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      Frequently Asked Questions About Celiac Disease   04/07/2018

      This Celiac.com FAQ on celiac disease will guide you to all of the basic information you will need to know about the disease, its diagnosis, testing methods, a gluten-free diet, etc.   Subscribe to Celiac.com's FREE weekly eNewsletter   What are the major symptoms of celiac disease? Celiac Disease Symptoms What testing is available for celiac disease?  Celiac Disease Screening Interpretation of Celiac Disease Blood Test Results Can I be tested even though I am eating gluten free? How long must gluten be taken for the serological tests to be meaningful? The Gluten-Free Diet 101 - A Beginner's Guide to Going Gluten-Free Is celiac inherited? Should my children be tested? Ten Facts About Celiac Disease Genetic Testing Is there a link between celiac and other autoimmune diseases? Celiac Disease Research: Associated Diseases and Disorders Is there a list of gluten foods to avoid? Unsafe Gluten-Free Food List (Unsafe Ingredients) Is there a list of gluten free foods? Safe Gluten-Free Food List (Safe Ingredients) Gluten-Free Alcoholic Beverages Distilled Spirits (Grain Alcohols) and Vinegar: Are they Gluten-Free? Where does gluten hide? Additional Things to Beware of to Maintain a 100% Gluten-Free Diet What if my doctor won't listen to me? An Open Letter to Skeptical Health Care Practitioners Gluten-Free recipes: Gluten-Free Recipes
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Teeth Cleaning At Dentist's

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I had my teeth cleaned yesterday and had a bad reaction. 27 hours later I am starting to get better. I don't see how it could be anything else I ate that day. Has anyone had a similar problem? If so, what type of professional cleaning product should I ask for? I react easily to any small amount of gluten and have to read all labels or I pay for it with a reaction.

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I had that happen about 18 months ago!

I called the hygenist and told her about the "allergic" reaction. She gave me a list of every product, complete with mfg. she used. I spent quite a bit of time researching. I called her back and told her I thought it was the gum numbing agent. I can't remember the name of the product or manufacturer, but it was pina colada flavored. (I'm not allergic or sensitive to coconut or pinapple, rum for that matter.)

I get my teeth cleaned every four months and haven't had another problem. There's a note in my chart not to use that product, if you like I can call her to get the name and mfg, but I'd really recommend calling your hygenist. What bugs me may not bug you. Good luck!

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I use Oral B fluoride rinse recommended by my dental hygienist as it is gluten free. My dental office cannot be 100% certain that their products are gluten free and do not want to use them on me (as per my last visit, anyway). You can get the rinse in daily or weekly formulations. Nice between cleanings. In fact, I only need to go once a year now!

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I will call my dentist's office back, but since my next cleaning appointment isn't until October I feel I have some time to do a little research first. Especially if it turns out they may be the type to "snicker" at the problem. Sad, but even in the medical community it can happen. I have quite a bit of elective dental work to have done before this time, if I so decide. I want to make sure it is something to do with the cleaning and not something else that may be used during the dental work.

Thank you. I will check out the gum numbing agent. Especially since this may be the same as they give before they give the shot. I wonder if this is in the toothpaste for sensitive teeth. Just a thought and something I will check out.

Since our mouth is only rinsed partially when our teeth are cleaned, we do swallow quite a bit of the cleaning product whether we realize it or not. I am so sensitive that just having it in my mouth is enough for me to have a gluten reaction.

I appreciate all comments.

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My dentist is experienced with fielding gluten-free issues. I'm not their first patient. They know what is/isn't gluten-free.

If your dentist gives you push-back, find another.

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I will call my dentist's office back, but since my next cleaning appointment isn't until October I feel I have some time to do a little research first. Especially if it turns out they may be the type to "snicker" at the problem. Sad, but even in the medical community it can happen. I have quite a bit of elective dental work to have done before this time, if I so decide. I want to make sure it is something to do with the cleaning and not something else that may be used during the dental work.

Thank you. I will check out the gum numbing agent. Especially since this may be the same as they give before they give the shot. I wonder if this is in the toothpaste for sensitive teeth. Just a thought and something I will check out.

Since our mouth is only rinsed partially when our teeth are cleaned, we do swallow quite a bit of the cleaning product whether we realize it or not. I am so sensitive that just having it in my mouth is enough for me to have a gluten reaction.

I appreciate all comments.

