Dentist-what Do I Do To Convince Him?

[hannahsue01]

I went to the dentis the other day for a cleaning. I did call in advance to make sure everything was gluten free. They didn't have any idea what celiac is. I did try to explain that it causes aborbtion issues. I asked if they thought this would explain why I have had so many cavities. I have had cavities every visit since I was a young child. I now need a root canal and have 8 cavities in teeth that have previously had cavities in them. There response was that teeth are formed well before celiac would effect my teeth. I have looked up symptoms for celiac and enamal problems including week enamal making it easy to get cavities is included as a symptom. I am good about brushing and all. Used to drive me nuts because my younger sister never and I mean never brushes her teeth and has yet to get a cavity.....errrr. Am I wrong about this? If I am not does anyone have any ideas how to inform them that they are wrong? I find it hard telling any of the doctors that they are wrong.

[angelbender]

Sorry, I don't know the answer to your post, but I had the same problem too. CAVITIES by the gazillions as kid......not allowed to have much candy and had to brush always after eating yet still got cavities all of the time.......and my sister had

maybe one cavity in her whole life! It continued into adulthood with numerous root canals due to the deep cavities/fillings in my teeth. The only thing that has seemed to halt the damage recently is when I quit clenching my teeth at night......that was exacerbating the condition. My dentist didn't know the answer either but I don't think he's really interested either. I would love to know as well.

[Guest cassidy]

Celiac does cause enamel problems. Personally, I choose to pick my battles. Informing this dentist that he is wrong probably won't make a difference in how he treats your teeth so I would probably skip it. As long as you verified everything they use is gluten-free then I wouldn't even bring it up again.

I am a drug rep and often run into doctors that have no clue about the disease states my products treat. It is very tricky to try to educate them without offending them and sometimes you just have to cut your losses.

My dentist said that it should be ok if the paste, etc. had gluten because it was only getting in my mouth. Now I know I always swallow some of that stuff. I made sure they checked everything and didn't argue with him.

[2kids4me]

it is hard to get "professionals" to listen to the patient. You could drop off an article or links ot one, maybe he would listen, maybe not. I have included some links for any of you that want something concrete to bring to the dentist. I included medical journals...

We are very lucky to have a dentist that not only knows about celiac but one of the dental hygenists has a mom with celiac. They assign this hygenist to see both kids and the dentist takes extra care to talk to the kids about their teeth and celiac. That is what we should all experience but sadly it appears my dentist is the exception.

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[annacsmom]

I also had tons of cavities as a kid, and have gum problems my whole life. I just took my son for a cleaning (he is gluten free due to intolerance issues, genes, etc.). Anyway, I self-diagnosed my own gluten intolerance since my daughter has tested positive. I discussed this with our dentist and he had never heard about enamel/dental problems although he is familiar with celiac since one of his doctor friends actually has it. His guess was that maybe something in the saliva of a celiac can cause problems, but who knows? I did ask his office to make sure that everything was gluten free, but again, who knows if it really was. I have to trust that they checked, but deep down I am skeptical. I really think dentists should be absolutely aware of the connection, since for young children they could be the first line of defense in connecting dental problems and celiac as a screening measure. Dental problems run in my family and if I had only known then what I know now!

[blueeyedmanda]

I noticed in my worst days before the diagnosis of celiac my teeth really had problems, I got a lot of weak spots and a lot of tooth pain, luckily no cavities.

[happygirl]

also see---

https://www.celiac.com/st_prod.html?p_prodi...-59107106795.85

https://www.celiac.com/st_prod.html?p_prodi...-59107106795.85

[tarnalberry]

1. give the doc peer-reviewed, published studies citing the link between enamel hyperplasia and celiac

2. talk to him about your concerns that this could have been an issue if your celiac problems were present at birth but went without diagnosis for decades

3. determine whether it's worth fighting with him or not - as was noted, it might not make a substantial difference in treatment.

some people are more prone to cavities, enamel defects or not.

