<<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...... *************** 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. *************** If anyone has anything more up to date I would love to see it. Thank you.......... Martha in NH