by Mudita Agrawal, University of Michigan (2016)


A few weeks ago, a patient of mine walked into the clinic panting and puffing. As a general protocol followed here at school, I took his blood pressure and was shocked to see 220/110 mmHg. Upon asking, the patient reported never having visited a physician, so I requested that he get a consultation done with one as soon as possible. This is a perfect example of ways in which dentists are the first to diagnose not just oral health issues but systemic health issues as well.

During oral examination if we see white or red patches with oral ulcers that do not heal. This could be signs of cancer.  Similarly, HIV or AIDS can present with with unexplained sores or white patches as well as oral yeast infection. Changes in oral healthcare habits and poor oral hygiene can be signs of mental diseases such as dementia.

“Inflamed gums and loose teeth can be warnings of heart disease,” says Alyson Hope Koslow, DDS, a clinical assistant professor of restorative dentistry at the University of Illinois Chicago. “That’s because if you have a gum disease like periodontitis, the bacteria in your gums could travel to your heart and contribute to coronary artery disease.”

Gum disease, bad breath, bleeding gums, and loose teeth may be warning signs of other systemic diseases such as diabetes. These patients may also tend to have a slower healing time. Osteoporosis can cause changes in the bone that supports the teeth, too. This may be seen clinically as receding gum line and loose teeth.

Erosion on the teeth could be signs of gastroesophageal reflux or forced vomiting in a young person with bulimia. The stomach acid wears away at enamel and it makes the teeth more sensitive. Erosion in bulimia tends to occur on the tongue side of the incisors whereas GERD often presents on the upper back molars.  Reflux disease can cause erosion of the esophagus and may even lead to esophageal cancer.

Dry mouth may be caused by medications or it may be a sign of a disease such as diabetes or Parkinson’s disease. Pale oral tissue may appear in anemic patients, and they may also have a swollen and inflamed tongue (termed glossitis).

Infectious Diseases such as herpangina may present with white sores in the mouth and throat. Renal disease may also contribute to soft tissue ulcers and possibly a metallic taste.

There are a lot more diseases which can be diagnosed by a dentist while doing oral examinations. I feel blessed to be a dentist as we could be the ones to diagnose diseases, even before the family physician does. We can save so many lives with some awareness and vigilance to our patients.

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