How Dentists and Medicine Align: Partners in Your Overall Health

Dentists look at more than just teeth! Sure, every appointment with your dentist is an opportunity to check for cavities and have your teeth cleaned, but it’s also so much more than that. Each time you visit your dentist, they take a well-rounded look at your oral health – your tongue, gums, cheeks, throat, and neck. Some medical conditions have oral symptoms, which can tip off your dentist about other possible health issues. 

Your dentist also provides valuable advice for maintaining good oral hygiene, which can impact your overall health (Dental Health and Overall Health: 5 Telltale Symptoms, (n.d.)). For example, regular oral health checkups can help prevent and treat issues like tooth decay and gum disease, which are linked to other health problems such as  tooth loss, dementia, or heart disease.

It’s important to consider your dentist as a member of your health team. They work in tandem with your physician to determine your healthcare needs. 

Here’s how your dentist works as a partner in your overall health: 

Links Between Your Oral Health And Holistic Health 

The condition of the inside of your mouth provides insights into your overall health. It may be surprising to some, but your mouth provides some of the earliest indications as to how your body is doing. Dentists are trained to look for these indications – there is considerable overlap in first-year dental and medical courses, giving all dental practitioners a comprehensive understanding of health beyond the mouth. Many dentists also have additional qualifications and specialisms outside of dentistry. Our very own Dr Bains, for instance, has a BSc Hons in Genetics, and an MSc in Experimental Pathology, as well as being a qualified Doctor of Dental Surgery. The skills and knowledge she has acquired from these studies give her a detailed understanding of whole-body health which helps her diagnose the wide variety of medical conditions that have at least a partial oral presentation, but which create serious problems for a person’s overall health.

Here are some of those conditions that dentists can gauge through oral check ups:

Crohn’s Disease

Crohn’s disease is a form of inflammatory bowel disease which causes inflammation in the stomach, intestines, or esophagus (Government of Canada, (n.d.))

Crohn’s can sometimes present oral symptoms such as aphthous ulcers (also called canker sores), swollen lips, dry mouth, or inflamed salivary ducts. If a dentist spots a combination of these symptoms, they may recommend you make an appointment with your doctor.

Diabetes

“Diabetes is a chronic condition that stems from the body’s inability to sufficiently produce and/or use insulin which the body needs to use sugar as an energy source.” (Government of Canada, (n.d.))

Dentists may be able to identify the warning signs of diabetes or prediabetes. For example, one of the most common signs of diabetes is periodontal disease, more commonly referred to as gum disease, which usually involves swollen or bleeding gums, loose teeth, and halitosis  (bad breath). People with diabetes are more susceptible to periodontal disease due to compromised immune systems and difficulty controlling blood sugar levels. Also, if a patient has recently undergone oral surgery or had an injury and healing is taking a long time, it can be a sign of undiagnosed diabetes (Diabetes Canada Type 1 and 2 symptoms lists, (n.d))).

Anemia

Anemia is caused by low hemoglobin levels in the blood, and can lead to tiredness, difficulty concentrating, and in severe cases breathing difficulties (Canadian Blood Services, (n.d.))

Anemia is characterized by a drop in red blood cells, which may change the appearance of parts of your mouth. For example, pale oral tissues could be a symptom of anemia. Dentists may also spot an inflamed and smooth tongue, also called glossitis – another symptom of anemia.

If you know that you have anemia, tell your dentist before any procedures, as anemia can interfere with some medications. 

GERD

Gastroesophageal reflux disease (GERD) happens when stomach acid flows back into your mouth (Canadian Digestive Health Foundation, (n.d.)). Unsurprisingly, this has a tremendous impact on your teeth. As with other conditions, dentists will always be looking for warning signs. Halitosis is a common sign of GERD, as is dry mouth and persistent decay or cavities from the acidic stomach contents. 

Intense stress

Prolonged high stress levels can lead to a wide variety of mental health and medical issues. (Centre for Addiction and Mental Health, (n.d.))

Your dentist can often tell how stressed you are by looking at the structural integrity of your teeth. For example, grinding your teeth is a common symptom of stress.If your dentist sees additional wear and tear on your teeth, gum inflammation, or tenderness in your jaw, they may ask you about your stress levels and suggest you seek additional treatment for it.

