tooth enamel?

[Kaylee's Mommy]

I have noticed on Kaylee's two front teeth that she has two large spots of enamel missing .. a section on each front tooth, its pretty big.. almost the entire face of her tooth.. my dh thinks it from her drinking from water type bottles.. but the bottle doesn't hit on that part of her tooth...her lip would be in the way.. I'm concerned this is something to do with T1D.. she's hasn't had T1D for quite a year yet.. its on her baby teeth.. anyone have any ideas?

[Ellen]

Has she been to a pediatric dentist yet?

There is some info online about tooth enamel defects and celiac disease. Has she been tested for celiac?

[Kaylee's Mommy]

I don't think they tested her when she was diagnosed (if they did they never said anything) her 1 year anniversary is coming up next month so I was going to make sure that she was tested then for celiac..

she has been to a dentist twice.. once when she had just turned two and then this past summer..this is BRAND new like in the past few days.. I noticed it on christmas morning.. when she was at the dentist this summer they said her teeth look great..

do yu have any good places to read about the enamel and celiac?

[Ellen]

: Eur J Paediatr Dent. 2005 Sep;6(3):129-32. Links
Enamel defects in children with coeliac disease.

• Farmakis E,
• Puntis JW,
• Toumba KJ.

Dept Paediatric Dentistry, University of Leeds, England.
AIM: This was to investigate the prevalence of enamel developmental defects in a group of children with a history of coeliac disease. METHODS: A study group of children attending the Dept. Paediatrics (Leeds General Infirmary), born between 1985 and 1986 and subsequently diagnosed and treated for coeliac disease (CD) were recruited. A group of age/sex-matched children attending the Paediatric Dentistry department were used as a control group (Cont). Examinations were carried out for enamel defects and opacities (DDE index), dmf, dmfs, DMF and DMFS (BASCD method), and a full medical and dental history were obtained. RESULTS: Significantly more children in the CD group had a greater number of enamel defects than controls for both primary (p=<0.02) and permanent (p=<0.001) dentitions. Opacities in both primary and permanent teeth were statistically significantly greater in the CD group than controls (p=<0.04 and p=<0.001 respectively). Dental caries in both primary and permanent dentitions was less in the CD group compared with the control group of children. CONCLUSION: Coeliac disease was associated with an increased prevalence of developmental enamel defects.
PMID: 16216092 [PubMed - indexed for MEDLINE]

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: Eur J Paediatr Dent. 2004 Jun;5(2):102-6. Links
A comparative study on the prevalence of enamel defects and dental caries in children and adolescents with and without coeliac disease.

• Priovolou CH,
• Vanderas AP,
• Papagiannoulis L.

Department of Paediatric Dentistry, School of Dental Medicine, University of Athens, Greece.
AIM: This was to test for differences in the prevalence of enamel defects and dental caries between children and adolescents with and without coeliac disease (CD). MATERIALS AND METHODS: The sample consisted of 27 children and adolescents, aged 3 to 18 years with CD, and a control group of 27 healthy subjects matched by age and gender. Enamel defects were diagnosed and classified according to criteria described by Aine [1986], while dental caries was recorded as DMFT(S) and dmft(s) indices [Koch, 1970]. Dental plaque was recorded by the Plaque Control Record Index. Information related to medical history, oral hygiene habits, use of fluoride, history of dental trauma and socioeconomic factors was collected by a structured parental questionnaire. Also, in children with CD the age of initiation and diagnosis of the disease was recorded. STATISTICS: The chi square and the paired t-test were used for the statistical analysis of the qualitative and quantitative data respectively. The logistic multiple regression analysis was applied to test whether the time period between the initiation and diagnosis of CD and other related factors had a significant (p<or=0.05) impact on the presence of enamel defects. RESULTS: The prevalence of enamel defects was higher in the CD group. Differences in frequency and symmetrical distribution of the defects were statistically significant between CD and control groups. With respect to dental caries, significant differences in the mean values of DMFS/dmfs were found between the two groups. Higher values of DMFS/dmfs were recorded in the control group. CONCLUSION: CD increases the risk of developing enamel defects in permanent teeth but not of having dental caries.
PMID: 15198629 [PubMed - indexed for MEDLINE]
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This one refutes the hypothesis

: Int J Paediatr Dent. 2001 May;11(3):179-83. Links
Celiac disease and mineralisation disturbances of permanent teeth.

• Rasmusson CG,
• Eriksson MA.

Department of Pedodontics, Uddevalla Hospital, Uddevalla, Sweden.
In a study from Finland in 1986 it was shown that celiac disease was often associated with tooth enamel defects of permanent teeth. This study also showed a strong association between the time of gluten challenge in the diagnostic procedure and enamel defects. In the current study, dental examinations were carried out for a group of 40 children and adolescents suffering from celiac disease diagnosed according to the criteria of The European Society of Paediatric Gastroenterology and Nutrition (ESPGAN) at the Department of Paediatrics, Hospital of Uddevalla, Sweden. A control group made of 40 healthy children of the same age, sex and living area was examined in the same way. The results failed to show disturbances of the same type, degree of severity or frequency as was reported in Finland and no statistically significant differences concerning enamel defects were found between the patients with celiac disease and the controls.
PMID: 11484467 [PubMed - indexed for MEDLINE]

[Kaylee's Mommy]

I just talked to her Pedi endo.. they said she was checked back in april for celiac and they don't see a need to have her checked again until april.. but they want her to come in for a calcium something or other test tomorrow.. so at noon, thats what we are doing and when the dentist office opens on the 2nd I'm going to get her in there..
thanks for your help