I have had more dental work than most people, due to Celiac related teeth issues. I have done extensive research on dental products and have to say, I never found any that contained anything remotely related to gluten. Dental products do make use of gums and I had a severe reaction after having an impression done for a new tooth. It was the gum that got me. I get my teeth cleaned every 3 months and have never had a reaction from a cleaning. Unless you are in another country other than the US, most dental offices use one of a few dental products out there. I use flavored toothpastes at the dentist and researched them, which means I called company reps and they were very helpful. No gluten.

Some of the ingredients used in these products might be hard on a Celiac's delicate digestive tract and that is much more likely to be the problem. They do not put gluten derived products in numbing agents either. I am very sensitive to trace amounts of gluten so would definitely have a reaction if there was any amount of gluten in a product.

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I've had my share of dental work. When I was first DXed I was due for a cleaning and check-up. When I called to make the appointment I told the Dentist about my DX and asked if she could check for gluten ingredients. She was glad I mentioned it ahead of time so she could check and said there was nothing that should bother me when I went in.

I just got a crown redone too, and didn't react to anything...other than the bill. :o

*A funny side note...my Dentist questioned if I had any autoimmune issues because of the enamel on my teeth long before any Dr. Dxed Celiac!

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I've had my share of dental work. When I was first DXed I was due for a cleaning and check-up. When I called to make the appointment I told the Dentist about my DX and asked if she could check for gluten ingredients. She was glad I mentioned it ahead of time so she could check and said there was nothing that should bother me when I went in.

I just got a crown redone too, and didn't react to anything...other than the bill. :o

*A funny side note...my Dentist questioned if I had any autoimmune issues because of the enamel on my teeth long before any Dr. Dxed Celiac!

Wow, that's very interesting! I'm just dying to know how long before you got diagnosed that he asked that!

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I will call my dentist to make sure just in case there was a type of problem. Whatever it is, something happened that caused a major problem that day and was definitely a gluten reaction. Today I ate everything I had that day again and no problem. I had only eaten at home that day and today and I keep no gluten in my house...that I know of. However, there could always be surprises. Things get on our hands and even could be on the gloves at the office...they may have just eaten something with the gloves...something that simple like a cookie when her gloves were on would be enough to do me in. I love leading a normal life which isn't easy with being Celiac and having MS. But the way I do it is thru knowledge of what is happening to me and knowing what is causing it and kicking it off...That is why I was so happy to find this site.

Thank you all for your help!

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I am extremely sensitive and have had problems the last three times I went. My hygenist is very sympathetic and careful. The first time I noticed a reaction it was a bad one. Before the next cleaning I called the office and she researched it carefully. The second time she only used water and unpowdered gloves and I still had a minor reaction. It was also pretty uncomfortable as I have sensitive teeth. The third time she used the products and the reaction was also minor. I'm not sure what to do for the next time except to make sure that I don't have anything important to do the next day.

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I can honestly say that I always feel lousy for several days after major dental work because I have trouble with the "caines". (You know, lidocaine, novacaine, etc) Dental molds also gave me grief--but I THINK it is the gums they use.

My dentist assures me there is no gluten in the materials and I trust his judgement. He told me has other celiac patients (long before I came to his practice) and they have not reported any problems to him. I am just very sensitive to drugs.

I react rather quickly to trace gluten, and I have not had any problems post-cleaning.

However, something did not agree with you, that's for sure. I would like to think your dental hygenist changed gloves before working on you (so no crumbs--- or anything for that matter :blink: --could get in your mouth) but it could't hurt to ask her to please change them before working on you next time.

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At my last cleaning my hygienist used just ground pumice and water. It's not flavored and really like having your teeth cleaned with chalk, but I could at least rest easy knowing it was gluten-free. Otherwise they use a "sand blast" type instrument and she wasn't sure if the starchy material (Cavitron Jet Fresh Densply) had gluten or not. I've tried contacting Cavitron about it and have never gotten a reply to phone or email inquiries.

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This is kind of gross & I have no actual scientific basis...its just a gross thought. Is is possible that there was some gluten from the old gluteny days stuck in the teeth and covered in that stuff they scrape off? the first time I went, I felt glutened all day after. But not any of the times since.

Yuck! :ph34r:

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This is kind of gross & I have no actual scientific basis...its just a gross thought. Is is possible that there was some gluten from the old gluteny days stuck in the teeth and covered in that stuff they scrape off? the first time I went, I felt glutened all day after. But not any of the times since.

