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Celiac disease and Oral manifestations

Updated: Dec 2, 2021

Celiac disease is a serious problem. When the affected person eats gluten, their body initiates an immune response that attacks the digestive system. The attack damages the lining of the small intestine and compromises the absorption of nutrients.

Specific oral manifestations observed in childhood may help to identify patients with early celiac disease before serious disease progression and harm develop.

How Celiac Disease Affects Your Oral Health

Anyone from a newborn to an adult can be diagnosed with celiac disease. Although the disease is hereditary, certain illnesses like Type 1 Diabetes put you at higher risk. The younger the patient, the worse the damage to your gums and teeth. Below are the oral manifestations of celiac disease.

Oral manifestations of celiac disease identified in children may include delay in dental eruption, reduction of salivary flow, recurrent aphthous stomatitis, angular cheilitis, and dental enamel defects in primary and permanent teeth. The dental enamel defects are often a result of hypoplasia, and most commonly occur in the permanent dentition.

Enamel Defects

The enamel protects the inner parts of the teeth. However, celiac disease in children can hinder the development of the enamel. This mostly occurs if a child is diagnosed with celiac disease before the age of seven. Teeth that lack enamel may appear patchy white, yellow, or even brown. A compromised enamel opens up the teeth to cavities and tooth sensitivity. In extreme cases, the teeth can have visible grooves running across the teeth. Although enamel defects are common in children, adults are not exempted. Since the enamel damage is irreversible, the earlier you are diagnosed, the better.


Many people who are diagnosed with celiac disease often complain of cavities. There is a simple explanation. Since enamel defects develop early, they leave your teeth unprotected. An underdeveloped enamel combined with calcium and vitamin D deficiency opens the door for cavities. By the time you are diagnosed with celiac disease, the damage is done.

Mouth Sores

The medical term for mouth sore is aphthous ulcers. Although these oral ulcers can develop randomly in healthy people, they are more common if you have celiac disease. Celiac related oral ulcers develop on the lips, tongue, and gums. This is attributed to the compromised digestion with causes deficiency of iron, Vitamin B12, and foliate. This pain can make eating and talking impossible.

Dry Mouth

Studies show that there is an overlap of autoimmune disease. It is estimated that 15% of people with Celiac disease also develop Sjorgren's Syndrome. This syndrome attacks the glands that produce moisture in the body. As a result, your mouth produces less saliva causing dry mouth and eyes. Since the saliva kills harmful bacteria in the mouth, it puts you at risk of cavities and gum infections.

Dental products and celiac disease

A recent study testing oral hygiene and cosmetic products found that only 4 out of 66 (6%) contained gluten in concentrations greater than 20 ppm, which is the threshold concentration for a product to be considered gluten-free.

Many polishing pastes, fluoride gels and varnishes, and most toothpastes are gluten- free, however not all gluten-free products are labeled as such.

Diagnosis and Treatment of Celiac Disease

only a diagnosis can confirm the existence of the celiac disease. Usually, people with celiac disease have elevated levels of anti-endomysium antibodies. A common blood test performed will include the following:

  • Cholesterol test

  • Liver function test

  • Serum albumin test

  • Complete Blood count

If the results are still inconclusive after these tests, an upper endoscopy is performed. Here a thin tube is threaded through the mouth down the small intestine. A tiny camera is attached because it allows the doctor to check for any damage to the villi. Tissue samples may also be taken (biopsy) and analyzed further. Unfortunately, no treatment exists for celiac disease. The only way to manage the disease is to adhere to a strict gluten-free diet. Although this can be challenging, there are more gluten-free products in the market than ever before. You also still get to enjoy favorite dishes like fresh meat, fish, rice, vegetables, and wine. The symptoms will improve within days of making these changes.

If you have any questions, please call us at 212-274 8338 or Book Online for a regular check-up at Empower Your Smile.

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