbi.nlm.nih.gov/articles/PMC11990238/