[pinktulip]

I'm not alone. I always knew it damaged teeth but omg. I had braces and had perfect teeth health wise before braces, I got the braces off and had pretty much a mouth full of cavaties (all had been under brackets). It's the most embarassing thing but to know I'm not alone helps so much!

[rez]

Hey Tina, We had Thomas in to see Dr. Guandalini last week and he noticed that Thomas' teeth were starting to show dental enamel defects. Dr. Peter Green's book among many others also talk about dental enamel defects.

[blueeyedmanda]

I'm not alone. I always knew it damaged teeth but omg. I had braces and had perfect teeth health wise before braces, I got the braces off and had pretty much a mouth full of cavaties (all had been under brackets). It's the most embarassing thing but to know I'm not alone helps so much!

I am due to get mine off in a few months, I am keeping my fingers crossed that I don't have that happen. I am a real freak about brushing. Did you have any of the spots where the brackets were?

[Dr. S.]

I am a dentist and I ended up on this website because I was doing some research on Celiac disease after one of my patients told me that she has it. We do a thorough medical history and I take every chart very seriously. I research their meds to identify possible interactions with the anesthetics that we use or with meds that I commonly prescribe.

The reason why I am telling you this, is because if your dentist is not spending the time (which you probably already paid for during your new patient exam, or during your hygiene recall exam) to learn about your condition and your needs, then you need to look for another dentist.

I personally don't get offended if a patient asks me about a condition that I am not familiar with or a product that I haven't come across yet! I take that as an opportunity to educate myself and also provide a service to my patients.

this is my second time gathering information on Celiac disease. There's so much iformation and it is hard to digest all at once. But I can tell you from what I've read so far, the "scientific jury" is still out on whether or not Celiac disease is the direct casue of enamel hypoplasia. However, to me it is only common sense that an undiagnosed Celiac patient would end up with enamel defects. Very simply, if you're undiagnosed by the age of 8 yrs old, you'll most definitely have vitamin K, calcium and phosphate deficiencies, which translate into less Hydroxylapatite (Ca5(PO4)3(OH)) = the building block of enamel.

by the age of 8 months, 90% of baby teeth have their crowns (the part outside the gums) formed= babies breast-fed for 1 year are protected against damage to their primary teeth.

by the age of 8 years, 90% of adult teeth have their crowns formed = enough time to cause permanent damage to teeth before they even errupt.

I hope this answers some of your questions.

Regards,

Dr. S.

[ENF]

I am a dentist and I ended up on this website because I was doing some research on Celiac disease after one of my patients told me that she has it..............I hope this answers some of your questions.

Regards,

Dr. S.

Thank you very much for the information that you have provided, Dr. S.

Before I was aware of celiac, and still consuming gluten, I had an incident, after an extraction, of tissue filling in the space. This totally confounded the dentist, and he asked me if I was on some kind of "crazy" diet. I was sent for oral surgery, and given a Rx for vitamin A. Besides that, I have had three bridges, several crowns, numerous root canals, discolored enamel spots, receded gums and infections. Since going gluten free, 3 1/2 years ago, I have not had a single new cavity, but got a long-standing infection, in a root-canal, fixed by extraction after several attempts by my Dentist and Endodontist to avoid this meaure.

It's very encouraging to the celiac community when doctors and other medical professionals take an interest in our problem. Your input, and commitment to providing the correct treatments for patients with celiac, is extremely valuable and very much appreciated on this forum.

[tom]

Dr. S!!!

If you're in San Jose CA, I want YOU to be my new dentist!!

[ravenwoodglass]

I am a dentist and I ended up on this website because I was doing some research on Celiac disease after one of my patients told me that she has it. We do a thorough medical history and I take every chart very seriously. I research their meds to identify possible interactions with the anesthetics that we use or with meds that I commonly prescribe.

