Thursday, May 22, 2014

Signs Gluten Causing Dental Decay, By Dr. Sylvia Onusic: Dentists Play an Important Part-Part 2

Dr Sylvia Onusic, writing for Healthy Home Economist, describes the connection of celiac connective tissue abnormalities (besides dental and oral manifestations), and the triggers which have been identified: bottle feeding, low vitamin D ingestion and sun exposure, virus's, C/S and timing of ingestion of gluten in the infant. She rightly identifies gluten induced disorders as a connective tissue disease.....NOT A FOOD ALLERGY, with stimulation of the abnormal lymphatic tissues.

Here she writes:

Celiac Disease is an autoimmune disease, not a food allergy, which affects infants, children and adults and results in a permanent intolerance to gluten, a protein found in wheat, rye and barley.

Celiac disease is a common disorder and about 1% or more of North Americans may develop it and it can occur at any age. With celiac progression, there is increasing damage to the villi of the small intestine, which are responsible for uptake of nutrients, leading to nutrient- related diseases such as osteoporosis, malabsorption syndromes, anemia, even lymphoma and other cancers. 1-2

Celiac is an inherited disease which can show up because of a variety of different conditions. The most important factor in preventing development of celiac in at-risk babies is breastfeeding up to a year or more, especially upon first exposure to gluten.Studies show that the timing of the introduction of gluten and amount of gluten given is important. Babies ingesting gluten laden cereals, crackers or other gluten containing foods during the first three months of life are an increased the risk for development of celiac disease, compared to infants who were first given gluten around six months of age.

In Swedish studies from the 1990,’s prompted by an epidemic of celiac disease, it was found that babies given higher amounts of wheat baby foods were much more likely to develop celiac disease. 3

For persons who have a relative or parent with celiac disease, the disorder can show up after a virus, accident, pregnancy, or stressful situation. 1

I would recommend, if you are concerned for your children's teeth or you look after children that you read the whole thing.

To Your Health
Dr. Barbara

Wednesday, May 14, 2014

55% of Kids with Celiac Disease have Dental Enamel Defects- Dentists Play an Important Role-Part 1

Grade 1 enamel defects in celiac disease
As it turns out, it is depressingly common for adults and children with celiac disease to have problematic teeth. And expensive. And these may lead to long-term health problems.Previous studies have shown that celiacs tend to have more dental problems than average, and new research backs that up.

As reported in bold), the study, published in the European Journal of Internal Medicine, looks at dental enamel defects in adult celiac disease. Defects in your teeth's enamel, or coating, can appear as discoloration or as pitted, rough surfaces.

grade 2 enamel defects, notice the scalloped edges

The researchers performed a dental exam in 54 adults with celiac disease to look for enamel defects, and found them in a whopping 85% of those they examined. One-third had minor defects (also called "grade 1" defects), another 30% had grade 2 defects, 15% had grade 3 defects and 7% had grade 4.                                                                    

The researchers, who are based at the University of Pavia in Italy, noted that "dentists have a chance to refer people for celiac disease testing if they find enamel defects".

And according to researchers out of Halifax, Nova Scotia, Canada, 55% of children with the diagnosis of celiac disease have dental enamel defects. These may be the only manifestation of this disorder. They say "Dentists can play an important role in identifying people who may have unrecognized celiac disease". J Can Dent Assoc 2011;77:b39.

Other oral and dental manifestations of celiac disease, besides enamel defects include delayed eruption, recurrent aphthous ulcers (RAS), Cheilosis, oral lichen planus, atrophic glossitis, dens invaginatus, squamous cell carcinoma of the pharynx and mouth, red smooth shiny tongue, and dry mouth. According to this paper sometimes aphthous ulcers are the only sign of celiac disease.

A clinical guide for dentists is here. Dr. Rashid and his colleagues recommend the following clinical tips for dentists:

-Consider celiac disease as a possible diagnosis in any patient with dental enamel defects, recurrent oral      aphthous ulcers or both.
-Question about other clinical symptoms of celiac disease, including abdominal pain, diarrhea, weight loss,  poor growth, anemia and extreme fatigue. Remember that absence of these symptoms does not rule out  celiac disease.
-Inquire about the presence of other autoimmune diseases, especially type 1 diabetes and thyroiditis. The  presence of these will further increase the probability of celiac disease.
-Consider adding celiac disease to the list of disorders that you inquire about during family history screening.  Having a first- or second-degree relative with celiac disease increases the likelihood of a positive diagnosis.
-If celiac disease is suspected, the dentist or dental hygienist may wish to coordinate laboratory testing with  the patient’s primary care physician or specialist. The currently recommended screening test for celiac  disease is serum IgA-TTG antibody test, which is readily available. The TTG is an IgA-based test and IgA  deficiency is common in celiac disease. Therefore, total IgA level should also be measured.

