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Celiac disease and Oral health

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Symmetrical spots of hypocalcification on incisors. Severe structural defects ... for Pediatric Gastroenterology, Hepatology & Nutrition (NASPGHAN) - 2006Jan ... – PowerPoint PPT presentation

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Title: Celiac disease and Oral health


1
Celiac diseaseandOral health
  • Trey L. Petty, DDS, FADI, FAGD
  • Holy Cross Hospital Centre
  • Calgary Alberta Canada

2
celiac Disease Oral health
  • Oral Manifestations
  • Recurrent aphthous stomatitis, canker sores
  • Atrophic glossitis
  • Xerostomia - dry mouth
  • Squamous cell carcinoma

3
celiac Disease Oral health
  • Oral Manifestations
  • Enamel defects

4
celiac Disease Oral health
  • Oral Manifestations
  • Enamel defects
  • Range
  • Symmetrical spots of hypocalcification on
    incisors
  • Severe structural defects

5
celiac Disease Oral health
  • Oral Manifestations
  • Enamel defects
  • North American Society for Pediatric
    Gastroenterology, Hepatology Nutrition
    (NASPGHAN) - 2006Jan
  • Included as symptom of Celiac Disease

6
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

7
celiac Disease Oral health
  • Oral Manifestations
  • Enamel defects
  • Often first step to diagnosis of CD
  • May be only presenting manifestation

8
celiac Disease Oral health
  • Oral Manifestations
  • Enamel defects
  • Differential diagnoses
  • Dental fluorosis
  • Amelogenesis imperfecta
  • Dentinogenesis imperfecta
  • Osteogenesis imperfecta

9
celiac Disease Oral health
  • Oral Manifestations
  • Enamel defects
  • Differential diagnoses
  • NEGLECT
  • ... ABUSE ...

10
celiac Disease Oral health
  • Oral Manifestations
  • Enamel defects
  • Permanent requires restoration
  • Bonding, veneers, crowns

11
celiac Disease Oral health
  • Dental Materials
  • Do they contain gluten?
  • Some do...
  • Some dont...

www.withoutthewheat.com/Dental_Products.html
12
celiac Disease Oral health
  • Dental Materials
  • Do they contain gluten?
  • Problem is SORBITOL
  • Artificial sweetener
  • Typically corn derived
  • MAYBE wheat derived

13
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

14
celiac Disease Oral health
  • Dental Materials
  • Do they contain gluten?
  • In general, dental filling materials do NOT
    contain gluten

15
celiac Disease Oral health
  • Dental Materials
  • Do they contain gluten?
  • In general, toothpaste does NOT contain gluten

16
celiac Disease Oral health
  • Dental Materials
  • Do they contain gluten?
  • In general, denture adhesives MIGHT contain
    gluten, but
  • Denture cleaners do NOT

17
celiac Disease Oral health
  • Dental Materials
  • Do they contain gluten?
  • In general, local anesthetics topical
    anesthetics do NOT contain gluten

18
celiac Disease Oral health
  • Dental Materials
  • Do they contain gluten?
  • In general, SOME mouth rinses MAY contain gluten

19
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

20
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

21
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...

22
celiac Disease Oral health
  • People living with Celiac Disease
  • Find a dentist to manage symptoms
  • Oral ulcerations
  • Dry mouth
  • Enamel defects

- caution
23
Celiac diseaseandOral health
  • Trey L. Petty, DDS, FADI, FAGD
  • Holy Cross Hospital Centre
  • Calgary Alberta Canada
  • trey.petty_at_gmail.com

Primum non nocere...
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