The
eyes may be the window to your soul, but for a look into
your physical health, open wide: Your teeth and gums say
a mouthful.
Receding
or inflamed gums, cavities, tooth loss, gingivitis, and
other dental dilemmas in adults can indicate the
presence of serious health problems -- including heart
disease, diabetes, cancer, vitamin deficiencies, and
even the risk of having a premature or low-birth-weight
baby. Usually, these dental problems result from poor
dental hygiene such as not brushing well or not flossing
regularly. But even by following your dentist's golden
rule, you may still be hurting your overall
health.
"Every
time you brush your teeth, especially if there's any
inflammation in the mouth, it puts some bacteria into
your bloodstream," says Honolulu
periodontist Michael P. Rethman, DDS, president
of the American Academy of Periodontology. "This isn't
good, but it is normal."
That
may explain a recent jaw-dropping study in the journal
Circulation that links any of five common dental
problems with an increased risk of heart disease. The
kicker: Dental problems proved to be stronger predictors
of heart disease than more traditionally used risks
factors such as low "good" cholesterol, high
triglycerides, or high levels of a clotting factor
called
fibrinogen.
And it doesn't end there.
Dental
Detectives and What They Find
"Often,
it's a dentist or periodontist who is the first to
identify a systemic health problem because of what they
see in the patient's mouth," says Col. Brian Mealey,
DDS, chairman of periodontics (the treatment of gum
diseases) at Wilford Hall Medical Center in San
Antonio, the nation's largest Air Force hospital. "And
as more evidence
accumulates, I think you'll
see more dentists looking at oral health specifically to
search for possible
problems affecting the rest of the body. They're
now teaching this stuff in dental schools, which wasn't
the case 10 years ago."
So
what can these dental detectives detect in those
twice-yearly exams?
Diabetes
Undiagnosed
diabetes, or poor blood sugar control in those already
diagnosed with the disease, can be identified by several
dental woes, says Sally Cram, DDS, a
periodontist in Washington, D.C., and spokeswomen
for the American Dental Association.
"Diabetics
tend to get periodontal disease at a rate three to four
times higher than people without diabetes, but when
their condition is controlled with medication, diet, or
other treatments, their periodontal condition will
usually stabilize and return to health," she tells
WebMD. "If I see a lot of inflammation in someone who
brushes and flosses regularly, or they have an abscessed tooth
(an infection-caused pocket of pus in the tissue next to
a tooth), I ask, 'Have you checked your blood sugar
lately?'"
That's
because uncontrolled diabetes impairs white blood cells,
the main defense against bacterial infection -- and
periodontal disease results from bacterial infection.
Besides gum problems, diabetes also can produce dry
mouth, thrush, a burning of the mouth or tongue, or a
distinct, telltale breath odor. "It's called 'acetone
breath' and produces a sweet smell that's associated
only with diabetes," adds Rethman. "Breath that really
smells bad, meanwhile, could indicate infection of the
nose, mouth, lungs, or stomach."
Osteoporosis
Osteoporosis
and tooth loss often go hand-in-hand because the same
decrease in bone mineral density that boosts risk of hip
and other fractures affects the jawbone and teeth.
That's one reason why women are especially vulnerable to
tooth loss following menopause -- and why despite its
other health risks, estrogen replacement therapy has
been found to reduce their rates of tooth loss and
gingivitis.
"Actually,
there are four times in a female's life when she's more
vulnerable to oral problems," says Cram. "Besides
menopause, during puberty, during pregnancy, and around
the time of her monthly period, certain hormones levels
are elevated that stimulate inflammatory mediators that
make them more susceptible and responsive to bacteria in
the mouth."
So mark your calendar, ladies: It's during these
times when a dental exam is especially
useful.
Heart
Disease
In
the recent Circulation study, after comparing the oral
health of 256 adult heart patients with that of 250
others with no heart disease, researchers did some
math.
Their
calculations showed that the
strongest predictor of heart disease was pericoronitis,
an infection around the third molar; followed by root
remnants, in which teeth decay to the point that only
the top of the root remains,; gingivitis, an
inflammation of the gums due to improper cleaning;
cavities; and missing teeth. The possible
connection: "It seems that bacteria often found in the
mouth can appear as the same atherosclerotic plaque
associated with cardiovascular disease," Rethman tells
WebMD.
Premature
and Low-Weight Births
Research
shows that women who have gum disease during pregnancy are seven
times more likely to have a baby that is born too early
and too small than other expecting mothers -- and the
risk increases with
the severity of their gum problems. "That's because
when you have periodontal disease, the inflammation
causes certain chemicals to be released in your
bloodstream that could affect the baby's birth weight
and delivery," Cram
states.
So
if you're pregnant, head to the dentist or periodontist.
A study last year in the Journal of Periodontology
suggests that performing a common procedure to remove
plaque and tartar from teeth that cause gum problems
could reduce risk of
premature delivery.
Other
Conditions
Leukemia
causes gums to be fiery red, very inflamed, and spongy.
Bulimia.
"When
you binge and purge, it creates acid in the mouth that
eats away at tooth enamel, especially on the insides of
teeth,” says Cram.
“Bulimics also have a lot more gum recession and
high rates of cavities.” Kidney
problems can
cause inflamed gums. Gastroesophageal
reflux disease (GERD) can
also cause tooth erosion from digestive acids entering
the mouth. Vitamin
deficiencies. Not
getting enough iron for example, can cause sores at the
corners of the mouth, the taste buds to become small, or can
lead to a sore tongue. Drugs
Do Damage, Too
Hundreds
of drugs -- including antidepressants, high blood
pressure medications, and allergy remedies such as
antihistamines and decongestants -- can cause dry mouth.
"When the mouth dries out, you don't have the protective
enzymes in saliva that help kill bacteria," says Cram.
vulnerable times of womanhood -- or if you're about to
be hospitalized.
"If
you're going in to the hospital for an extended stay,
having an oral exam and good cleaning is a great idea
because you're going to decrease the risk of
hospital-acquired problems such as pneumonia," Mealey
tells WebMD. "It's also advised to have a cleaning
before getting joint replacement surgery, because the
mouth can be a source of bacteria that, if it seeds, can
cause an infection that could destroy tissue around the
joint."
But
even you're feeling perfectly fine, there's good reason
for opening wide and staring at the ceiling as your
mouth is picked and probed. "Today, more dentists aren't
just looking at teeth and gums," says Cram. "They're
giving you a good medical exam."
I
hope this information has been helpful for you and your
loved ones.
Dr.
D. Scott Trettenero, DDS
239-344-7210
