Celiac disease triggers an immune response in the small intestine. For individuals who are sensitive to gluten, this can occur if they eat foods containing wheat, barley, and rye. Patients with celiac disease often experience uncomfortable symptoms such as upset stomach, nausea, constipation, fatigue, and itchy skin. Children may also exhibit early signs of the disease in their mouths and teeth. While celiac disease can cause other health risks or issues if left unmanaged, catching it in childhood can help physicians and caregivers to take action before its effects become severe. Donna Greco, DMD discusses what you should know.
What are the first signs of childhood celiac disease that my child’s dentist or I might notice?
Recurrent mouth ulcers (canker sores) or developmental enamel defects in the teeth might be among the first signs. Parents and caregivers who brush their children’s teeth regularly could notice these, or a dentist might spot them during an exam.
How common is celiac disease?
Celiac disease is vastly underdiagnosed—it sometimes takes up to 11 years to diagnose. In North America, 1% of the population is estimated to have it. “If I see 200 patients in a week, then statistically, two of those individuals would have the condition, but it’s not frequently listed in patients’ medical history,” says Dr. Greco. “So this is a new way for dentists to think about things. The presentation and profile of celiac disease resemble those in patients with Crohn’s disease.”
At what age do these signs of celiac disease typically appear?
These signs typically appear in a child’s mouth around age 7, which is when permanent teeth usually begin erupting. The signals can also appear in primary dentition (baby teeth), but usually appear after age 7.
What else should I know about childhood celiac disease and the oral issues it can cause? What happens if we delay or skip taking steps to control it?
The oral issues, which include recurrent mouth ulcers, can be quite painful. Dr. Greco notes, “I’ve seen children with major or multiple mouth ulcers run low grade fevers, suffer swollen lymph nodes, and have difficulty eating. Because it blocks absorption of vital nutrients, the condition can delay growth and puberty in youngsters. It can also cause persistent vomiting, which negatively affects the mouth and teeth. Taking steps to control the condition is tremendously important for this reason.” If a child is vomiting persistently, it introduces high levels of acid that can erode tooth enamel and increase the rate of decay. Therefore, it’s crucial to get a firm diagnosis and take steps to control the symptoms.
If my child’s dentist observes oral signs and suspects that celiac disease is causing them, what should we do next?
In this situation, your child’s dentist should refer you to your pediatrician for further testing.
Is there a cure for celiac disease?
Because it is a chronic disease of the autoimmune system, it can only be treated. The Celiac Disease Foundation website has plenty of helpful information. But there’s good news: patients who stick closely to the advice of their physicians can certainly overcome their symptoms to regain and maintain their good health.
Celiac Disease. Ada.org.
https://www.ada.org/en/member-center/oral-health-topics/celiac-disease. Updated September 29, 2016. Accessed January 30, 2019.
Celiac Disease. Mayoclinic.org. https://www.mayoclinic.org/diseases-conditions/celiac-disease/symptoms-causes/syc-20352220. Published March 6, 2018. Accessed January 30, 2019.