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[The relationship between celiac disease (CD) and dental problems].

M Perez-Davidi¹

¹Dept. of Prosthodontics, The Hebrew University Hadassah, Faculty of Dental Medicine, Jerusalem, Israel.

Refu'At Ha-Peh Veha-Shinayim (1993)

|April 5, 2012

Summary

Celiac disease (CD) can manifest in adults with oral symptoms like dental enamel defects, often misdiagnosed. Early diagnosis and dental intervention are crucial for managing CD patients and their oral health.

Area of Science:

Gastroenterology and Immunology
Dentistry and Oral Health
Genetics

Background:

Celiac disease (CD) affects 1% of Western populations, causing small intestine inflammation triggered by gluten.
While often diagnosed in childhood, CD can develop in adults, presenting with varied symptoms including gastrointestinal issues, anemia, and neurological problems.
CD is strongly associated with HLA-DQ2/HLA-DQ8 genotypes and characterized by villous atrophy and increased intraepithelial lymphocytes in the small intestine.

Observation:

Oral manifestations of CD include dental enamel defects, aphthous ulcers, and atrophic glossitis.
Celiac disease patients exhibit a lower prevalence of caries and sometimes damaged tooth eruption sequences.
Dental enamel defects in undiagnosed CD patients are frequently misdiagnosed as tetracycline pigmentation or white spot lesions.

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Findings:

A case report details a 47-year-old female diagnosed with CD at 40, presenting with persistent, unpredictable dental enamel defects.
Conservative treatments for enamel defects were insufficient, prompting a demand for comprehensive functional and aesthetic dental restoration.
Full mouth rehabilitation with Porcelain Fused to Metal (PFM) crowns, specifically 3M Lava zirconia crowns, provided a successful solution for the patient's dentition.

Implications:

Dental practitioners should consider celiac disease in patients with unexplained enamel defects and refer for further examination.
Timely diagnosis and appropriate dental management, including full mouth rehabilitation, can significantly improve the quality of life for adult CD patients.
This case highlights the importance of interdisciplinary care, integrating gastroenterological diagnosis with specialized dental treatment for celiac disease patients.