CELIAC PRESENTING AS ATYPICAL DENTAL DISEASE

Introduction-Celiac disease has immune based autoimmune disease which is noticed in genetically predisposed persons and isdue to gluten allergy. It was initially thought that it is disease of children and presents with typical or classical symptoms associated with gastro-intestinal tract like pain abdomen, diarrhoea or constipation. Now, it has been proven that it is commonly seen in adult age also and in half of cases presents with atypical or unclassical symptoms which are mainly due to nutrients or minerals deficiency. Thus, patients can have neurological, psychiatric, dental or reproductive problems. The dental problems have varied presentations like delayed eruption of teeth, dental enamel defects, dental decay, periodontitis etc. The dental involvement in celiac disease is mainly seen in children and may or may not respond to complete gluten restriction.

Case Report- We report a case of seven-year-old child who was asymptomatic but celiac disease was diagnosed recently in his father due to unexplained transaminitis and on family screening, he was diagnosed to be celiac and his dental examination showed dental enamel defect localized unilaterally in upper incisors and canines only. He was put on strict gluten restricted diet but even after follow up of one year, there was no improvement in teeth.

Conclusion- Celiac disease has varied atypical presentations like involvement of teeth which is commonly missed. It lays stress of its awareness among Dentists, Endocrinologists and General Physicians for timely diagnosis for avoiding permanent damage to teeth which have huge cosmetic value.