Your Mouth Is The First Stop For Gluten
Your mouth is the entrance to your gut. When you ingest gluten, it has to go through your mouth first. Here are the ways untreated celiac disease can affect your teeth in several ways through a combination of malnutrition and unchecked immune response.
Celiac Disease can cause enamel defects, mouth ulcers and dry mouth, and yet most dentists are completely unaware. Unfortunately, these symptoms have more than one cause, and celiac disease is just one of them. There's no numbers on how many people have Celiac Disease-caused damage to their teeth, but it seems to be fairly common. Treatment is fairly easy and in most cases, damage is reversible.
Enamel Defects - Most Common
This one is the most common presentation of Celiac Disease in teeth. The enamel is the tooth's shield and the shiny hard exterior. With Celiac Disease, the enamel can be damaged, showing pits or horizontal grooves. The teeth can look brown or yellow, which people can mistake as stains. In severe cases, the shape of the teeth can be affected. Teeth can also be thinned and seem transparent. If Celiac Disease develops in young children, the time when enamel develops, adult teeth will show permanent damage. It may even cause teeth to delay in erupting.
This is due to alterations in quantity or quality of minerals available for the body when making enamel. If your body isn't getting the necessary building blocks, it can't make proper enamel. The number of teeth is related to how long someone is not treated for Celiac Disease.
Enamel damage can be fixed with veneers and crowns, but these can only be applied after the age of 18.
Mouth Ulcers - Less Common
Mouth ulcers, known as aphthous stomatitis or canker sores can be very painful and in the case of Celiac Disease, will take longer to go away. In one study, 22.7% of patients with celiac disease had mouth ulcers, as opposed to 7.1% without (Campisi).
Symptoms of other problems usually show up at the same tIme as mouth ulcers. It's possible that mouth ulcers and dry mouth can appear when gluten stimulates the mouth lymph nodes, creating an aggressive immune response like in does in the intestine. Another theory is that they are caused by malabsorption of vitamins B1, B2, B6, B12 and vitamin C (Ahmed).
Not matter the cause, avoid spicy and acidic foods, which will irritate the skin even more. Check with a dentist and they may prescribe a medication and vitamin supplements.
Dry Mouth - Less Common
Like mouth ulcers, dry mouth is usually seen with other damage in the mouth. Gluten exposure can lead to salivary gland disfunction. It can also be a sign of Sjögren's syndrome which occurs in 4.5-15% of people with Celiac Disease (Ahmed). With Sjögren's syndrome the immune system attacks moisture-producing glands causing dry eyes and dry mouth (Anderson).
Dry Mouth (called xerostomia) can cause bad breath, thirst and cavities.
Atrophic Glossitis is caused by a lack of B12 or iron and causes a bright red or pink tongue that is almost completely smooth and shiny from an atrophy of papilae. In a study of 128 celiac disease patients, 8% had a form of atrophy on the tongue (Pastore).
Oral Lichen Planus - This is a disease caused by an autoimmune disorder where white blood cells react aggressively to a perceived allergen threat. Patients have bright red gums and white lines in the mouth which burn and cause pain.
Cheilosis - Ulcers appear at the angles of the mouth from nutritional deficiences or a bacterial/fungal infection.
Ahmed, Sara. "Celiac Disease and Dentistry." Medical Myths and Milestones. Four Points by Sheraton, Norwood, Ma. 1 Apr. 2017. Lecture.
Anderson, Jane. "Is There A Link Between Celiac Disease and Sjogren's Syndrome?" Verywell.com. VeryWell, 4 Apr. 2016. Web. 04 Apr. 2017.
Campisi, G., C. Di Liberto, A. Carroccio, D. Compilato, G. Iacono, M. Procaccini, G. Di Fede, L. Lo Muzio, A. Craxi, C. Catassi, and C. Scully. "Coeliac Disease: Oral Ulcer Prevalence, Assessment of Risk and Association with Gluten-free Diet in Children." Digestive and Liver Disease 40.2 (2008): 104-07. Print.
Pastore, Luca, Lorenzo Lo Muzio, and Rosario Serpico. "Atrophic Glossitis Leading to the Diagnosis of Celiac Disease." New England Journal of Medicine 356.24 (2007): 2547. Print.