“The body is all connected,” says Sally Cram, DDS, consumer advisor for the American Dental Association. “There are a lot of things you can see [in the mouth] that might lead us to think there is something else going on in the body.”
Diabetes, anemia, and various autoimmune diseases are all conditions with symptoms that can show up in your mouth. Here are some of the health concerns your dentist might be able to spot just by taking a peek.
Virtually no part of the body escapes the effects of diabetes. In your mouth, a distinctive symptom is breath that has a fruity smell. This is a byproduct of your body burning fat instead of sugar for energy.
There are other signs of diabetes in the mouth your dentist might see too. For instance, people with diabetes have a higher risk of developing periodontal disease, which often shows up as swollen, sore, and bleeding gums. Cold sores and dry mouth are also common if you have diabetes, as is oral thrush, a fungal yeast infection. (Yeast is always in your body at low levels, but because diabetes weakens your immune system, it can proliferate more easily.)
Research also suggests that people who have gum disease are more likely to develop diabetes.
GERD or gastroesophageal reflux disease causes acid from your stomach to bubble up into your esophagus, giving you heartburn, chest pain, and trouble swallowing. The acid can also lead to bad breath, canker sores, and dry mouth.
It’s not always easy to pinpoint the problem as GERD just by looking, but your dentist may be able to narrow it down by noting any medications you’re on. “It’s always important to tell your dentist about any medications you’re taking, even over-the-counter,” says Cram.
Left untreated, acid reflux can eat away at your tooth enamel, a tip-off to your dentist. GERD can also increase your risk for cancer.
Sure, your regular dental checkups can reveal cavities and evidence that you haven’t (or have) been flossing as much as you should. But during those visits, your dentist can also find signs of head and neck cancers, including cancers of the mouth and throat.
In the mouth, Cram says, dentists scan for “any red or white spots that are abnormal, any ulcerated areas in the cheeks, lumps, bumps, and swelling that shouldn’t be there.”
Dentists usually also check the glands around your neck for any sign of swelling that could indicate an illness, including cancer.
Always talk to your dentist about any changes you notice in your mouth. “When something is present for two weeks or longer or increasing in size or shape, then we start becoming worried, especially if there’s a history of tobacco use,” says Ryan Kauffman, MD, an ear, nose, and throat specialist at Piedmont Healthcare in Atlanta.
Tobacco use is the leading cause of head and neck cancer. If you see your dentist twice a year, he or she may be able to find cancer early when it’s easiest to treat.
Osteoporosis is the steady thinning of your bones that’s most common among postmenopausal women. While the classic image of osteoporosis is an older person with a stooped back, osteoporosis can also affect the bones in your jaw that anchor your teeth.
“If [a person has] loose teeth and receding gums without periodontal disease and with good dental care at home, this could be a sign of osteoporosis,” says Cram.
Dental X-rays can be used to screen for osteoporosis.
There are many effective treatments for osteoporosis, but some of them, including bisphosphonates such as Fosamax and Boniva, can cause rare additional problems in your jaw and in your femur bone.
People with HIV or AIDS are prone to several different mouth problems. One of the more common is oral thrush, the same yeast infection affecting people with diabetes. It produces a white, cottage-cheese-like cover on your tongue.
Other oral health problems linked with HIV/AIDS include dry mouth (this can lead to tooth decay), recurrent cold sores, gum disease, and warts from the human papillomavirus (HPV). This is the same virus that can cause cervical and some head and neck cancers.
Kaposi sarcoma can be a later complication of HIV/AIDs. It’s a form of cancer that appears as deep purple or red spots on the skin or in your mouth.
In autoimmune diseases, the body’s immune system mistakenly attacks healthy cells instead of threats like viruses or bacteria. Many autoimmune conditions can manifest in the mouth; Sjogren’s syndrome is one example. In people with Sjogren’s, the immune system tends to specifically target moisture-producing glands in the mouth area, causing dry mouth. It also affects tear ducts and causes dry, itchy eyes.
Rheumatoid arthritis and lupus can also come with mouth issues ranging from painless bumps to painful canker sores, problems swallowing or talking, and changes in taste. About half of people with rheumatoid arthritis get sometimes-painful swelling in the jaw. Many people who have Sjogren’s also have one of these other autoimmune disorders.
If you have celiac disease, ingesting gluten–a protein found in wheat, rye, and barley–spurs your immune system to ravage your small intestine, but symptoms can extend all the way into your mouth. You or your dentist might notice problems with the enamel on your teeth or frequent canker sores, and you might experience a dry or burning feeling on your tongue.
The only treatment for celiac disease is to stay away from gluten. This will generally curb symptoms and stave off long-term health problems.
Anemia occurs when you don’t have enough red blood cells or they’re not working properly. Typically, the main symptom is fatigue–but your dentist may notice you’re losing color in your gums, tongue, and other parts of your mouth. “Because the oral cavity tissue is more transparent than typical skin tissue, you can see a distinct difference if [patients] are anemic,” says Dr. Kauffman.
The most common cause of anemia is iron deficiency, which, in turn, can be the result of heavy periods, chronic diseases, gastric bypass surgery, or vitamin deficiencies. This type of anemia can often be treated with supplements or changes in your diet.
Chronic kidney disease
Healthy kidneys quickly and cleanly get rid of your body’s waste products. If the kidneys aren’t working correctly, toxins can build up and cause trouble throughout your body, including your mouth. Your breath, for instance, may smell like urine or even have a sweet odor. Dry mouth is also common.
Your dentist may ask you about kidney disease if he or she notices your mouth is unusually dry. Certain treatments–like diuretics and dialysis–can be dehydrating, which can produce dryness and irritation in the mouth, Dr. Kauffman says.