The reason why I am telling you this, is because if your dentist is not spending the time (which you probably already paid for during your new patient exam, or during your hygiene recall exam) to learn about your condition and your needs, then you need to look for another dentist.

I personally don't get offended if a patient asks me about a condition that I am not familiar with or a product that I haven't come across yet! I take that as an opportunity to educate myself and also provide a service to my patients.

this is my second time gathering information on Celiac disease. There's so much iformation and it is hard to digest all at once. But I can tell you from what I've read so far, the "scientific jury" is still out on whether or not Celiac disease is the direct casue of enamel hypoplasia. However, to me it is only common sense that an undiagnosed Celiac patient would end up with enamel defects. Very simply, if you're undiagnosed by the age of 8 yrs old, you'll most definitely have vitamin K, calcium and phosphate deficiencies, which translate into less Hydroxylapatite (Ca5(PO4)3(OH)) = the building block of enamel.

by the age of 8 months, 90% of baby teeth have their crowns (the part outside the gums) formed= babies breast-fed for 1 year are protected against damage to their primary teeth.

by the age of 8 years, 90% of adult teeth have their crowns formed = enough time to cause permanent damage to teeth before they even errupt.

I hope this answers some of your questions.

Regards,

Dr. S.

Hello Dr and welcome.

I wish all dentists were as willing to learn as you seem to be. I have had 2 crowns and a porcelian facing sitting in my dresser because I can not find a dentist that will not poison me. In other countries dentists are one of the first medical professionals to suggest celiac disease be looked for in their patients, because of the well documented effects that gluten intolerance has on the tooth enamel. Here in the US the same mouth brings just accusations of never brushing the teeth or extreme sugar consumption. There is a great deal of very well documented research on this, but perhaps not in our country.

Please, please check your products thoroughly. Suggest celiac screening for children and adults with defective enamel especially if they have multiple health issues. As stated your profession, in other countries, saves the health and even the lives of many of their celiac patients. Enamel defects can show up long before other problems are more than an annoyance. Please do not discount research from other countries. Many have been celiac savvy for much longer than our pharmacopic society.

One additional note, many celiacs have bad phobias about dentists because of not only the large number of dental procedures we need but because we become so ill after we leave the chair. One of the most common ways for this to be dealt with is to give the patient something to relax them. Many times I have been handed a script for Xantac, do not prescribe this for your phobic patients. It may be newer and be pushed a lot by the drug companies but there is not a safe form of this drug for us. Check everything, and I do mean everything and eliminate gluten containing lotions and soaps from your practice. You have many more celiacs in your practice than you realize, unfortunately most of them most likely do not even know they have it. Remeber it takes an average of 11 years for us to be diagnosed in the US. They are the lucky ones, it took 40 years and almost dieing for me to finally get diagnosed.

Lastly if you are in Upstate NY would you please PM me and let me know where your office is. At the moment the only teeth I have that I can eat with are 4 crowns on one side, 2 top 2 bottom and with 2 temp crowns and missing porcelian facings I do not have the nicest mouth in the world for all the literally thousands of dollars we have spent. The only dentist that actually checked products and didn't poison me left for a larger city.

[loco-ladi]

I take this on in a whole different manner......

My sister is the office manager for a dentist..... I send her every article I can on the relationship between dental issues and Celiac... by the way thanks for a few new ones!

[casnco]

I am a dentist and I ended up on this website because I was doing some research on Celiac disease after one of my patients told me that she has it. We do a thorough medical history and I take every chart very seriously. I research their meds to identify possible interactions with the anesthetics that we use or with meds that I commonly prescribe.

The reason why I am telling you this, is because if your dentist is not spending the time (which you probably already paid for during your new patient exam, or during your hygiene recall exam) to learn about your condition and your needs, then you need to look for another dentist.

