The Checkup That Can Save Your Life (cont.)
Silent Threats
Dentist can recognize signs of cancer, including lymphoma, leukemia and particularly oral cancer, as in Lorne Jones's case. This extremely dangerous and disfiguring cancer is diagnosed in 3,000 Canadians every year, and 1,000 people die of it. To screen for it, a dentist thoroughly checks the tongue, palate, gums, insides of the cheeks, lips, face and neck, for any bumps or unusual sores. "Screening for oral cancer is always in the front of our minds as dentists, especially when the patient has a history of tobacco use," says Dr. Christopher Robinson, an oral surgeon and past president of the Canadian Association of Oral and Maxillofacial Surgeons. If, like Lorne Jones, a person mentions pain or discomfort in their jaw or teeth, that gets a dentist's attention too.
Pain in the mouth does not always arise from cancer. Oral pain can also be a sign of a dental infection. These infections can have serious repercussions. A bad tooth can trigger an infection in the surrounding tissue. These can crop up quickly and spread like fire through the mouth and even the rest of the body. "If a dental infection is not addressed promptly, it can spread into the deeper tissue of the neck and lead to obstruction of the airway. It can also lead to such things as kidney damage, brain abscesses or heart valve infections," says Robinson.
He and his colleagues see infections on a daily basis, especially among patients who haven't been getting regular dental care. Last year he saw a man who had tried to pull out his own tooth with a pair of pliers. The botched self surgery turned into a full facial and bodywide infection that nearly closed off his airway and almost cost him his life. He spent three weeks in intensive care, and the infection worsened problems he already had with his heart valves. Runaway dental infections have also been known to eat through the skin in jaws, faces and necks, burrow in to brains and, yes, even kill people.
While mild gum infections, called gingivitis, may lead to red and swollen gums, they're not especially dangerous by themselves. But they can worsen into periodontitis, painless but chronic gum infections that, if left untreated, degrade bony sockets and ligaments that hold the teeth in place. The immune system fights gum infections to keep oral bacteria from spreading to other parts of the body. It usually succeeds, but not always. Gum-disease bacteria can enter the blood-stream and move to the heart, creating life-threatening infections in previously damaged heart valves. What's more, scientists believe the resulting inflammation releases infection-fighting compounds that can inadvertently damage other tissues.
The arteries may be the most common target. People with periodontitis are twice as likely to die from a heart attach and three times as likely to die from a stroke, according to a study that examined 18 years of medical histories for 1,147 people. Steven Offenbacher, director of the Centre for Oral and Systemic Diseases at the University of North Carolina School of Dentistry and co-author of the study, is helping conduct another to see if treatment of periodontitis in cardiac patients will cut the risk of heart attacks.
Pregnant women with serious periodontal disease have about four times the risk of delivering preterm babies and they face an increased risk of pre-eclampsia, in which blood pressure climbs sky-high after the 20th week, threatening the loves of both mother and fetus. In an early clinical trial, researchers found that treating seriously infected gums reduces preterm births fivefold, but the results need to be confirmed in larger trials.
Diagnostic Dentists
Diagnosing cancer and infections is just the beginning. Dentists can also spot signs of gastrointestinal problems, such as Crohn's disease, skin diseases, autoimmune diseases and more. "There are signs in the mouth that can alert us that a patient may have diabetes, and they many net even be aware of it," says Wright. She comes across undiagnosed diabetes at least once a month. "A lot of changes that are happening in the body are just easier to see in the mouth.." That's because the mouth is so full of blood vessels and nerve endings that many changes in the body's health cause colour changes, small sores and a change in saliva that a dentist can identify, sometimes with even just a look.
If more people realized the consequences of not taking care of their teeth and gums, they'd probably call a dentist tomorrow. "People lose sight of the fact that their head is attached to the rest of their body," says Dr. Kenneth Krebs, president of the American Academy of Periodontology. Healthy teeth and gums let us talk, smile, laugh and kiss without embarrassment. That's reason enough to take care of our oral health. But as medical science reaffirms that head and body are indeed connected, there are more reasons than ever to brush and floss daily, get dental checkups every six months and see a dentist promptly when you have a problem.
Even if your smile looks fabulous.
Dr. Molly Rodgers, General Dentist - Providing services in cosmetic dentistry to the area of Edmonton Alberta, Canada.
