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Title Exposure to Gluten, Used in the Manufacture of Dental Materials, Can Exacerbate Celiac Disease
Clinical Question In patients with celiac disease, does exposure to gluten-containing dental materials pose a significant health threat?
Clinical Bottom Line For patients with celiac disease, exposure to plasticized gluten in dental prostheses can produce symptomology and serology indicative of active disease.
Best Evidence (you may view more info by clicking on the PubMed ID link)
PubMed ID Author / Year Patient Group Study type
(level of evidence)
#1) 24137038Memon/2013 A 9-year-old child with celiac disease demonstrating positive serum markers for active disease during exposure to an orthodontic retainer.Case Report
Key resultsThis study reported celiac serology over a 19-month period. Tissue transglutaminase IgA levels significantly declined over a 6-month period following celiac diagnosis and establishment of a strict gluten-free diet. Tissue transglutaminase IgA levels increased over the course of 3-months after gluten exposure from an orthodontic retainer. However, after retainer removal, serology declined over a 3-month period, achieving normalized levels by month 10.
Evidence Search (("Celiac Disease"[Mesh]) AND "Orthodontic Appliances"[Mesh]) AND "Glutens"[Mesh]
Comments on
The Evidence
Validity: There was only one subject included in this case report. The study achieved adequate follow-up by recording celiac serology over a 19-month period, including an 11-month period after retainer removal. There is no reason for recall bias to be of concern in this report. As stated in the article, the authors declared no potential conflicts of interest, nor did they receive financial support, with respect to the research, authorship, and/or publication of the article. Because this is such a recent finding, the impact of this study may be increased by additional research of celiac patients and sensitivity to gluten-containing dental materials, which extends beyond orthodontic retainers.
Applicability This report is applicable to dental patients with celiac disease or gluten-sensitivity. Currently, more focus lies on dietary sources of gluten in terms of disease exacerbation, however, patients and dental providers should be aware of potential extra-dietary factors as well. Orthodontic retainers are widely used but are not commonly known to contain gluten. This study has shed light on what could be an important health factor for many patients currently wearing orthodontic appliances, or who will undergo treatment. Additionally, it has increased awareness of similar gluten-containing dental materials that may pose a health threat.
Specialty/Discipline (General Dentistry) (Orthodontics) (Prosthodontics)
Keywords celiac disease, celiac, gluten, orthodontics, retainer
ID# 2836
Date of submission: 03/24/2015spacer
E-mail Robison@livemail.uthscsa.edu
Author Taylor Robison
Co-author(s) e-mail
Faculty mentor/Co-author Georgiana S. Gross, MPH
Faculty mentor/Co-author e-mail
Basic Science Rationale
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