Between 50% and 94% of patients with celiac disease have dental enamel defects, according to a new study.

Enamel defects included discoloration, pitting, or grooving of the teeth. Patients were also more likely to have decayed, missing, or filled teeth; tooth sensitivity; aesthetic issues; and dental caries compared with controls. Further, 68.6% of the patients with celiac disease reported experiencing dry mouth, according to a study published in the Journal of Clinical Medicine.

Celiac disease is known to cause localized and systemic health issues. Following gluten consumption, the intestinal villi experience inflammation and atrophy, thereby reducing nutrient absorption and causing symptoms such as diarrhea, weight loss, fatigue, and anemia. The prevalence of celiac disease may be increasing across U.S. patients, regardless of age, ethnicity, and geographic location.

In the study, the investigators used PRISMA and International Prospective Register of Systematic Review Registry guidelines to identify 18 randomized controlled trials, randomized controlled clinical trials, and case reviews that met the inclusion criteria across the PubMed, Cochrane Library, Scopus, and Web of Science databases between January 1, 2013, and January 1, 2024. They then explored the relationship between celiac disease and dental enamel defects, the mechanisms behind the connection, and strategies for early diagnosis and treatment. 

The investigators found that the defects may have been the result of malabsorption of nutrients like calcium and vitamin D because of damage to the small intestine or an autoimmune response triggered by gluten consumption.

The investigators underscored that recognizing the oral manifestations of celiac disease early may help patients better manage the condition. Dentists performing routine oral examinations may have the opportunity to identify dental enamel defects that match the patterns of those observed in patients with celiac disease and subsequently refer patients for additional testing through serological analysis or intestinal biopsy. The investigators underscored that dentists should collaborate with gastroenterologists to monitor celiac disease and its oral manifestations.

No conflicts of interest were disclosed.