If you have noticed white spots or enamel pitting on your teeth, something in your diet may be the cause. If accompanied by other general symptoms, these dental problems may stem from a possible intolerance to gluten.
Gluten is a protein found in grains like wheat, barley or oats. Some people (an estimated one in 130 Americans) have a condition called Celiac Disease (CD) in which their immune system mistakenly treats gluten as a threat and initiates an attack of antibodies (individual proteins made by the immune system to target and kill specific foreign substances) against it. Tiny hair-like structures in the small intestine called cilia that aid in nutrient absorption may be destroyed in the process. As a result, the body can't properly absorb nutrients.
CD can be difficult to diagnose because its symptoms resemble other conditions like Irritable Bowel Syndrome. Typically, though, CD causes digestive issues like diarrhea, bloating and stomach aches, as well as fatigue, growth abnormalities and vitamin deficiencies. In the mouth, the most common symptoms are enamel defects like spotting and pitting. Patients may also lose a portion of their enamel in the grooves of the central incisors where the enamel may appear chalky or opaque rather than shiny, evidence of a condition called decalcification. CD may also cause canker sores.
Determining if you have CD is a two-step process. You must first undergo a blood test to see if antibodies are present for gluten. If the test returns positive confirming you have CD, the next step is a biopsy in which a small amount of intestinal tissue is removed and analyzed. This measures the degree of damage to the stomach lining, which will indicate whether or not you should remove foods containing gluten from your diet.
While research is ongoing to develop counteracting medications, removing gluten from your diet remains the most effective treatment for CD. Enamel defects caused by CD can also be treated with fluoride toothpastes and other aids to foster re-mineralization (restoring calcium and other mineral content to the enamel), and with cosmetic techniques to reduce any discoloration effect. CD patients should continue with normal oral hygiene efforts, with one exception: hygiene products (including polishing pastes and fluoride gels used in professional cleanings) should be gluten-free.
If you would like more information on how gluten may affect your oral health, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Gluten & Dental Problems.”