<<Disclaimer: Verify this information before applying it to your situation.>>
 
              Please forgive me for not getting back to all of you on
the subject of teeth.  I had sinus surgery over the Holidays, and
even though recovery from it has been excellent, keeping up with my
three kids sport routine this winter (while trying to protect my poor
nose) has been a miracle in itself.
        When I figured out I was gluten intolerant I ordered a lot of
information from the GIG in WA. and the CSA in NE.  The GIG had/has a
"Research Report on Dermatitis Herpetiformis" by Elaine I. Hartsook,
Ph.D.,R.D.  (Gluten Intolerance Group of North America, 1993)  My
oldest daughter (13) has fought exema all her life.  We have had more
doctors call it more things... the GF diet has been the only cure.
The whole article is quite interesting (18pages) - included is a
section on Dental Enamel Defects.  So far, it is the only indepth
article I have ever found.... my Dentist thought it was great and
much more informative than anything he has......
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        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.
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If anyone has anything more up to date I would love to see it.  Thank
you.......... Martha in NH