What Your Mouth Says About Your Health

(This article previously appeared on Grandparents.com.)

Mouth issues usually signal something happening just in the oral cavity — cavities, gum abscess or maybe periodontal disease. But sometimes, your mouth can be like the canary in the coal mine, signaling a health problem happening elsewhere in the body.

If you have any of the symptoms below, get a checkup with your dentist.

“Dentists will try to rule out an oral cause, and if they can do that, they may send you to a physician to be evaluated for other contributing factors,” says American Dental Association (ADA) spokesperson Dr. Sally Cram, based in Washington, D.C.

These most often mean periodontal disease. But if the problem is chronic, it may also be due to:

1. Diabetes. High glucose in the saliva encourages bacteria growth, which raises the risk of cavities and gum disease.

2. Blood disorders such as leukemia and neutropenia. These diseases kill off white blood cells that fight infections, causing inflammation of the gums.

Swollen or bleeding gums are not a sign of cardiac disease. However, people who have untreated gum disease (with swollen bleeding gums) may be more at risk for cardiac problems. “This is because the inflammation in your mouth associated with gum disease releases c-reactive protein, which is a known inflammatory chemical in atherosclerosis, the thickening and narrowing of the blood vessels which can lead to heart attacks and strokes,” cautions Cram.

Symptoms of gum disease, according to the ADA:

• Gums that bleed during brushing
• Red, swollen, tender gums
• Gums that have pulled away from the teeth
• Persistent bad breath
• Pus between gums and teeth
• Loose or separating teeth
• A change in your bite
• A change in the fit of partial dentures

Action: Take good care of your gums to prevent periodontal disease. Brush twice a day and floss once a day. Get dental checkups twice a year. (Diabetics or people with blood disorders should discuss with their dentists whether they should go more often.) If you have gum inflammation that lasts more than two weeks, see your dentist immediately for evaluation to screen out the more serious causes.

Sores can be cancerous lesions, but they can also be the result of autoimmune diseases (lichen planus, lupus, pemphigoid, pemohigous) or diabetes, which affect the body’s ability to fight chronic periodontal infection.

Action: Also pay attention to any hard swelling or lump in your cheeks or tongue that doesn’t go away within a week or two, Cram says. Smokers and people who drink more than two alcoholic beverages daily are at high risk. If you are one of those people, pay particular attention to what is going on in your mouth. Even better, stop smoking, chewing tobacco and cut back on alcohol, all of which can cause oral cancer.

Eroded teeth could be a sign of:

1. Bulimia. When a bulimic purges after binging, the vomit is very acidic, which erodes the enamel on the teeth.

Action: Eating disorders can be prevented or cured. Patients and their loved ones can get more information at National Eating Disorders Association.

2. Gastroesophageal reflux disease (GERD), a chronic digestive disease in which stomach acid flows back up the esophagus. You may experience a burning sensation in your chest, sour stomach fluid in your mouth, dry cough or trouble swallowing. Again, the acid erodes the enamel off teeth. Persistent bad breath can also be the result of GERD. If uncontrolled, GERD could burn holes in the esophagus and the inside of your cheeks.

Action: See a physician who will assess how serious the problem is and can prescribe medications. (Some previously prescription-only drugs, such as Zantac, are now available over the counter.)

“Lifestyle changes can also help, says Dr. Sanford H. Benjamin, St. Vincent Gastroenterology Associates, affiliated with St. Vincent Infirmary, Little Rock, Ark. Some suggestions:

• Figure out your food triggers and avoid them. Spices? Tomatoes? Fried or greasy food? Caffeine?
• Lose weight. Excess pounds push on your stomach, forcing acid upwards.
• Eat smaller meals.
• Eat three hours before going to bed.
• Wear loose fitting clothes.
• Elevate the head of your bed. Put phone books under the legs or wedges between the box spring and mattress. Don’t just put a lot of pillows on; you’ll just eventually slide down.
• Quit smoking, which irritates the esophagus.

Lack of saliva can be due to certain medications for depression and cardiac disease. But it also may be a symptom of autoimmune disease such as diabetes, rheumatoid arthritis, scleroderma, systemic lupus erythematosus and Sjogren’s syndrome, Cram says. When a mouth dries out, bacteria proliferates, causing gum disease, bad breath and tooth decay.

Action: Get checked for underlying disease before trying any treatment to ensure you aren’t just masking a bigger problem. If the problem is due to medications, talk to your physician about changing or adjusting the prescription. If you can’t change, there are over-the-counter products that can help — lubricants such as Oral Balance and Biotene, salivary stimulants like SalivaSure and Dentiva, and saliva replacements like Oral-Lube. 

This painful symptom can be caused by vitamin deficiencies such as A, C and D, hormonal changes, allergies to dental products, dry mouth, certain medications (such as blood pressure drugs) or acid reflux, according to the National Institute of Dental and Craniofacial Research.

Action: See your dentist, who can work with you to find pain relief. Home remedies include avoiding smoking; hot, acidic and spicy foods and alcohol (including mouthwashes with alcohol).

Before you start downing vitamins, discuss proper doses with your dentist or physician. To ensure the vitamins you take are best quality, check that they have been approved by a third-party independent verification source, such as CL ConsumerLab (CL), Good Manufacturing Processes (GMP), NSF International (NSF) or U.S. Pharmacopeial Convention (USP).

Also know as thrush, this condition is a type of fungal infection called candida albicans. Thrush could be serious if you are immuno-compromised or if it gets in your esophagus or lungs. “The candida is present in all of our mouths at very low levels. However when you become immune-compromised (like diabetes, HIV, cancer chemotherapy or radiation to salivary glands) or you have dry mouth (medications, diabetes), the fungus proliferates,” Cram explains.

Action: Thrush can be treated with prescription antifungal rinses or lozenges, or sometimes in severe cases, with oral antifungal medications.

NOTE: On its own, bad breath can be a sign of periodontal disease or dry mouth.