Yuck! :ph34r:

That actually makes a lot of sense! Especially for those who don't floss well or often.

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:o gasp! I cannot imagine our Karen being a slip-shod flimsy flosser! :lol:

(try to say that three times!)

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At my last cleaning my hygienist used just ground pumice and water. It's not flavored and really like having your teeth cleaned with chalk, but I could at least rest easy knowing it was gluten-free.

Interesting. So, do I just request this plain ground pumice next time. They keep this "on hand" do they? I am thinking I may go that route.

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I tell you. I have got to hope that there isn't any 5 year old gluten still sticking to my teeth!!!! :unsure:

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I will call my dentist to make sure just in case there was a type of problem. Whatever it is, something happened that caused a major problem that day and was definitely a gluten reaction. Today I ate everything I had that day again and no problem. I had only eaten at home that day and today and I keep no gluten in my house...that I know of. However, there could always be surprises. Things get on our hands and even could be on the gloves at the office...they may have just eaten something with the gloves...something that simple like a cookie when her gloves were on would be enough to do me in. I love leading a normal life which isn't easy with being Celiac and having MS. But the way I do it is thru knowledge of what is happening to me and knowing what is causing it and kicking it off...That is why I was so happy to find this site.

Thank you all for your help!

No reputable dental office would ever have an employee eating cookies AFTER they out their dental gloves on! :blink:

When I had a reaction to the gums in the dental composite, it was exactly like a gluten reaction. There are things you will react to and it will totally mimic a gluten reaction but isn't. I had one severe reaction in years of regular dental work.

It was the gums. I have not had one since and I probably rank as having one of the highest levels of dental work in the Celiac population...I know I will send my dentist's kid to college. ;) Don't over think this and don't be afraid to go to the dentist. As a Celiac, you'll be a regular there, unfortunately!

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I have a cleaning tomorrow. I'll ask the hygenist. I'm pretty sure I swallowed a little bit of the numbing agent by mistake. I detest going to the dentist. My parents were poor and elected to not pay for any pain killers, so the dentist would drill away on our teeth sans pain killer. I grip the armrails when I go in there.

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I never had novocaine when I was a kid either. The first time a dentist came at me ( as an adult) with a needle to numb me, I said "What the hell is THAT for?? " :ph34r:

Not many of our generation did get novacaine, from what I have learned from others. :unsure:

I think it set me up for real "dental phobia".

I like my dentist personally, but I despise going there. I grip the arm rests, too. UGH!

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When I had a reaction to the gums in the dental composite, it was exactly like a gluten reaction. There are things you will react to and it will totally mimic a gluten reaction but isn't.

This is EXACTLY what happened to me! Dental molds and any of the "caines"--feels just like I have been glutened. :angry:

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I went in for a cleaning a month ago and I commented on how bad the toothpaste they used taste. They said that they had to switch to gluten-free, dye-free toothpaste because so many patients have issues. This was without me ever asking about the ingredients in the toothpaste. So apparently some do contain gluten...or it was just a marketing scheme by some toothpaste manufacturer.

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I went in for a cleaning a month ago and I commented on how bad the toothpaste they used taste. They said that they had to switch to gluten-free, dye-free toothpaste because so many patients have issues. This was without me ever asking about the ingredients in the toothpaste. So apparently some do contain gluten...or it was just a marketing scheme by some toothpaste manufacturer.

The hygenist said it was the Colgate Perigard, not the gum numbing agent. The active ingredient is Chlorhexidine Gluconate and is manufactured by a number of companies. Before it went generic, it was just known as Perigard by the trade, because they're who introduced it. I have a high gag reflex and I know I swallowed some. In her words, "That's heavy duty stuff". But that's what she wrote down in my chart after I called her back.

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The hygenist said it was the Colgate Perigard, not the gum numbing agent. The active ingredient is Chlorhexidine Gluconate and is manufactured by a number of companies. Before it went generic, it was just known as Perigard by the trade, because they're who introduced it. I have a high gag reflex and I know I swallowed some. In her words, "That's heavy duty stuff". But that's what she wrote down in my chart after I called her back.