Canker sores can also be triggered by increased stress. Your dentist may recommend over-the-counter treatments or prescribe medication to help alleviate the pain and promote the healing of the sores.

Osteoporosis

A dentist may be the first medical professional to see signs of this disease, which reduces bone density and causes them to become thin and weaker (Government of Canada, (n.d.)). When assessing your annual X-rays, your dentist can detect bone loss in your jaw, where it supports the teeth. When comparing new x-rays to older ones, they may be able to determine if there is an issue with your bone density, and may refer you to your doctor for further assessment.

Dementia

There are multiple types of dementia with different causes, but they all cause decreasing brain function, causing a range of symptoms (Government of Canada, (n.d.))

People with dementia often experience oral health issues as their ability to maintain or change routines (such as brushing teeth or cleaning dentures) declines. Dentists may also spot reduced salivary flow, another oral manifestation of dementia.

Periodontal disease has also been linked to Alzheimer’s Disease specifically, as scientists have discovered that inflammatory bacteria present in periodontal disease can spread to the brain to both cause and exacerbate Alzheimer’s (Dominy et al, 2019)

Arthritis

Arthritis actually refers to more than 100 conditions affecting the joints, their surrounding tissue, and other connective tissue, with symptoms typically including joint pain and stiffness (Government of Canada, (n.d.))

The swelling and inflammation associated with arthritis can also appear in the mouth. One of the most common indicators of arthritis in the mouth is temporomandibular joint disorder (TMD or TMJ), a condition which causes pain and discomfort in the jaw. Due to joint inflammation, those living with arthritis are more likely to suffer from TMD (Head Pain Institute, 2021)  and so, if your dentist identifies TMD they may recommend you speak to your doctor for further examination.

If a patient has difficulty opening their mouth or experiences pain while chewing or speaking, it can also hint about undiagnosed arthritis. That increased inflammation can eventually lead to gum disease, which your dentist will always look for during dental check-ups. 

Heart disease

Heart disease “refers to the buildup of plaque in the heart’s arteries that could lead to a heart attack, heart failure, or death.” (Government of Canada, (n.d.))

The link between oral health and cardiovascular health has been well-established, and health researchers continue to explore the mechanisms behind these links.(Batty et al, 2018).

Periodontal disease is a major indicator of increased risk of cardiovascular disease, including heart attacks and strokes.

It’s important to note that jaw pain which feels similar to a toothache can be a sign that you are experiencing a heart attack. If you experience unexplained jaw pain alongside any other symptoms common to heart attacks, seek urgent medical care immediately (note that jaw pain can be indicative of a number of conditions, so jaw pain on its own may not be a cause for immediate panic!). 

Thyroid issues

There are many different types of thyroid disease, though most cause the same conditions: hypothyroidism (an underactive thyroid, causing a slow heartbeat, sensitivity to cold, and slowed mental processes), or hyperthyroidism (an overactive thyroid, causing a rapid heartbeat, weight loss, and restlessness or anxiety) (Thyroid Foundation of Canada, (n.d.))

Many thyroid dysfunctions can present orally. A dry mouth, alongside other thyroid-related symptoms, is one of the most common symptoms of thyroid issues. This is because the thyroid gland regulates the body’s metabolism, which can impact the amount of saliva produced. When there isn’t enough saliva inside your mouth, it can lead to a dry mouth. When the mouth is dry for too long, it can lead to additional issues including tooth decay, gum disease, and bad breath.

Other thyroid disorders, have slightly different oral manifestations. For example, when checking for thyrotoxicosis, your dentist may ask questions about burning mouth syndrome and check for swelling around your tongue.

What Signs Do Dentists Look For To Assess Your Overall Health?

Your dentist is working through a bit of a mental checklist each time they peek inside your mouth. 

Color changes

Discoloration can be a sign of various conditions, including oral cancer. Your dentist will check for any abnormal changes in the color of your tongue and gums and look for any lesions in your mouth. Lesions can sometimes be an indication of other health problems, too.

Tongue texture

A healthy tongue should be pink and covered in small bumps called papillae. Your dentist will look for any signs of abnormal texture, such as roughness or a coating, which could indicate a broader issue. 

Wear on your teeth

If your teeth appear worn down or chipped, that’s a clue to your dentist that something else is going on. Teeth that are broken, cracked, or excessively worn down can be an indication of bruxism (teeth grinding). Bruxism can cause headaches, jaw pain, and damage to your teeth over time.