I personally don't get offended if a patient asks me about a condition that I am not familiar with or a product that I haven't come across yet! I take that as an opportunity to educate myself and also provide a service to my patients.

this is my second time gathering information on Celiac disease. There's so much iformation and it is hard to digest all at once. But I can tell you from what I've read so far, the "scientific jury" is still out on whether or not Celiac disease is the direct casue of enamel hypoplasia. However, to me it is only common sense that an undiagnosed Celiac patient would end up with enamel defects. Very simply, if you're undiagnosed by the age of 8 yrs old, you'll most definitely have vitamin K, calcium and phosphate deficiencies, which translate into less Hydroxylapatite (Ca5(PO4)3(OH)) = the building block of enamel.

by the age of 8 months, 90% of baby teeth have their crowns (the part outside the gums) formed= babies breast-fed for 1 year are protected against damage to their primary teeth.

by the age of 8 years, 90% of adult teeth have their crowns formed = enough time to cause permanent damage to teeth before they even errupt.

I hope this answers some of your questions.

Regards,

Dr. S.

Dr. S. Thanks for posting. It is good to know there are doctors out there who will take the extra time to learn about this disease. I would give anything to have a dentist like you. If you post where your practice is I bet you could become a Celiac Dental Specialist! HA! HA! We would all be waiting in line to see you.

[nutralady2001]

Thanks for posting Dr S. I at long last have an answer as to why my teeth have been the bane of my life since I was a child to the point where I now have a top plate and am staring down the barrel at a bottom one in the not-to-distant future.

I used to get so upset when dentists told me I wasn't looking after my teeth when I knew I was

[Dr. S.]

To answer your questions: I am currently working for another dentist in the Niagara Peninsula, Ontario, Canada. I am going on my own in June of 2008.

It is very simple to differentiate between decay caused by inadequate plaque control and that caused by structural defects in the enamel itself.

1-enamel hypoplasia has a distinct appearance, which can be detected very quickly, unless the patient's teeth are already covered with crowns and fillings.

2-inadequate plaque control results in decay at the gumline and in between the teeth. Enamel hypoplasia and demineralization causes decay on those surfaces as well as on flat surfaces.

3-inadequate plaque control causes soft tissue inflammation and bleeding upon probing. However, good plaque control results in tighting of the gums around the teeth and presents less bleeding upon probing (reference point: less than 10% of sites probed bleed). Although in severe undiagnosed celiac disease cases, soft tissue inflammation has been documented.

4-if I feel that the patient is slacking with their home routine and I start to get concerned, I sit them up and I remind them of the recommendations (rinse with water after meals and wait 30 mins before brushing, use a straw when drinking soft drinks and acidic juices + stay away from red wine, brush 3x/day for 2 mins, and floss 1-2x/day especially impt. before bedtime, use a fluoride mouth wash, scrape your tongue before bedtime). most patients realize the seriousness of our discussion and they'll tell me if they haven't been doing that, at that point we give them a second instruction sheet and see them in 3-6 months.

However, if a patient says that they are doing everything I've recommended for the past 6 months and they have more than 3 cavities in one checkup, we then move them into a prescription toothpaste, custom made trays and home fluoride solution.

if things improve, then fine, otherwise, it is time to get a second opinion. Refer them to a specialist or back to their physician.

I've never had to send anybody for a second opinion. Our patient with celiac disease is doing really well and we've been able to manage her with satisfactory results.

generally 1 cavity every 6 months is considered acceptable

2-3 cavities, requires oral hygiene instructions and investigation into the cause

over 4 cavities should raise a red flag and requires a comprehensive approach.

Again, I hope this answers some of your questions

Regards,

Dr. S.

[Gemini]

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[rumbles]

I'm having difficulty with the statement that "the "scientific jury" is still out on whether or not Celiac disease is the direct casue of enamel hypoplasia." Doctors and Dentists in the U.S. knew about the dental hypoplasia link to celiac decades ago when I was young (unfortunately, they believed that those of us that had it would grow out of it, but that's a different topic, and thankfully, those stone age beliefs are history). I just went to the NIH web site, typed "celiac + dental" in the search field, and came up with quite a few articles about the link between celiac and hypoplasia. I'm confident that many other respected medical web sites would have similar results.

