What Your Dentist Knows About Your Health

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. These dental problems can 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, "This isn't good, but it is normal."

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 cell function, 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.