It’s important to note that an oral health issue doesn’t necessarily mean you’re dealing with another condition. Most disorders have a specific combination of symptoms, so if your dentist spots something they will flag it to you, and add it to your patient file. Over time, if they see several things that may point to a health issue, they may advise you to seek further help from your doctor. This is one of the reasons why regular cleanings and visits to the dentist are important – they help your dentist get to know you and your body. That familiary helps them to track any issues they spot, and helps them better understand symptoms they see during examinations, reducing the chances of them missing something important.

What Does My Dentist Do If They Suspect Other Medical Issues?

While dentists are skilled in diagnosing and treating problems related to the teeth and gums, they also play a major role in identifying potential medical issues that may manifest in your mouth. 

If your dentist suspects you may have an underlying medical condition, they’ll usually refer you to a specialist for further evaluation and treatment. For example, if your dentist discovers a lesion in your mouth that may be cancerous, they may refer you to an oral surgeon or oncologist for a biopsy. Similarly, if your dentist believes that you might have diabetes, they may recommend that you see your doctor for blood tests.

Your dentist may also collaborate with your other healthcare providers to develop a treatment plan. For example, if you have a medical condition that requires medication or treatment, such as radiation therapy for cancer, your dentist may need to weigh in on your treatment plan to account for any potential side effects causing discomfort, pain, or issues to your teeth and gums.

It’s important to remember that if your dentist suspects you have an undiagnosed medical issue, you need to take their concerns, recommendations, and referrals seriously. 
Book an appointment with Dr. Bains today to discuss the condition of your mouth and get a well-rounded assessment of your health.

Reference list:

Dental Health and Overall Health: 5 Telltale Symptoms. (n.d.) Lewis Estates Dentists Centre website., https://lewisestatesdental.com/blog/dental-health-overall-health-5-symptoms/   

Type 1 Diabetes. (n.d.) Diabetes Canada website, https://www.diabetes.ca/en-CA/about-diabetes/type-1/symptoms [reference page]

Type 2 Diabetes. (n.d.) Diabetes Canada website, https://www.diabetes.ca/en-CA/about-diabetes/type-2/symptoms [reference page]

GERD. (n.d.) Canadian Digestive Health Foundation, https://cdhf.ca/en/digestive-conditions/gerd/ [reference page]

Mental Illness and Addiction Index. (n.d.) Centre for Addiction and Mental Health, https://www.camh.ca/en/health-info/mental-illness-and-addiction-index/stress [reference page]

Osteoporosis. (n.d.) Government of Canada, https://www.canada.ca/en/public-health/services/chronic-diseases/osteoporosis.html [reference page]

Dominy, S.S., Lynch, C., Ermini, F., Benedyk, M., Marcyzk, A., Konradim A., Nguyen, M., Haditsch, U., Raha, D., Griffin, C., Holsinger, L. J., Arastu-Kapur, S., Kaba, S., Lee, A., Ryder, M.l., Potempa, B., Mydel, P., Hellvard, A., Adamowicz, K.,… Potempa, J. Porphyromonas gingivalis in Alzheimer’s disease brains: Evidence for disease causation and treatment with small-molecule inhibitors. 2019. NIH, https://doi.org/10.1126/sciadv.aau3333

Arthritis. (n.d.) Government of Canada, https://www.canada.ca/en/public-health/services/chronic-diseases/arthritis.html [reference page]

Arthritis: A Common Cause of TMJ Disorders. 2021. Head Pain Institute, https://www.headpaininstitute.com/arthritis-a-common-cause-of-tmj-disorders/ 

Batty, G.D., Jung, K.J., Mok, Y., Lee, S.J., Back, J.H., Lee, S., & Jee, S.H. Oral health and later coronary heart disease: Cohort study of one million people. 2018. National Center for Biotechnology Information,  https://doi.org/10.1177/2047487318759112 

Heart Disease In Canada. (n.d.) Government of Canada, https://www.canada.ca/en/public-health/services/publications/diseases-conditions/heart-disease-canada.html [reference page]

Thyroid Disease: Know the Facts. (n.d.) Thyroid Foundation of Canada, https://thyroid.ca/resource-material/information-on-thyroid-disease/thyroid-disease-know-the-facts/ [reference page]