How your dentist can tell a lot more about your health than you think
By Lisa Salmon
You go to the dentist to get your teeth checked, right?
Actually, it's only partially correct. Because while dentists do check up and fix your teeth of course, they can also spot a whole host of other health problems - and these don't just involve your mouth.
As well as identifying if you've got tooth decay or your gums could do with some extra TLC, dentists can potentially detect warning signs of conditions like cancer, high blood pressure, diabetes, stroke, heart problems and anaemia.
"Dental professionals are not just there for when you have a problem or need a filling. During each routine check-up, your dentist will give you a potentially lifesaving mouth cancer examination. Early detection is vital for survival and dentists play a vital role in spotting the disease in its early stages," says Dr Nigel Carter, chief executive of the Oral Health Foundation.
"Our mouths are a window to the rest of our body. They are a good indicator of the health of a person, but also what problems they may be at risk of developing," Carter adds. "It's important to maintain regular visits with your dental team - it can have an impact on your whole body, not just the health of your mouth."
And assessments can begin as soon as a patient enters the surgery, notes Dr Neil Banton, a dentist at Bupa Dental Care. "By using sight, sound and smell, dentists are in a prime position to spot health conditions in the rest of the body and inform patients before they'd have an opportunity to raise them with their doctor. What's more, dentists who've built long-term patient relationships are even more likely to spot changes in patient health - I've been treating some of my patients for more than 20 years," Banton adds, "so I often notice things like rapid weight-loss or changes in speech."
Here, Banton outlines what health conditions a dentist can spot during each stage of the dental appointment...
"If I pass a patient in reception, I can quickly identify posture, movement, speech and behavioural issues, which I take into account during their examination," he says.
"Even something simple, like a patient struggling to complete their medical form, can be a signal of arthritis, or if a patient appears agitated it could suggest they're in a lot of pain. I also look out for slurred speech or a croaky voice, as these may potentially be the result of nerve damage to the vocal cords, cancer, or a minor stroke.
"Speech problems can also indicate someone may suffer from dry mouth, which can be a result of not drinking enough fluids, causing a lack of saliva. This is a common symptom of Sjogren's syndrome, a disease of the salivary glands. In rare cases, dry mouth can show in people who are malnourished or an alcoholic.
"Many medications can also cause a dry mouth, inflammation of the gums, or altered taste. Some medications may, as side-effects, cause confusion, drowsiness, or dehydration - particularly in elderly patients, which can all affect the provision of dental treatment. And all medication, whether prescribed or over-the-counter, have side-effects, like potentially increasing the risk of bleeding after an extraction. This is why dentists ask you to complete a medical history form and repeat the process frequently, and why you must tell them if you're taking something new or different, or have stopped taking it."
In the surgery
"I take a lot of notice of a patient's appearance when they're called into the treatment room, as it can help me determine whether any precautions are necessary, as well as have a bearing on what treatment options are available to them. For example, someone who has a flushed face may suffer from high blood pressure, which means they won't be eligible for sedation and/or certain drugs.
"I've also seen some patients who have very pale skin, accompanied by pale lips, tongue, palms of the hands, inside of the mouth and lining of the eyes, and after suggesting they visit their doctor and get a blood test, they've found their pale complexion is linked to anaemia - a blood condition in which your body doesn't produce enough red blood cells."
In the chair
A closer examination of the face can help dentists identify everything from swollen glands to signs of diabetes. "Swollen salivary glands can cause puffy cheeks and a tender, swollen jaw, which are easy to spot and suggestive of multiple health conditions, such as mumps. My advice to patients showing symptoms of mumps is always to contact their GP to seek medical advice.
"Swollen glands can also be a side-effect of bulimia, an eating disorder which can cause patients to sound hoarse and suffer from a sore throat, but the signs tend to become more apparent when I look inside a patient's mouth."
In the mouth
Inside a patient's mouth, dentists can spot another sign of bulimia - tooth erosion. "A distinct pattern of tooth wear can be due to repeated episodes of vomiting, which can contribute to increased cavities," says Banton.
Dentists are also trained to identify odour coming from the teeth and gums. "Certain smells mean different things - for example, the smell of pear drops is often indicative of uncontrolled diabetes and is something patients will need to see their doctor about."
They will also look for signs of mouth and neck cancer, like an ulcer that won't heal, or difficulty swallowing or chewing. But not every disease is visible, and Banton says when a patient mentions they're experiencing severe jaw pain or a burning sensation in the mouth, it could be a symptom of a heart attack. "Around 5% of coronary episodes manifest in the jaw," he says.
"My message is to be open about wider health concerns with dentists, to ensure we can properly deliver our duty of care, making sure everyone lives longer, healthier, happier lives."
When to see a GP
While dentists can spot warning signs of wider health concerns and provide appropriate dental treatment, patients are advised to always contact their doctor if a possible health condition is flagged up. They'll be able to arrange further tests if necessary.
And remember, experiencing any of the symptoms above does not automatically mean something is seriously wrong, but it's always best to get things checked out sooner rather than later.