Celiac Disease: How to Recognize and Manage Them

Celiac disease is a serious genetic autoimmune disease with over 300 symptoms, and most people manifest with a combination of them. It is caused by intolerance to gluten, which is a protein found in wheat, rye, barley, and other cereals. Gluten is usually present in the small intestine, and in patients with celiac disease, the lining of the small intestine gets attacked. Consequently, a number of organs and/or body systems are affected, making it extremely difficult to pointedly say that a person has celiac disease.

These symptoms cover almost all systems of the body including reproductive to digestive, cardiovascular to endocrine, respiratory to neuromuscular, and even affect the bones, and the teeth. Another major variation also is the age at which celiac disease becomes symptomatic. While some show symptoms quite early in their childhood, some others show symptoms later in their life, and some may not manifest with any symptoms all through their life.

Talking of the oral/dental symptoms, there are two main causes for concern one involving the soft tissues and the other involving the teeth. Let us look at the two in a little more detail.

Similar to the canker sores or the usual mouth ulcers, celiac disease also cause whitish sores. Unlike the canker sores which appear on the lips, the celiac mouth sores are common on the insides of the cheek, gums, lips, palate, and sometimes even the tongue. The appearance is very similar to that of aphthous ulcers, which have a whitish or grayish margin. They appear at random with no specific reason. The soft tissue lining of the digestive system is present from the stomach or intestine all the way to the mouth, and therefore these ulcers are seen. These can be quite discomforting and interfere with nutrition. Topical creams and/or gels can be applied to treat them. If celiac disease is diagnosed by then, abstaining from a gluten-free diet will help relieve the symptoms. Else, they may continue to recur and symptomatic treatment would be required.

The second oral symptom of celiac disease is the presence of visible defects of discoloration in the enamel. There are usually white, brown or yellow spots, usually discolored on the incisors and molars (front and back teeth). The bad news with the tooth issue is that these do not go away once a gluten-free diet is adopted. Depending on the severity, these may require tooth whitening treatments ranging from bleaching to veneers to full crowns.

The next time you have a group of symptoms, with the above two oral symptoms, contact your doctor and have a detailed discussion. It does not take much effort to diagnose and treat celiac disease.