Cavities, gum disease, abscessed teeth —
everyone knows a dentist is looking for these at your checkup. br />
people don’t know is that the dentist is also looking for the
connections these things may have to your overall health. From diabetes
to osteoporosis, and from heart disease to acid reflux, dentists help
patients discover what ails their bodies, by seeing what’s in their
DIABETICS HAVE DENTIST AS DIABETICS
Take diabetes, for example. Dr. Tim McGaw, professor of oral medicine
and pathology at the University of Alberta, says, “As dentists, we know
that people with poorly controlled diabetes are more likely to have oral
Research confirms diabetics have a harder time fighting infections such
as gum disease and that they are less able to repair the bone loss
caused by such infections. A dentists may be the first health-care
provider to suspect diabetes when gum disease is found at a routine
The dentist’s observations of a patient who already knows that they have
diabetes can also be useful.
If a patient’s diabetes is not properly
managed, the dentist may notice that their medication has caused the
patient to have dry mouth
(xerostomia). Saliva acts to help keep the
teeth and gums clean, and also acts as a buffer to neutralize the
harmful acids produced by cavity-causing bacteria. Sometimes patients
don’t even notice they have a dry mouth, but the dentist may
notice the sudden appearance of cavities, or irritated or infected
However, there’s good news coming from the dentist’s office for diabetic
patients. “The relationship between periodontal disease and diabetes
appears to be a two-way street,” says McGaw.
“Preliminary studies have documented that
when the periodontal disease is cleaned up or managed through
improved personal oral care, professional cleaning and scaling, and/or
antibiotics, there has also been improvement in the medical control
of the diabetes.”
As studies continue to illustrate this connection, proper oral health
care will be as important to controlling diabetes as diet and exercise.
OSTEOPOROSIS IN MENOPAUSAL WOMEN
SHOWS UP IN DENTIST CHECK-UP.....
Menopausal women are also especially prone to periodontal disease, due
to changes in calcium levels in the body making bone loss difficult to
repair, as in diabetics. Interestingly, observation of a patient’s
full-jaw X-ray could give the dentist reason to believe the patient is
suffering from osteoporosis
and to refer them to their physician for
Dr. Sreenivas Koka, chair of dental specialties at the Mayo Clinic, was
a presenter last year at the Alberta Dental Association and College
annual congress. A researcher who explores oral-systemic links, Koka has
most recently been investigating the use of saliva to measure bone
turnover, which is an important aspect of osteoporosis.
SALIVA TEST FOR MANY MEDICAL
“Right now, we use blood and urine to test for many
medical conditions,” Koka says.
“Why not saliva? It may be easier to draw a sample of this
body fluid than others, particularly for the elderly, and may well
reveal as much.”
PERIODENTAL DIESEASES DETECTED BY
DENTIST DURING PREGNANCY SHOWS POTENTIAL FOR FOR LOW BIRTH WEIGHT AND
Pregnant women should also not skip their dental checkups.
changing hormone levels, many pregnant women find that their
and bleed during pregnancy. This is especially important to manage,
given recent findings that periodontal disease may be linked with not
only low birth weight, but pre-term labour.
ORAL BACTERIA DETECTED BY A DENTIST
IMPLICATED IN RESPIRATORY DISEASES......
Oral bacteria are also implicated in respiratory diseases. Those with
periodontal disease and untreated decay are more prone to respiratory
There is a correlation between oral diseases and
obstructive pulmonary disease (COPD) and, of particular concern to the
ill, of pneumonia
being caused by the inhalation of oral bacteria.
Regular dental care is as essential to the ill or hospitalized patient
as it is to a healthy one.
DENTIST CAN DISCOVER DIGESTIVE DISEASES.....
Digestive disorders are also often discovered by the dentist.
acid reflux (or gastroesophageal reflux disease, GERD) can lead to a
very specific erosion of the teeth.
Other signs dentists watch for
include cobblestone fissures in the mouth, which can denote
gastrointestinal diseases such as Crohn’s. Swollen lips can also
indicate Crohn’s, ulcerative colitis
or similar gastro-intestinal
Chronic liver disease or
hepatitis can result in thin,
yellowish gum tissue, and candidiasis (thrush) will cause white patches
“Candidiasis is often a sign of an underlying disease that is
compromising the immune system,” says Dr. Randall Croutze, a general
dentist in Edmonton and a past-president of the Alberta Dental
Association and College.
CARDIOVASCULAR DISEASES SHOWS UP
Cardiovascular disease is one of the leading causes of death in Canada.
Studies are showing associations with oral health in this area as well.
Studies not only show that
heart disease show
similar patterns of inflammation, but also that there are genetic
linkages between them and tooth loss.
Routine full-jaw X-rays taken by
the dentist can even show the hardening of the carotid arteries in the
neck, a major risk factor for strokes.
OTHERS DOCTORS CAN HELP DENTISTS
THROUGH MEDICAL HISTORY SHARING OF PATIENTS ...
While dentists are looking for connections to overall health, it’s
crucial that patients keep their dentists informed of any changes to
their medical history or health.
People with prostheses such as
artificial joints, pacemakers or heart
valves, or on chemotherapy for cancer, are prone to infections, and oral
bacteria can get into the bloodstream to cause severe infection, so antibiotics may be prescribed before or after dental treatment for
Patients on blood thinners
due to heart problems or surgical
interventions, or who have hemophilia where the blood fails to clot
properly, may need to have their medications monitored and/or adjusted
to reduce the risks posed by some dental procedures like extractions or
“We work with the University of Alberta blood clinic to regulate their
medications,” says Croutze. “Indeed we frequently work in tandem with
our medical colleagues when treating anyone with an unusual condition.”
DENTISTS MAKE REFERALS TO
MEDICAL SPECIALISTS WHEN SEEING SIGNS AND SYMPTOMS BEYOND DENTISTRY....
Croutze says dentists use a combination of signs (what they see) and
symptoms (what they are told) to determine whether to refer the patient
to a dental specialist or a medical doctor for further diagnosis and
- “It is important for people to tell
us about all the physical changes they have noticed and let us do a
what could be a sign of a serious disease is simply a reaction to
medication or stress,
- We spend considerable time with our patients; they
trust us and have confidence in what we say and do.”
GOOD ORAL HEALTH = LONGER LIFE
A recent study in Sweden that looked at seniors aged 80 years and up
found a correlation between longer lifespan and better oral health.