Dental Enamel Defect

The Gluten File


From: Current Approaches to Diagnosis and Treatment of Celiac
Disease: An Evolving Spectrum
ALESSIO FASANO* and CARLO CATASSI‡
GASTROENTEROLOGY 2001;120:636–651
"Dental enamel hypoplasia. Dental enamel hypoplasia has been found in up to 30% of untreated patients with CD.25,26"


"Esthetic Repair of the Consequences of Celiac Disease: A Case Report"  [PDF]
Journal of the American Academy of Cosmetic Dentistry, Fall 2009

PubMed Abstracts

Oral manifestations of celiac disease: a clinical guide for dentists.
PMID:21507289  April 2011

Celiac disease is an autoimmune disease, caused by a permanent intolerance to gluten, that occurs in genetically predisposed individuals. It causes enteropathy. In these individuals a prolonged exposure to gluten increases the risk of developing other pathologies, which may affect both developing dentition and oral mucosa. Clinical presentations are various and atypical. Celiac patients may have enamel hypoplasia, higher prevalence of dental caries, delayed eruption of teeth and lower jaw growth. These factors predispose to malocclusion.
[Celiac disease and malocclusion]

PMID: 20540401 April 2010

CONCLUSIONS: This study supports that CD is highly associated with dental enamel defects in childhood, most likely because of the onset of CD during enamel formation; no such association was found in adults. Our study also supports the association between CD and aphthous ulcer. All physicians should examine the mouth, including the teeth, which may provide an opportunity to diagnose CD. In addition, CD should be added to the differential diagnosis of dental enamel defects and aphthous ulcers.
The Association Between Celiac Disease, Dental Enamel Defects, and Aphthous Ulcers in a United States Cohort.
PMID: 19687752 Aug 2009

CONCLUSIONS: This study showed significantly more systematic enamel defects in children with celiac disease and deciduous dentition compared with a control group in the same stage of dentition. Dental examination of these defects may be useful to alert for this disease.
Prevalence of dental enamel defects in celiac patients with deciduous dentition: a pilot study.
PMID: 18585624 July 2008

The prevalence of enamel defect in CD subjects was found to be significantly higher (42.2%) than in healthy subjects (9.4%) (p < 0.001). Grade I type enamel defects were most commonly diagnosed in both groups (20.3% and 6.3%, respectively). The number of caries-free subjects in the control group was higher (38%) than in the CD group (17%). This study clearly showed that children with CD were at an increased risk of dental enamel defects compared with healthy subjects. Enamel defects were associated with an increased caries incidence.
The presence and distribution of dental enamel defects and caries in children with celiac disease.
PMID: 18365591  Feb 2008

Forty-six out of 197 coeliac disease patients (23%) were found to have enamel defects vs. 9% in controls (P < 0.0001). Clinical delayed eruption was observed in 26% of the pediatric coeliac disease patients vs. 7% of the controls (P < 0.0001). The prevalence of oral soft tissues lesions was 42% in the coeliac disease patients and 2% in controls (P < 0.0001). Recurrent aphthous stomatitis disappeared in 89% of the patients after 1 year of gluten-free diet.
Oral pathology in untreated coeliac disease.
PMID: 17919276  Dec 2007

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.
Dental enamel defects in children with coeliac disease.
PMID: 17397459 May 2006


CD increases the risk of developing enamel defects in permanent teeth but not of having dental caries.
A comparative study on the prevalence of enamel defects and dental caries in children and adolescents with and without coeliac disease.
PMID: 15198629

Oral cavity alterations are often indicative sign of chronic gastrointestinal disorders, such as malabsorption and malnutrition syndromes. This paper should be seen against this background since it examines the possible connection between celiac disease and the presence of oral alterations as an index of disease.
Hypoplasia of enamel. A useful marker in the diagnosis of celiac disease in its subclinical
PMID: 8984327

As coeliac disease patients are often clinically silent with no gastrointestinal symptoms, or they complain only of minimal abdominal discomfort, both dentists and physicians could select patients with coeliac-type enamel defects for gastroenterological and dermatological consultations, including serological screening tests and later jejunal mucosal biopsy.
Coeliac-type permanent-tooth enamel defects.
PMID: 8932499

The presence of dental enamel defects in coeliac disease and their relation to hypocalcaemia or a particular HLA class in 82 Italian children with coeliac disease was studied.
Coeliac disease, enamel defects and HLA typing
PMID: 7734869

The results obtained confirm that celiac patients are more likely to manifest oral pathologies.
Oral cavity changes in the child with celiac disease
PMID: 8065283

The present finding of frequent coeliactype dental enamel defects in adults with dermatitis herpetiformis suggests that these patients were already suffering from subclinical gluteninduced enteropathy in early childhood, at the time when the crowns of permanent teeth develop.
Coeliac-type dental enamel defects in patients with dermatitis herpetiformis.
PMID: 1350136

The present study clearly shows that symmetrically and chronologically distributed enamel defects are strongly associated with CD. Therefore in the absence of symptoms and signs of malabsorption dentists could easily select the right patients possibly suffering from CD for gastroenterologic consultations.
Dental enamel defects in celiac disease.
PMID: 2401959