Is your dentist finding more than just cavities?

A quick glance in the mouth and your dentist can spot a plethora of bad habits, like opening bobby pins with your teeth or chewing ice. But did you know they can also see more serious health issues that may be lurking elsewhere in the body? William Wathen, D.M.D., associate professor at the Texas A&M University Baylor College of Dentistry, gives an inside perspective of what your dentist sees during a regular checkup.

Cardiovascular/Cerebrovascular Disease

To understand how oral health is linked to cardiovascular disease and cerebrovascular disease we must look first at how plaque affects the gums in the mouth.

Plaque is a sticky deposit on the teeth where bacteria proliferate. When plaque is not removed by regular brushing or flossing, the bacterial byproducts begin to irritate at the gums, producing an ulcer in the gums. This hole in the gum allows the germs to enter the blood stream.

“This irritation triggers an inflammatory response, which sends powerful chemicals that rush to repair the damage done by the plaque,” Wathen said. “However, these chemicals may damage tissues they are not meant to, like artery linings, which can be a factor in heart attack or stroke.”

Dementia

The same type of inflammatory response that happens in the mouth when gums are irritated has also been linked to dementia, Wathen noted.

When inflamed gums are left untreated, it can turn into periodontal disease, a serious form of gum disease that can cause tooth loss. Worth noting, patients with tooth loss seem to be at a higher risk for developing dementia.

“The more teeth patients have lost means that they have been battling chronic inflammatory disease for quite some time, which can affect other organs in the body,” Wathen said. “In the brain, chronic inflammation can damage nerve cells and cause a buildup of proteins both of which are linked to dementia.”

It’s important to note that gum disease does not cause dementia, but it is a contributing factor.

Diabetes

Bad breath, or halitosis, is the most common symptom of hidden issues found elsewhere in the body, but did you know that the same can be said for fruity breath? Fruity breath is a common symptom of ketoacidosis, a condition particularly associated with Type 1 diabetes.

Type 1 diabetes occurs when the metabolic process – controlled by the pancreas – is not working correctly. When the body doesn’t have enough insulin, it instead uses fatty acids for energy, which produces acidic ketones (byproducts of fat metabolism). When ketones build up in the blood, they make it more acidic. In extreme cases, ketoacidosis can lead to diabetic coma or even death.

Eating Disorders

The two most common eating disorders – anorexia nervosa and bulimia nervosa -both leave distinct markers on the teeth.

Anorexia nervosa, along with vitamin deficiency in general, can cause lesions on the mouth and tongue and also cause the corners of the mouth to crack.

Bulimia nervosa, and in particular purging bulimia  – or self-induced vomiting – can cause the stomach acid to erode the enamel on the backs of the teeth. As the enamel weakens, the tops of the teeth can also become worn down, especially if patients also grind their teeth or eat a course diet.

Oral Cancer

Each year, there are 30,000 new cases of oral cancer diagnosed in the United States. While oral cancer is curable if found early, the signs can be hard to spot on your own. Luckily, dentists are trained to look for these telling signs making regular check-ups all the more important.

The most common symptoms are a red or white lump or a sore that does not go away after two weeks. Other symptoms include: thickening in the oral soft tissues, soreness or a feeling that something is caught in the throat, difficulty chewing or swallowing, difficulty moving the jaw or tongue, hoarseness, numbness in the mouth or swelling in the jaw.

“For most people, the dangerous triad is smoking, heavy alcohol use and poor oral hygiene, but anything that causes irritation in the mouth can lead to an increased risk for oral cancer,” Wathen said.

Pregnancy

While a pregnancy test is your best bet in determining whether or not you are pregnant, your dentist may notice subtle changes that occur in the mouth that often point to pregnancy.

“In pregnancy, there are some natural hormonal fluctuations that take place and cause the gums to be more fragile,” Wathen said.

Common oral issues expecting mothers tend to see are pregnancy gingivitis (swollen red, bleeding gums) and tumors (swollen gums).  Pregnancy gingivitis can occur due to the gums becoming more susceptible to inflammation and infection. To help prevent this, Wathen said that expecting mothers should be extra vigilant in brushing and flossing, particularly if they notice any irritation. Pregnancy tumors can also arise and are nothing more than an isolated swollen gum, and while they can be uncomfortable, they will usually resolve after the baby is born.

Sinus Infections

There are two oral issues that sinus infections can cause: bad breath and toothaches.

“Sinus drainage can cause bad breath, as it can be hard to keep the sinuses cleaned out. To resolve the issue, patients will generally need to go to an ear, nose and throat specialist to have their sinuses flushed out,” Wathen said.

Toothaches caused by sinus infections aren’t actually toothaches at all. The nerves of the back, upper teeth are very close to the sinus cavity. When there is inflammation caused by a sinus infection, it can push on the nerves of the teeth, which can cause some minor discomfort.

“If the pain is coming from the tooth, the nerves are inflamed and swollen and it throbs and hurts,” Wathen said. “When that’s not the case, we can typically tell the pain is coming from somewhere else.”

It is important to note that oral issues do not create these systemic issues, but they can add to an existing issue or a symptom of a bigger problem that is going on elsewhere in the body.

“Your mouth is the gateway to the rest of your body,” Wathen said. “Oral health is much more than preventing cavities and gum disease, it is an important part of your overall health.”