There are more than 200 signs and symptoms of celiac disease, according to the University of Chicago’s Celiac Disease Center.  The common symptoms include:  stomach pain, vomiting, diarrhea, anemia, osteoporosis, but there are some symptoms that may not be so common, but nonetheless are signs of celiac disease.

Discoloration from enamel trouble due to undiagnosed celiac. Photo Courtesy of Ted Malahias, DDS

Discoloration from enamel trouble due to undiagnosed celiac. Photo Courtesy of Ted Malahias, DDS

These include something your dentist might see.  Ted Malahias, DDS of Bridgeworks Family Dental in Groton, Connecticut is an expert in dentistry and celiac disease.  He says celiac symptoms can manifest in the mouth with frequent canker sores and poor enamel.

Detecting Possible Celiac Symptoms in the Mouth

When celiac affects a person’s tooth enamel, what does that look like?  “Bilateral yellow or white staining of the enamel that is uniform.  It has to be present in all four quadrants, and not just one tooth, ” says Malahias.

When Malahias sees that, he recommends the patient get tested for celiac through their primary care physician.  Malahias said he has had doctors contact him, being resistant at first, thinking he was wasting their time.  Even a gastroenterologist called him to say that a patient (who Malahias suggested should be tested), was positive and the GI had no idea that there could be celiac symptoms in the mouth.

That is why, with the help of Columbia University’s Celiac Center, Malahias did research in this area.  Back in 2009, they did a study and found kids with celiac overwhelmingly (87% versus 33% of the control group) displayed with enamel problems likely because celiac onset may happen during formation of enamel.  In adults, the number isn’t as staggering 32% in celiacs and 29% in the control.  As for canker sores, the report said 42% of celiac patients had canker sores versus 23% of the control group.

In the paper, researchers note while celiac is not the only cause of dental enamel defects or canker sores, celiac should be considered a possibility by the dentist.  You can see the full study on the Bridgeworks website.

In children, the dental symptoms are slightly different.  Malahias says dentists can see the marks on the teeth with enamel defects,  but also children with celiac don’t lose their baby teeth as fast as other kids.  Dentists tend to catch on early with kids and celiac because they haven’t had work done on their teeth to mask damage like adults do.  Unfortunately that dental work could be covering up the tell-tale symptoms.

Once a patient is diagnosed with celiac and goes gluten free, their mouths and gums heal, but the teeth staining will remain.  Cosmetic work will need to be done to clean that up.

Dr. Ted Malahias is speaking on this very subject during the Gluten Intolerance Group’s Conference in Fargo this weekend.  He will offer additional information that can be helpful to all of us like what kinds of dental products are safe for celiacs!



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