<<Disclaimer: Verify this information before applying it to your situation.>> >From the CCA's "Celiac News" dated Spring '94. For subscription info contact: Canadian Celiac Association 6519B Mississauga Road Mississauga, Ontario L5N 1A6 (905) 567-7195 (800-363-7296 in Canada) Excerpts from "Update" Nov. 93, a publication of the College of Dental Surgeons of Britsh Columbia. Reprinted with permission. Children with celiac disease often reveal pathognomonic enamel defects systematically and chronologically in all four quadrants. Dentists can play an important role in screening patients possibly suffering from celiac disease. Patients with symmetrical enamel hypoplasia in permanent teeth should be advised to seek serologic screening using sensitive and/or invasive tests for evidence of small bowel mucous villous atrophy. Celiac Disease as Classified by Enamel Defects are: Grade 0: No defect. Grade I: Defect in colour of enamel only; single or multiple cream, yellow or brown opacities with clearly defined or diffused margins; all or part of the enamel surface is without a natural glaze. Grade II: Minor structural defects; rough enamel surface, horizontal grooves or shallow pits, light opacities and/or discoloration may be found; or part of the enamel surface is without a natural glaze. Grade III: Evident structural defects; all or part of the enamel surface is rough with deep horizontal grooves of varying width; may have large vertical pits; large opacities of strong and varying discoloration. Grade IV: Severe structural defects; the shape of the tooth may be abnormal with cusp tips sharply pointed and/or the incisal edges unevenly thinned and roughened; margins of the lesions are well defined and strongly discoloured.