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5 Scary Health Conditions Your Dentist Can Spot

The health of your mouth may shine a light on what’s happening in the rest of your body. (Kulka/Corbis)



You expect your dentist to flag cavities, but did you know your drill-wielding doc might also be able to spot trouble that extends well beyond your pearly whites?



“It’s becoming clear that we need to consider integrating oral and general health care,” says Steve Offenbacher, D.D.S., director of the Center for Oral and Systemic Diseases at the University of North Carolina at Chapel Hill. “The oral cavity is the mirror to the rest of the body, so we can pick up on systemic problems by simple dental examinations.” In other words, the state of your smile may shine a light on the rest of your body — sometimes even before other symptoms show up.



Case in point: Offenbacher once told a middle-aged patient he suspected she was pregnant, based simply on the redness of her gums. “The next week, she came back and said, ‘I went to the doctor, and yes, I am pregnant!’’ he recalls. In that case, Offenbacher was the bearer of good news, but not all of the secrets your mouth may reveal are so positive. Your teeth may also provide clues about these five health-threatening conditions:



Diabetes



Your dentist isn’t just worried about how white your teeth are. In a 2014 study, nearly two-thirds of dentists said they’d refer a patient with periodontitis (inflammation around the gums) for a diabetes evaluation. Why that’s a good thing: “Diabetes is not only a common problem, but it’s also highly under-diagnosed,” says Offenbacher. Read: Lots of people have diabetes and don’t know it, which means adding your dentist to your team of health detectives is a smart idea.



So what’s the dental-diabetes link? High blood sugar may be as damaging to your oral health as the sweet stuff in a can of soda. That’s because the condition can cause dry mouth, which increases plaque build-up, making people with uncontrolled diabetes more prone to dental problems.



“[Periodontal disease in diabetics] is usually severe for their age or for local factors, meaning they have pretty clean mouths, but they still have a periodontal problem,” says Offenbacher.



Two common oral signs of diabetes: multiple abscesses on the gums and bad breath. “It’s kind of a sour fruit smell,” Offenbacher says. “It’s ketones — metabolic products associated with poor glycemic control — in their bloodstream that you can smell.”



Heart disease



Your teeth may reveal what’s going on with your ticker. A 2007 study review found that people with periodontal disease are significantly more likely to develop heart disease than folks with good oral health. Among people who have both diseases, “if the periodontal disease is treated, the heart disease is greatly improved,” says Marjorie Jeffcoat, D.M.D., a professor and dean emeritus of dental medicine at the University of Pennsylvania.



The common thread? Inflammation. “When you look in a patient’s mouth and you see chronic inflammation, you know that it’s creating systemic stress,” says Offenbacher.



Although there are no dental red flags specific to heart disease, “more severe periodontal disease is strongly associated with heart disease risk,” Offenbacher says. Signs include loose, shifting, or missing teeth, and increased probing depths, where the pockets around the teeth have deepened.



Dementia



Can tooth loss indicate memory loss? In recent British research, a lack of teeth was associated with mental decline, while a 2012 study found that older adults with poor dental hygiene were 76 percent more likely to develop dementia. This is a relatively new area of research, which means the link between the two isn’t entirely clear, says Jeffcoat. However, a small 2013 study detected Porphyromonas gingivalis — a bacteria associated with gum disease — in the brains of people with dementia, suggesting that it may play a role in the inflammation associated with cognitive decline.



Osteoporosis



Osteoporosis won’t cause your teeth to decay — but your dentist may be able to spot bone loss in the surrounding structures, like the jaw, with digital X-rays, says Jeffcoat. Normal, healthy bone should be dense both at the edges and in the interior, and when that’s not the case, “the patient is more likely to have osteoporosis,” she explains.



In fact, in a 2013 study in the Journal of Research in Medical Sciences, the thickness of postmenopausal women’s jawbones — as measured with a panoramic X-ray — was correlated with the bone density of their spine. This means that dentists could potentially diagnose osteoporosis, which often goes undetected until a fracture occurs, in its early stages, the scientists say.



Acid reflux disease



You may feel heartburn most intensely in your chest, but its effects may be most obvious in your mouth. If you have acid reflux disease, the constant uprising of stomach acid could wear away at the enamel on your teeth, says Jeffcoat. “You’ll usually see it in the lower front teeth,” she says. “You’ll see erosion of the teeth — they get thinner. You can’t miss it.” Another sign you may be suffering from acid reflux disease: You have a persistent sour taste in your mouth, she says.



In a 2008 study review, researchers found that about a third of adults with dental erosion also had gastrointestinal esophageal reflux disease, or GERD. Keep in mind, this erosion can happen even in the absence of chest pain — that is, you may have reflux without knowing it, until your dentist points out the damage to your choppers.



Source: https://www.yahoo.com/health/5-scary-health-conditions-your-dentist-can-spot-105279962062.html



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Long-in-the-Tooth Dental Advice

Terry O’Brien, 73, a retired administrative assistant in Billerica, Mass., recently had to make a tough decision about her dental care.



