Coeliac-type Permanent-tooth Enamel Defects

Abstract

Systematic and chronologically distributed permanent-tooth so-called coeliac-type enamel defects are highly prevalent both in children and adults with coeliac disease (gluten-sensitive enteropathy) and dermatitis herpetiformis. Coeliac-type enamel defects were also found in healthy first-degree family members of coeliac disease patients. Our family study showed that these persons with the typical defected enamel were genetically similar to coeliac disease patients (A1;B8;DR3). 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.

Lack of association between celiac disease and dental enamel hypoplasia in a case-control study from an Italian central region

“…RAS is often associated to haematinic (iron, folate, vitamin B12) deficiency [51,52]; since atypical or latent CD may not manifest itself with gastrointestinal signs/symptoms but often with iron/folate deficiency [53-56] we suggest that when patients show persistent RAS they should be examined for haematinic deficiencies. Only if one or more of these deficiencies are present, they should be screened for CD.…”

Dental enamel defects in children with coeliac disease

“…The cause of the dental enamel defects is unknown. Speculations have been made about hypocalcaemia caused by malabsorption 10 , a gluten‐induced immunological process between the ages of 6 months up to 7 years, damaging the enamel‐producing organ 11–13 , or a genetic cause 14 .…”

Genetic Aspects of Dental Caries

“…Alterations within MHC can modify the host immune response to S. mutans. These associations were confirmed in patients with celiac disease by Aine [23] and Aiguirre et al [24]. They discovered the affiliation between HLADR3 and the presence of defects in the enamel predisposing it to the development of caries lesions among these patients.…”