An odontological perspective on food allergy and food intolerance
There is no exact data on the prevalence of food allergy in the Danish population. The cumulative incidence of food allergies in children in the first three years of life is estimated to be 7-8%, most of them growing from their allergies. The point prevalence of diagnosed food allergies in adults is 3%. It is usually common foods that trigger allergic reactions e.g. eggs, milk, nuts, shellfish, peanuts and fresh fruit.
Cross reactions are the most common food allergy in adolescents and adults. Patients with pollen allergy comprise a special risk since about 50% of them will react allergic to certain types of fresh fruit and vegetables, which can trigger oral allergy syndrome. Cross reactions could potentially also be triggered in relation to dental treatment, and due to exposure to the different materials used in dental practice.
It is important to differentiate between food allergy and food intolerance. Food allergies activates the immune system via an IgE-mediated response, whereas food intolerance is a form of hypersensitivity to one or more food items, either as a result of lack of degradation in the gastrointestinal tract or as due to an autoimmune-mediated inflammation in the intestine. The precise incidence of food intolerance is unknown, but is estimated to be lower than that of food allergy. The most common forms of food intolerance include lactose intolerance and celiac disease. Undiagnosed and untreated, these conditions may result in malabsorption and consequently oral manifestations like enamel defects and aphthous stomatitis.
This article discusses the mechanisms underlying food allergy and food intolerance, associated symptoms and oral manifestations and diagnosis and treatment of these conditions.