"I had to force myself to get out of bed … to do everything.”
That’s how Linda Small remembers life in 2011, when exhaustion made even simple daily activities seem insurmountable.
“Something just wasn’t right,” she recalls.
Her primary care physician advised Small to get more rest, eat healthier and exercise regularly. She did as told, but still couldn’t shake her feeling of fatigue. It wasn’t until she visited Dr. Glenn Gequillana’s office for a routine dental cleaning that she finally found the source of her ailments.
While examining Small’s throat, a standard procedure for Gequillana’s dental exams, he felt a nodule on her thyroid. Later that week, a surgeon confirmed what Gequillana suspected: Small had early-stage thyroid cancer.
“I never would’ve found it on my own,” says Small, who had her thyroid removed in February 2012 and is cancer-free today.
Small’s case is just one example of how dentists can act as the first line of defense for preventing – or, in this instance, detecting – more serious health issues.
“It’s not necessarily out of line to bring these things to patients’ attention,” says Gequillana. He believes dental exams shouldn’t be isolated to what’s inside the mouth. To be clear, he isn’t diagnosing patients; he’s just making them aware of potential concerns.
“If I’m wrong, I’m wrong,” he says. “But I’d rather be wrong than not bring something to their attention.”
According to the American Academy of Family Physicians, careful examinations of the mouth may reveal symptoms related to an underlying systemic disease.
Swollen gums, ulcers, bad breath and dry mouth are just a few symptoms that could signal more serious conditions, such as diabetes, cancer, heart disease, kidney disease, osteoporosis and more.
So the next time you’re in the dentist’s chair, here are a few warning signs your dentist may be looking for and what they might mean.
Ever wonder why the receptionist hands you the clipboard and asks you to detail your medical history and all the medications you’re taking? What do those over-the-counter and prescription drugs have to do with your teeth? It turns out, more than we think.
“A lot of patients balk over why I need to know all this information,” Gequillana says. “But as dentists, it tells us what we need to watch for.”
For example, dry mouth is a common side effect of many medications. Surgery or injury that causes nerve damage, as well as certain cancer therapies, can also lead to chronic dry mouth.
“When you have dry mouth, you’re prone to more cavities, teeth breaking and developing gum disease,” says Dr. Paul Levine of Levine Dental Associates.
It works like this: The saliva in our mouths makes it easier for us to chew and swallow food. It also keeps our mouths clean by neutralizing acid and suppressing bacterial growth. Without enough, you could end up with a mouth full of cavities.
Dry mouth can also hint at more serious health conditions, including diabetes, Parkinson’s disease, anxiety disorders, depression, sleep apnea as well as some autoimmune diseases. If your dentist notices that you’re on a medication or have a condition associated with dry mouth, he can recommend alcohol-free mouthwashes and special toothpastes, and may even work with your physician to adjust your medications.
WORN TOOTH ENAMEL
Worn tooth enamel is usually an indicator that you’re grinding your teeth, a condition also known as bruxism. In adults, studies have shown that teeth grinding is an indicator of obstructive sleep apnea. In children, it can indicate blocked airways.
“If children are grinding their teeth, that’s usually a sign they’re trying to find a better way to breathe at night,” Gequillana says. “By resting their lower jaw forward, it allows them to get more air.”
JAWBONE WEAKNESS & PAIN
If you’re a woman over 50, your dentist could be the first person to break the news that you may have osteoporosis. Osteoporosis, a condition that affects an estimated 10 million Americans, mostly women, causes bones to become weak.
“When we take an X-ray, we can see the varying degrees of bone density,” Levine explains.
X-rays can also reveal bone loss around the teeth. Additionally, tooth loss, dentures that don’t fit right and gum disease can be warning signs. People diagnosed with osteoporosis are encouraged to get adequate amounts of calcium and vitamin D, as well as decrease their caffeine and alcohol intake.
Another warning sign dentists watch for in the jaw: localized pain. It could be a sign of a potential heart attack.
“A lot of patients dismiss the pain because it’s not in the arms,” Levine says. He recalls a colleague telling him about a patient who had a problem with a particular tooth. “He couldn’t find any dental reason for the pain. It turned out the patient was having heart issues.”
BAD BREATH & SWOLLEN GUMS
The American Diabetes Association estimates 25 percent of diabetics go undiagnosed, but dentists could help change that by detecting telltale signs of the disease, such as persistent bad breath and red, swollen or bleeding gums.
“Those are all signs of an infection,” Levine says, “and diabetics don’t heal as fast from infections.”
By identifying the warning signs, dentists may help lower the risk of developing diabetes-related dental complications, including tooth decay and gum disease.
A PROACTIVE APPROACH
Gequillana and Levine emphasize that dentists aren’t trying to take the place of primary care physicians. Instead, it’s about creating a more collaborative, proactive and holistic approach toward patient care. Most people see their dentists twice a year and their primary care physician maybe once. To them, having a dentist who understands the mouth-body relationship just makes sense.
“Our bodies are not disconnected from the mouth,” Gequillana says. “Everything plays a role. If one aspect of it is off kilter, the rest can follow suit.”