I recently discovered an interesting connection between patients suffering from Celiac Disease and its effects on the oral cavity. Celiac disease is an autoimmune digestive disease that damages the micro-villi of the small intestine and interferes with absorption of nutrients from food. What does this mean?

Celiac disease is triggered by consumption of the protein called gluten, which is found in wheat, barley, rye, and oats. When people with celiac disease eat foods containing gluten, their immune system responds by damaging the fingerlike villi of the small intestine. When the villi become damaged, the body is unable to absorb nutrients into the bloodstream, which can lead to malnourishment.

Roughly one out of every 133 Americans has celiac disease, but 97% remain undiagnosed. This means that almost three million Americans have celiac disease and only about 100,000 know they have it.

Left untreated, people with celiac disease can develop further complications such as other autoimmune diseases, osteoporosis, thyroid disease, and cancer.

Symptoms: Symptoms of celiac disease may or may not occur in the digestive system. For example, one person might have diarrhea and abdominal pain, while another person has irritability or depression. In fact, irritability is one of the most common symptoms in children.

Some of the most common symptoms of celiac disease include: bloating or gas, diarrhea, constipation, fatigue, joint pains, tingling/numbness, headaches, irritability and infertility.

Dental symptoms include discolored teeth or loss of enamel and canker sores. I must admit, over the years, I’ve seen plenty of these symptoms in my patient’s mouths but never once made this connection. It’s also interesting to note that there are no known etiologies for the causes of canker sores either.

Remember, the oral cavity is alike a window to the rest of the body and Biological Dentistry offers this unique interpretation to our patients as we continue to think outside the box and we search for these “tooth and body” connections.

In our office, a clinical examination of the oral cavity offers more than just a casual evaluation of the teeth and gums. Looking for clues that may suggest systemic imbalances or a compromised condition in general health is our main focus for our patients.

Diagnosis: Accurately diagnosing celiac disease can be quite difficult largely because the symptoms often mimic those of other diseases including irritable bowel syndrome, Crohn's disease, ulcerative colitis, diverticulosis, intestinal infections, chronic fatigue syndrome, and depression.

Blood tests will usually be ordered to gain a proper diagnosis of celiac disease.

It is important to continue eating a normal, gluten-containing diet before being tested for celiac. If the blood tests and symptoms indicate celiac, a physician may suggest a biopsy of the lining of the small intestine to confirm the diagnosis.

Treatment: The only treatment for celiac disease is a lifelong gluten-free diet. A gluten-free diet means avoiding all foods that contain wheat (including spelt, triticale, and kamut), rye, oats, and barley.

Despite these restrictions, people with celiac disease can eat a well-balanced diet with a variety of foods, including bread and pasta. For example, instead of wheat flour, people can use potato, rice, soy, or bean flour. Or, they can buy gluten-free bread, pasta, and other products from specialty food companies. Just keep in mind that some people may also have sensitivities to other foods such as soy.

The gluten-free diet is a lifetime requirement for people with celiac disease. Eating any gluten, no matter how small an amount, can damage the intestine. This is true for anyone with the disease, including people who do not have noticeable symptoms. As with other chronic illness, as the immune system is continuously attacked over time, other more serious illnesses may develop.

Following a gluten-free diet may seem daunting at first. However, with a little creativity anyone can make delicious gluten-free meals! For example, plain meat, fish, rice, fruits, and vegetables do not contain gluten, so people with celiac disease can eat as much of these foods as they like.