The Connection Between Weak Tooth Enamel and Inflammation

“Weak enamel” since childhood is often associated with Celiac disease.

When anyone comes to the clinic - I check their mouth and teeth. This keys me in to so many things, but one thing I always check is if they have signs of weak enamel.

In folks who’ve had “soft” teeth since childhood, I’ll screen for Celiac. A small study found that the percentage of pediatric patients with celiac disease with dental enamel hypoplasia (weak enamel) may be as high as 40-50% compared to about 6% in dental hypoplasia patients without celiac disease.

Celiac occurs when the small intestinal enzyme protein transglutaminase 2 (TGM2) modifies the gliadin protein, a component of gluten in the diet, in the gut.

The immune systems of affected people react to the enzyme/gliadin complex and produce autoantibodies against both these proteins. The appearance of antibodies against TGM2 is so specific to the disease that it is also used to screen for celiac disease.

We thought for a long time that pediatric Celiac disease, which results in inflammation of the gut, inhibited the proper absorption of vitamins and minerals required for enamel formation, and thus - weak enamel.

But, a recent paper in Nature added some bulk to our understanding of this phenomenon. They showed for the first time that the defects in enamel formation can be caused by the very antibodies produced against proteins by binding to proteins that control the development of tooth enamel.

This is due to the fact that tooth enamel proteins have similar binding sites for antibodies as the TGM2 enzyme.

Interesting right?

Other symptoms of celiac include:

• Abdominal pain

• Bloating and gas

• Constipation

• Diarrhea

• Depression and anxiety

• Fatigue

• Headaches or migraines

• Iron-deficiency anemia

• Itchy, blistery skin rash (dermatitis herpetiformis)

• Joint pain

• Missed periods

• Mouth ulcers and canker sores

• Nausea and vomiting

• Osteoporosis and osteomalacia

• Peripheral neuropathy

• Reduced functioning of the spleen (hyposplenism)

• Weight loss and short stature

PMID: 37993717