After googling Colgate Periogard this is what I came up with http://celiacshack.blogspot.com/2011/07/gluten-free-medications.html. Under the list of NON gluten-free drugs, it's listed but dated 3/08. I'm not sure if the patient called the manufacturer or where they got the information. Here is another website that confirms it as of 3/08 http://homepage.mac.com/sholland/celiac/GFmedlist.pdf. Things may have changed since that date, but you would only find out after contacting the manufacturer. It's unlikely that the active ingredient is actually the gluten-containing ingredient.

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The hygenist said it was the Colgate Perigard, not the gum numbing agent. The active ingredient is Chlorhexidine Gluconate and is manufactured by a number of companies. Before it went generic, it was just known as Perigard by the trade, because they're who introduced it. I have a high gag reflex and I know I swallowed some. In her words, "That's heavy duty stuff". But that's what she wrote down in my chart after I called her back.

If you look at the MSDS sheet for both Peridex and Periguard products, they both contain almost the exact same ingredients. I could find nothing suspect in the ingredients listing, however, they are listed as a GI irritant and some people may experience stomach upset and diarrhea. I think it's another case of no gluten but bad for those with sensitive stomachs. In fact, if you read the MSDS, it's pretty scary stuff. I always pass on dental rinses anyway.

I brush my teeth before each visit and it's up to them to keep their hands clean with the use of gloves. Dentists are pretty careful these days because they could end up getting sick from their patients. It's not just gluten you have to worry about.

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    WHAT IS CELIAC DISEASE?
    Celiac disease is an autoimmune condition that affects around 1% of the population. People with celiac disease suffer an autoimmune reaction when they consume wheat, rye or barley. The immune reaction is triggered by certain proteins in the wheat, rye, or barley, and, left untreated, causes damage to the small, finger-like structures, called villi, that line the gut. The damage occurs as shortening and villous flattening in the lamina propria and crypt regions of the intestines. The damage to these villi then leads to numerous other issues that commonly plague people with untreated celiac disease, including poor nutritional uptake, fatigue, and myriad other problems.
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    Celiac disease is most often uncovered because people experience symptoms that lead them to get tests for antibodies to gluten. If these tests are positive, then the people usually get biopsy confirmation of their celiac disease. Once they adopt a gluten-free diet, they usually see gut healing, and major improvements in their symptoms. 
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    LESS OBVIOUS SYMPTOMS
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    NO SYMPTOMS
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    There is currently no enzyme or vaccine that can replace a gluten-free diet for people with celiac disease.
    There are enzyme supplements currently available, such as AN-PEP, Latiglutetenase, GluteGuard, and KumaMax, which may help to mitigate accidental gluten ingestion by celiacs. KumaMax, has been shown to survive the stomach, and to break down gluten in the small intestine. Latiglutenase, formerly known as ALV003, is an enzyme therapy designed to be taken with meals. GluteGuard has been shown to significantly protect celiac patients from the serious symptoms they would normally experience after gluten ingestion. There are other enzymes, including those based on papaya enzymes.

    Additionally, there are many celiac disease drugs, enzymes, and therapies in various stages of development by pharmaceutical companies, including at least one vaccine that has received financial backing. At some point in the not too distant future there will likely be new treatments available for those who seek an alternative to a lifelong gluten-free diet. 

    For now though, there are no products on the market that can take the place of a gluten-free diet. Any enzyme or other treatment for celiac disease is intended to be used in conjunction with a gluten-free diet, not as a replacement.

    ASSOCIATED DISEASES
    The most common disorders associated with celiac disease are thyroid disease and Type 1 Diabetes, however, celiac disease is associated with many other conditions, including but not limited to the following autoimmune conditions:
    Type 1 Diabetes Mellitus: 2.4-16.4% Multiple Sclerosis (MS): 11% Hashimoto’s thyroiditis: 4-6% Autoimmune hepatitis: 6-15% Addison disease: 6% Arthritis: 1.5-7.5% Sjögren’s syndrome: 2-15% Idiopathic dilated cardiomyopathy: 5.7% IgA Nephropathy (Berger’s Disease): 3.6% Other celiac co-morditities include:
    Crohn’s Disease; Inflammatory Bowel Disease Chronic Pancreatitis Down Syndrome Irritable Bowel Syndrome (IBS) Lupus Multiple Sclerosis Primary Biliary Cirrhosis Primary Sclerosing Cholangitis Psoriasis Rheumatoid Arthritis Scleroderma Turner Syndrome Ulcerative Colitis; Inflammatory Bowel Disease Williams Syndrome Cancers:
    Non-Hodgkin lymphoma (intestinal and extra-intestinal, T- and B-cell types) Small intestinal adenocarcinoma Esophageal carcinoma Papillary thyroid cancer Melanoma CELIAC DISEASE REFERENCES:
    Celiac Disease Center, Columbia University
    Gluten Intolerance Group
    National Institutes of Health
    U.S. National Library of Medicine
    Mayo Clinic
    University of Chicago Celiac Disease Center

