ENAMEL HYPOPLASIA (EH) OF PERMANENT TEETH IN COELIAC DISEASE (CD)
1Dept. Paediatr., Univ. Centr. Hosp. of Tampere, Tampere, Finland.
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Abstract
The
teeth of 86 children and adolescents aged 3 to 22 years with CD were
examined for dental enamel defects. Althogether 73 of 76 (96%) children
with permanent teeth had enamel defects. The defects were in contrast to
those in controls (n=150) symmetrically and chronologically distributed
in all four sections of dentition. 11 (14%) had colour defects, 40
(53%) mild, 14 (18%) moderate and 8 (11%) severe EH. A total of 1356 of
1811 (75%) teeth were found to be defected, in controls only 8%. Heavy
clinical symptoms resulted in more severe EH. Orthopantomographs showed
in children with deciduous dentition enamel lesions in unerupted
permanent teeth in 7 of 9 cases. Gluten free diet before the age of 2
years resulted in normal enamel development of the gingival segment of
first anterior permanent tooth in 14 of 16 children. In contrast 10 of
11 children with gluten challenge had EH in this segment (p<0.001).
In
conclusion, permanent teeth EH is a frequent finding in CD. Thus, when a
child has general EH, CD should be suspected. Because of the risk of
developing permanent teeth EH, the need of gluten challenge should be
reconsidered when planning it to children less than 7 years old.
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