An information sheet is available at Canadian Celiac Association , which would be helpful if you suspect or you know you or your child has celiac disease, and you want to open a discussion with your dentist.

Celiac Disease is an autoimmune disease, not a food allergy, which affects infants, children and adults and results in a permanent intolerance to gluten, a protein found in wheat, rye and barley. And other grain proteins found in oats, hemp and coffee.

Dentists play an important role in diagnosing celiac. More studies on the incidence of gluten sensitivity and dental disorders need to be done.

See Dr. Onusic's excellent article on the relationship of this abnormal autoimmune disorder, not a food allergy to our health in general and to our teeth, in "Part 2".

To Your Health

Dr. Barbara

Monday, May 5, 2014

Dr. Perlmutter's Brain Health Program in Grain Brain includes a Grain Free, GAPS Style Diet

I don't know anyone who doesn't want to age in good 
health and avoid Alzheimer's. 
We get a lot of information about how to do this, but does this information have to be updated from the 30's and 40's when most of these principles were established? There is a large movement to update classical teachings and Dr. Perlmutter, a neurologist in practice has put up-to-date research and recommendations into a book called "Grain Brain". 

Dr. David Perlmutter says in this interview: the first step is to stop gluten! (My bold):
Research suggests gluten can play a damaging role by the changes it imparts on your microbiome, the bacteria in your gut. But gluten can also wreak havoc with your neurological health via the inflammation it causes. Non-celiac gluten sensitivity may involve 30 to 40 percent of the population and according to work done at Harvard by Dr. Alessio Fasano, it may even affect every single human being.

The reason for this is because gluten, a protein found in wheat, barley, and rye, has significant effects on your gut cells, which leads to the production of a chemical called zonulin. Zonulin enhances inflammation and tends to make your gut porous and leaky (i.e. leaky gut syndrome). But that's not all. Dr. Fasano discovered that it can also make your blood-brain barrier leaky, allowing foreign proteins to migrate into your brain, where they clearly do not belong.

Listen to the full interview to pick up some brain saving tips.

Let's talk about those foreign proteins mentioned above. These proteins that migrate into the brain are recognized as "foreign invaders" mimicking a life threatening microorganism invasion, like "swine flu" or encephalitis, which then triggers a life saving reaction by the immune system. The reaction however, can go wrong with the confusion of the system when it thinks our own tissues look like gliadin proteins. Dr. Fraser Scott showed that celiac subjects had tissues that look like gliadin back in 2002, but other researchers have shown the same thing in other organs' connective tissues!!! 

This starts a reaction to one's own tissues with the production of anti deamidated gliadin, anti gliadin,  and  anti tissue transglutaminase antibodies (Tg2,3,and 6), especially worrisome is Tg6 but also Tg2, which attack the brain tissues and the tissues around the blood vessels blocking the "blood brain barrier".  Tg6's attack on the brain causes dozens of neurological disorders especially cerebellar ataxia, cerebral calcifications, peripheral neuropathy, epilepsy, migraines and possibly MS. 

Dr. Hadjivassiliou has written an extensive article  "Gluten Sensitivity; From Gut to Brain" on these neurological diseases and the good news is he has shown these conditions improve on a gluten free diet. If you want to see what the blood brain barrier thickened up with Tg6 looks like, go to page nine, and look at the picture labelled "A". The circle in the middle is the lumen of a blood vessel and around it is a cuff of thickness imbedded with Tg6 antibodies. This is very abnormal as the area around the blood vessel is rarely bigger than 1/5th of the diameter of the blood vessel. With one look at the diseased brain tissue's blood vessel you can tell there is something horribly wrong.

This abnormal attack on our own tissues also leads to psychiatric conditions. Here is a case of severe psychiatric symptoms, at one point requiring hospital admission, who improved with GAPS diet and B12 shots.

If your aim is good brain health, the first step is to stop eating gluten. 
You will want to get rid of all grains, though, because of the cross reactive and toxic proteins in them that promote leaky gut and inflammation just like gluten, which is the mechanism for the damage to the brain. 

There is more to do, of course, like remove chemical exposure especially to pesticides, proper dental care by a biological dentist, keeping your vitamin D levels good, keeping your blood sugar levels low and stable, keep your uric acid levels low by limiting your ingestion of fructose to 25 grams a day or less, monitor your B12 levels with a Homocysteine test, supplement with lots of folate (not folic acid, the chemical) probiotics and zinc, exercise moderately and keep your stress levels manageable.

To Your "Brain" Health
Dr. Barbara