One in three Norwegian children has enamel damage. In addition, up to 50 percent of children with celiac disease have problems with this, which leads to poorer dental health. But this is not because parents are bad at brushing their teeth. Now researchers at Haukeland University Hospital and the University of Bergen can determine for the first time that enamel damage is caused by an autoimmune reaction. – This comes as a surprise to all of us, says Trond Sundby Halstensen, leader of the Celiac Association’s professional council. Reacts to milk protein Research shows that people with celiac disease react to the protein kappa-casein, which is found in cow’s milk. – You can actually date when this “attack” has taken place, based on which teeth have damage, says professor and senior physician Eystein Husebye, who is one of the researchers behind the study. Professor Anette Wolff and Professor Eystein Husebye have researched this for over ten years. The study is now being published in the prestigious journal Nature. Photo: Oda Marie Rønning / news It is estimated that 1.5 percent of Norwegians have celiac disease. In addition, it is believed that three out of four are undiagnosed. In the same way that celiac patients react to gluten in the diet and get intestinal damage, they react to the milk protein and get tooth damage. These injuries occur when the enamel is formed, i.e. before the children are ten years old. In order for the damage to occur, the child must have had celiac disease within that time period, and the time when the damage occurred can be dated, almost in the same way as with annual rings in trees. The researchers see the same damage in adults who have recently been diagnosed with celiac disease. What is tooth enamel? Tooth enamel is a hard, white substance that covers the tooth. The enamel begins to form even before you are born, and is fully developed when children are around ten years old. Enamel is the body’s hardest substance, and damage to it cannot be repaired by the body once the enamel is formed. This means that no new enamel is made, so any damage is irreversible. Makes it easier to diagnose The researchers began investigating this in connection with finding enamel damage in another, very rare disease, called autoimmune polyendocrine syndrome type I (APS-I). There they found that almost all the patients had enamel damage. – So we started thinking about what other diseases have the same type of enamel failure? Yes, it is celiac disease, says professor and researcher Anette Wolff. The researchers can see if the patient has antibodies against the milk protein using a simple blood test. Photo: Oda Marie Rønning / news The study looked at 28 patients with APS-I, 48 adults with celiac disease, and 21 children with celiac disease. – The strength of the study is not in the number, but in the thorough studies that have been carried out to find the explanation for why enamel failure occurs, says Wolff. It is now easier to diagnose celiac disease at an earlier stage than was possible before, because the dentists can detect it. – This can therefore be the gateway to finding out that someone has celiac disease, says Husebye. What is celiac disease? Celiac disease is an autoimmune disease that makes you hypersensitive to gluten. If you eat gluten-containing food, the lining of the small intestine becomes inflamed and the nutrients from the food can thus be insufficiently absorbed. This can lead to a number of symptoms and health problems. Gluten is a protein found in wheat, rye, barley and spelt. The intestine is the part of the body most affected by celiac disease, but the disease can affect other parts of the body as well. Source: Helsenorge May have to cut milk For the time being, it is not certain that the children will have to cut out milk, but that could be a possible consequence of the finding. – One can imagine that those children can get milk without this kappa-casein, and perhaps that can prevent this enamel damage from developing further, says Husebye. The immune system of celiac patients reacts to the milk protein Kappa-casein. Photo: MIHAELA MARTHINUSSEN But that is easier said than done. Because according to Ellen Ulleberg, specialist manager at Melk.no, you can’t make milk without this protein. – The milk is composed of many proteins that are linked together, and kappa-casein is necessary for them to stay together. Without that protein, milk would not be milk, she says. The protein is not only found in cow’s milk, but also in goat’s milk and mother’s milk. In addition, it is a part of a number of other dairy products such as cheese and yoghurt. – I have verified this with the academic circles at Norway’s University of the Environment and Life Sciences, and they say that they also do not know of dairy products without kappa-casein. At least not that have been analyzed. – Comes as a surprise That people with celiac disease get enamel damage is not necessarily new, according to Sundby Halstensen. But what is new now is that the cause has been found. Here, the article is recorded on the big screen. The images are of the teeth of rats, which they tested on before they started examining humans. Photo: Oda Marie Rønning / news It has previously been shown that antibodies against gluten can affect the formation of enamel, and now this research shows that antibodies against the milk protein are also formed. The finding is important for further research into the phenomenon. Trond Sundby Halstensen, leader of the Celiac Association’s professional council, says he is looking forward to finding out more. – I think it’s great fun that you tackle this problem, he says.
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Researchers see a connection between celiac disease and enamel damage – news Vestland