[Dr. S.]

I'm having difficulty with the statement that "the "scientific jury" is still out on whether or not Celiac disease is the direct casue of enamel hypoplasia." Doctors and Dentists in the U.S. knew about the dental hypoplasia link to celiac decades ago when I was young (unfortunately, they believed that those of us that had it would grow out of it, but that's a different topic, and thankfully, those stone age beliefs are history). I just went to the NIH web site, typed "celiac + dental" in the search field, and came up with quite a few articles about the link between celiac and hypoplasia. I'm confident that many other respected medical web sites would have similar results.

I am not an expert on celiac disease, I have recently started doing my own evidence collection and I certainly came across several studies stating the link between celiac disease and enamel defects, yet there were enough peer-reviewed published studies stating lack of evidence that I had to consider those as well. The most recently published is the following:

Procaccini M, Campisi G, Bufo P, Compilato D, Massaccesi C, Catassi C, Lo Muzio L.

Lack of association between celiac disease and dental enamel hypoplasia in a case-control study from an Italian central region.

Head Face Med. 2007 May 30;3:25.

PMID: 17537244 [PubMed]

I saved the reference because I am going to see if I can order a translation of it. But you can do your own search on www.pubmed.com

Regards,

Dr.S.

[WW340]

I just saw my dentist 2 weeks ago. It was the first time I have seen him since my diagnosis almost 1 year ago.

He was very interested in my diagnosis and asked a lot of questions about celiac disease.

He made a couple of comments that I found interesting.

One is that he suspects that my celiac disease may have caused the microcavities and fissures I have all over the flat surface of my teeth. He had thought it odd that I had so many of these when he started treating me several years ago. I had only had 3 real cavities until age 50, then my teeth started cracking, chipping, and developed all these tiny microcavities and fissures.

The second thing he said was how great my tissues look and how I must be taking really good care of my gums.

This was such a new thing for me, because all my life I have had problems with gum inflammation. It never mattered what I did. I used to go every 3 months for teeth cleaning with no improvement. I have undergone treatments from peridontist with no real change. Yet, over the last 11 months the only thing I did differently was eat gluten free, and now my gums look great. I have to believe that the inflammation must have been related to the gluten reaction.

[darlindeb25]

I thought I would bump this up for some of you who have not read it yet. I think I missed this thread before. I have known for a long time that bad enamel is a symptom of celiac disease...I didn't realize a mouth full of cavities was!

As a teenager, I had a dentist chastise me because of all of my cavitives. He told me I wasn't brushing my teeth properly, and never enough. I am nearly 53, and I still remember his words. I kept telling him I brush my teeth, and I guess he thought I was lying. I have a mouth full of fillings, had a root canal done when my sons were in Little League (so painful, I promised myself I would never have one again, after it was done, I had pain for more than a year in the root) and now, I have teeth that are crumbling.

If only they knew then about celiac.

[Jess07]

Wow, I never knew until now that celiac causes so many problems with weak enamel. I admit, I have had some problems with brushing habits, but I still don't think my brushing habits were that bad.

I was initially diagnosed with celiac about two years ago. Over the past few weeks, I have started having to get some fillings as I just found that I have several cavities in my back teeth. I was very suprised to find out that I have cavities because I never had a problem with cavities before, I was prided myself on that. It also made me wonder why the orthodontist never said anything about it. It is such a relief to know that this could also be a major contributing factor.

Now it makes me wonder if and how much the gluten and my general health over the last two years,with losing so much weight, has contributed and even compounded to the problem.

Besides that, my grandpa had discolored teeth his whole life, several cavities, and eventually got all of his teeth pulled, getting dentures when he was 25.

It would be interesting to note what the scientific evidence is behind all of this.