    Jefferson Adams
    Celiac.com 04/17/2018 - Could the holy grail of gluten-free food lie in special strains of wheat that lack “bad glutens” that trigger the celiac disease, but include the “good glutens” that make bread and other products chewy, spongey and delicious? Such products would include all of the good things about wheat, but none of the bad things that might trigger celiac disease.
    A team of researchers in Spain is creating strains of wheat that lack the “bad glutens” that trigger the autoimmune disorder celiac disease. The team, based at the Institute for Sustainable Agriculture in Cordoba, Spain, is making use of the new and highly effective CRISPR gene editing to eliminate the majority of the gliadins in wheat.
    Gliadins are the gluten proteins that trigger the majority of symptoms for people with celiac disease.
    As part of their efforts, the team has conducted a small study on 20 people with “gluten sensitivity.” That study showed that test subjects can tolerate bread made with this special wheat, says team member Francisco Barro. However, the team has yet to publish the results.
    Clearly, more comprehensive testing would be needed to determine if such a product is safely tolerated by people with celiac disease. Still, with these efforts, along with efforts to develop vaccines, enzymes, and other treatments making steady progress, we are living in exciting times for people with celiac disease.
    It is entirely conceivable that in the not-so-distant future we will see safe, viable treatments for celiac disease that do not require a strict gluten-free diet.
    Read more at Digitaltrends.com , and at Newscientist.com

    Jefferson Adams
    Celiac.com 04/16/2018 - A team of researchers recently set out to investigate whether alterations in the developing intestinal microbiota and immune markers precede celiac disease onset in infants with family risk for the disease.
    The research team included Marta Olivares, Alan W. Walker, Amalia Capilla, Alfonso Benítez-Páez, Francesc Palau, Julian Parkhill, Gemma Castillejo, and Yolanda Sanz. They are variously affiliated with the Microbial Ecology, Nutrition and Health Research Unit, Institute of Agrochemistry and Food Technology, National Research Council (IATA-CSIC), C/Catedrático Agustín Escardin, Paterna, Valencia, Spain; the Gut Health Group, The Rowett Institute, University of Aberdeen, Aberdeen, UK; the Genetics and Molecular Medicine Unit, Institute of Biomedicine of Valencia, National Research Council (IBV-CSIC), Valencia, Spain; the Wellcome Trust Sanger Institute, Hinxton, Cambridgeshire UK; the Hospital Universitari de Sant Joan de Reus, IISPV, URV, Tarragona, Spain; the Center for regenerative medicine, Boston university school of medicine, Boston, USA; and the Institut de Recerca Sant Joan de Déu and CIBERER, Hospital Sant Joan de Déu, Barcelona, Spain
    The team conducted a nested case-control study out as part of a larger prospective cohort study, which included healthy full-term newborns (> 200) with at least one first relative with biopsy-verified celiac disease. The present study includes 10 cases of celiac disease, along with 10 best-matched controls who did not develop the disease after 5-year follow-up.
    The team profiled fecal microbiota, as assessed by high-throughput 16S rRNA gene amplicon sequencing, along with immune parameters, at 4 and 6 months of age and related to celiac disease onset. The microbiota of infants who remained healthy showed an increase in bacterial diversity over time, especially by increases in microbiota from the Firmicutes families, those who with no increase in bacterial diversity developed celiac disease.
    Infants who subsequently developed celiac disease showed a significant reduction in sIgA levels over time, while those who remained healthy showed increases in TNF-α correlated to Bifidobacterium spp.
    Healthy children in the control group showed a greater relative abundance of Bifidobacterium longum, while children who developed celiac disease showed increased levels of Bifidobacterium breve and Enterococcus spp.
    The data from this study suggest that early changes in gut microbiota in infants with celiac disease risk could influence immune development, and thus increase risk levels for celiac disease. The team is calling for larger studies to confirm their hypothesis.
    Source:
    Microbiome. 2018; 6: 36. Published online 2018 Feb 20. doi: 10.1186/s40168-018-0415-6