Gluten Can Damage the Mouth
There are a number of research studies demonstrating the impact of gluten on the oral cavity. From tooth enamel decay, to painful tongue syndrome, to mouth ulcers gluten can cause a number of problems in the mouth. After all, the mouth is part of the gastrointestinal tract, and all doctors should be trained to investigate for oral symptoms of gluten sensitivity. Typically, when we think about gluten causing damage, we think about getting exposure from what we eat. A new research case study identified a 9 year old girl with gluten sensitivity who was following a strict gluten free diet. However; she developed abdominal discomfort after wearing her retainer. The study abstract is below:Celiac disease is a gluten enteropathy that is treated with dietary elimination of gluten. Exposure to nondietary sources of gluten, which are used in the manufacture of products such as plastics, dental equipment, and cosmetics, can also trigger or exacerbate disease. We report the case of a 9-year-old child who presented with nonspecific abdominal discomfort with abnormal serology for celiac disease. She underwent duodenal biopsies that revealed Marsh 3B histopathology. Despite strict dietary elimination of gluten, she continued to be symptomatic and demonstrate positive serum markers for active disease. It was then discovered that the child was exposed to gluten from her orthodontic retainer that contained a plasticized methacrylate polymer. Gluten is a common additive in plastics. She discontinued its use and demonstrated symptom resolution and complete normalization of serology. All possible sources of gluten, including non dietary, must be considered when managing a child with celiac disease.Source: Clin Pediatr (Phila). 2013 Nov;52(11):1034-7
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