Celiac disease and Oral health

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Celiac diseaseandOral health

• Trey L. Petty, DDS, FADI, FAGD
• Holy Cross Hospital Centre
• Calgary Alberta Canada

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celiac Disease Oral health

• Oral Manifestations
• Recurrent aphthous stomatitis, canker sores

• Atrophic glossitis

• Xerostomia - dry mouth

• Squamous cell carcinoma

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celiac Disease Oral health

• Oral Manifestations

• Enamel defects

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celiac Disease Oral health

• Oral Manifestations
• Enamel defects

• Range
• Symmetrical spots of hypocalcification on
  incisors
• Severe structural defects

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celiac Disease Oral health

• Oral Manifestations
• Enamel defects

• North American Society for Pediatric
  Gastroenterology, Hepatology Nutrition
  (NASPGHAN) - 2006Jan
• Included as symptom of Celiac Disease

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celiac Disease Oral health

• Oral Manifestations
• Enamel defects

• Due to malabsorption during formation of teeth
• Tooth calcification
• Primary teeth 14wk - 11mo in utero
• Adult teeth 3mo - 25yrs

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celiac Disease Oral health

• Oral Manifestations
• Enamel defects

• Often first step to diagnosis of CD
• May be only presenting manifestation

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celiac Disease Oral health

• Oral Manifestations
• Enamel defects

• Differential diagnoses
• Dental fluorosis
• Amelogenesis imperfecta
• Dentinogenesis imperfecta
• Osteogenesis imperfecta

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celiac Disease Oral health

• Oral Manifestations
• Enamel defects

• Differential diagnoses

• NEGLECT
• ... ABUSE ...

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celiac Disease Oral health

• Oral Manifestations
• Enamel defects

• Permanent requires restoration
• Bonding, veneers, crowns

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celiac Disease Oral health

• Dental Materials

• Do they contain gluten?
• Some do...
• Some dont...

www.withoutthewheat.com/Dental_Products.html
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celiac Disease Oral health

• Dental Materials

• Do they contain gluten?

• Problem is SORBITOL

• Artificial sweetener
• Typically corn derived
• MAYBE wheat derived

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celiac Disease Oral health

• Dental Materials

• Do they contain gluten?

• Most companies are willing to make a clear Yes/No
  statement
• Others cannot rule-out presence
• Do not control raw materials

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celiac Disease Oral health

• Dental Materials

• Do they contain gluten?

• In general, dental filling materials do NOT
  contain gluten

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celiac Disease Oral health

• Dental Materials

• Do they contain gluten?

• In general, toothpaste does NOT contain gluten

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celiac Disease Oral health

• Dental Materials

• Do they contain gluten?

• In general, denture adhesives MIGHT contain
  gluten, but
• Denture cleaners do NOT

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celiac Disease Oral health

• Dental Materials

• Do they contain gluten?

• In general, local anesthetics topical
  anesthetics do NOT contain gluten

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celiac Disease Oral health

• Dental Materials

• Do they contain gluten?

• In general, SOME mouth rinses MAY contain gluten

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celiac Disease Oral health

• Caregivers
• Educate the local dental community on CD
• Dentists, Dental Hygienists
• Common oral conditions
• Referral pathways

- Pediatric - Hospital-based - Oral Medicine

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celiac Disease Oral health

• Caregivers

• Identify Dental Champions in your area
• Referral of frustrated people living with CD
• Knowledge base of gluten-free dental materials

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celiac Disease Oral health

• People living with Celiac Disease

• Find a dentist aware of CD
• Awareness lack of stigmatization
• Gluten-free dental materials
• You may have to educate about CD...

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celiac Disease Oral health

• People living with Celiac Disease

• Find a dentist to manage symptoms

• Oral ulcerations
• Dry mouth
• Enamel defects

- caution
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Celiac diseaseandOral health

• Trey L. Petty, DDS, FADI, FAGD
• Holy Cross Hospital Centre
• Calgary Alberta Canada
• trey.petty_at_gmail.com

Primum non nocere...