In 2019, new developments in guidelines by the European Society for the Study of Celiac Disease included recommending the screening of all patients who have dental enamel defects and recurrent canker sores for celiac disease.
Discolored teeth can be a symptom of celiac disease among other possible health issues. This symptom manifests as white, yellow or brown spots on the front and back teeth (incisors and molars). Tooth defects resulting from celiac disease are permanent and do not improve once a diagnosed person adopts a gluten-free diet.
If celiac disease is developing while the permanent teeth are forming in children under 7-years-old, dental enamel defect can occur.
It’s now recommended that dentists consider celiac disease when dental enamel defects or recurrent mouth ulcers or both are found. Tips for dentists include asking patients with defects or ulcers about other symptoms of celiac disease, including abdominal pain, diarrhea, weight loss, poor growth, anemia and fatigue. Patients should also be asked about related other autoimmune conditions, including type 1 diabetes and thyroiditis since they increase the risk of celiac disease. Celiac disease should also be added to the list of disorders dentists ask about during family history screening. If a dentist suspects celiac disease, the guidelines advise consulting with the patient’s primary care doctor.
Dentists are urged not to recommend a gluten-free diet to a patient suspected of having celiac disease prior to a definitive diagnosis.
Pale mouth sores (commonly referred to as “canker sores”) are caused by a break in the skin on the lips or surrounding the mouth. Various types of sores can appear anywhere within the mouth, including the inner cheeks, gums, tongue, lips or palate. They can have many causes. Mouth sores can be a sign of a more serious medical condition, including celiac disease.
For more information, see How Celiac Disease Can Affect Your Gums And Teeth on imaware.health and a topic overview on the American Dental Association website.
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