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Hello Everyone,

I did have something to post about celiac disease and enamel defects:

A GIG article titled "Research Report on Dermatitis Herpetiformis" by
Elaine I. Hartsook, Ph.D.,R.D. (Gluten Intolerance Group of North America,
1993) :

Dental enamel defects similar to those previously seen in both children and
adults with celiac sprue (Aine, 1989; Aine,1990) have been shown to be
present in adults and children with DH (Aine, 1991; Aine,1992). These
enamel defects occur while the crowns of the teeth are forming, that is,
usually before the age of 7 years. Celiac-type enamel defects are found on
'matched' teeth on both sides of the mouth (that is, they are symmetrical)
and they appear in the same location on the tooth surface, showing that
they occurred at same time (that is, they are chronologically matched).

Enamel damage has been classified by Aine and her coworkers as : Grade 1 =
enamel lesions include defects in the color of the enamel; Grade 2 = slight
structural defects with a rough enamel surface and horizontal grooves or
shallow pits; Grade 3 = evident structural defects with part of all of the
surface of the enamel rough and filled with deep horizontal grooves varying
in width or with large vertical pits; and Grade 4 = severe structural
defects in which the shape of the tooth has also changed.

Celiac-type dental defects were shown to be, overall, less severe in those
with DH than those with celiac sprue. Eighty-three percent of 40 adult
subjects with celiac sprue were shown to have enamel defects in Aine's 1990
study. Children with celiac sprue had the most severe defects, with 11%
showing Grade 4 enamel defects (Aine, 1986). In Aine's 1992 study, 53% of
the 30 adult study subjects with DH had celiac-type dental defects, while
only 2% of the 66 control subjects showed these types of defects. The
defects in those with DH were mild, Grade 1 and Grade 2. Severity of enamel
defects did not relate to the degree of damage to the lining of the small
intestine in these DH subjects. When the total number of affected teeth
were counted, 51% of the 793 teeth in DH subjects showed dental enamel
defects as opposed to only 18% of the 1,780 teeth from the normal control
group.

Dental enamel defects in the DH subjects occurred during the first seven
years of life. The average age at which the DH was diagnosed, however, was
28 years (ranging from 16 to 42 years). Enamel defects are thought to be
caused by nutritional or immunological factors. Thus, the DH subjects seem
to have been suffering from subclinical gluten-sensitive enteropathy from a
young age!

BIBLIOGRAPHY:

*Aine, L.: Dental enamel defects and dental maturity in children and
adolescents with coeliac disease. Proceedings of the Finnish Dental
Society, 82 (Suppl 3), pges 1-71, 1986

*Aine, l., Maki,M., Collin,P., and Keyrilainen, O.: Dental enamel defects
in celiac disease. Journal of Oral Pathology and Medicine. Vol. 19, pges
241-245, 1990

*Aine, L., Reunala, T., and Maki, M.,: Dental enamel defecrts in children
with dermatitis herpetiformis. Journal of Pediatrics. Vol. 118, pges
572-574, 1991.

*Aine, L., Maki, M., and Reunala, T.: Coeliac-type dental enamel defects in
patients with dermatitis herpetiformis. Acta Derm Venereol (Stockh). Vol.
72, pges25-27, 1992.


Scott Adams - San Francisco, USA
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