“I always took care of my teeth,” she said. But even so, she was told she needed a crown — an artificial cap — at a cost of about $2,000.



Since she and her husband lack dental coverage, she opted for a less expensive filling. She worries, however, about how she will fund dental care long term. “I’ll make 100, I bet,” she said. “But I wonder how long my teeth will last.”



Older Americans face such situations often, because many people over age 65 lack dental insurance. Only about 10 percent of retirees have dental benefits from their former employer, according to Oral Health America, a nonprofit advocacy group.



And 22 percent of Medicare beneficiaries had not seen a dentist in five years, the Kaiser Family Foundation reported in 2012. The main factor is the cost of care, said Tricia Neuman, a Medicare policy expert with the foundation.



Traditional Medicare, the federal health program for older adults and people with disabilities, doesn’t cover routine dental care or dentures. Some Medicare managed care plans offer coverage, but it is often limited to preventive care like cleanings. Medicaid, the federal-state program for low-income people, may cover some dental care for adults, but benefits vary by state. Individual plans are available, but they typically cap payments at low levels and may not cover any advanced treatments, like implants to replace lost teeth.



That means most older Americans must pay for dental care out of their pockets.



According to 2013 data from the American Dental Association, which surveyed private dentists, the average cost of a basic examination is about $45, while a cleaning is $85. X-rays are another $27; a tooth-colored filling is $149, while a silver filling is about $125. Costs vary widely, however, depending on the market.



Artificial implants average about $4,000 per tooth, the A.D.A. found. But the bill can be much higher, after adding anesthesia and related treatments like bone grafts. Implants involve inserting a metal screw into the jawbone to serve as the foundation for a replacement crown.



Implants are an economic impossibility for some patients, said Beth Truett, chief executive of Oral Health America. But, “If they can afford it, they are a great solution to maintaining not only that tooth, but the teeth around it.” A full set of teeth for an adult is 28 (32 if you still have your wisdom teeth), and you should have at least 22 teeth to eat properly, she said. Once a tooth is lost, nearby teeth bear additional strain and it gets more difficult to chew; that leads to a cycle of poor nutrition and further tooth loss, she said.



Ed Decker, 69, a retired hospital pharmacist in Ashland, Mass., said he had poor dental health his entire life and had budgeted to make dental care a priority. “I think my family was born with marshmallows instead of teeth,” he said. Ultimately, he lost so many teeth he couldn’t chew, and had 10 implants, at a total cost of about $50,000. He was able to pay for it, he said, because of successful investments recommended by his financial adviser. “When you put in an implant, it’s like having a natural tooth,” he said.



Judith Jones, a professor at Boston University Henry M. Goldman School of Dental Medicine and an authority on dental care for older people, recommends that after age 65, the bare minimum level of care needed is a professional examination and cleaning at least once a year. Poor mouth health has been linked to other ailments, like heart disease and diabetes.



Patients should brush at least twice a day for two minutes, she said. If older people aren’t able to do it themselves, family members or caregivers should assist them. Basic mouth hygiene, including daily flossing, is important to maintain healthy gums and remove tartar and plaque, which traps bacteria and can lead to infections.



People also need to be aware of the possibility of being pressured into unnecessary treatment. To find a reputable dentist, you may want to ask your doctor or your friends for a referral. And be skeptical of treatment that sounds overly aggressive. “If you go in and they want to replace every filling in your head, you should get a second opinion,” said Athena Papas, co-head of geriatric dentistry at the Tufts University School of Dental Medicine.



However, she noted, patients who haven’t been to the dentist for several years may have a real need for restoration work, particularly if they are on multiple prescriptions. Some medications can cause a reduction in saliva, which can promote development of cavities.



One way to limit costs for replacement teeth is to have implants on the lower jaw, and use dentures to replace upper teeth, said Dr. Papas; it’s easier to keep upper dentures in place.



Older adults on tight budgets generally should avoid cosmetic treatments like teeth whitening, dentists say. But many dismiss the idea that older people don’t need to spend on oral care because they are near the end of their lives. Patients who are in their 80s, but who are fit and have a healthy lifestyle, can benefit from technologically advanced dental care “because it is estimated that they will have another 10-15 years of life span,” Helena Tapias-Perdigón, an assistant professor at the Baylor College of Dentistry at Texas A&M Health Science Center, said in an email.



Some dental schools offer discounted treatment, although some require deposits and may have waiting lists. The American Dental Association lists accredited schools on its website.



You can also ask dentists if they offer a payment plan. But read the fine print of any discount program, said Jim Quiggle, a spokesman for the nonprofit Coalition Against Insurance Fraud, since some programs offer little in the way of true savings.



Source: http://www.nytimes.com/2014/11/19/your-money/long-in-the-tooth-dental-advice-.html



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New recommendations for fighting dental caries

Do you know what the most common chronic disease is affecting American children? It's not obesity. And it's not allergies, though those are good guesses. It's cavities. Or as health experts call them, dental caries.



Well, that's no big deal, right? Dental caries just affect the teeth — teeth that kids are going to lose anyway as they make way for their adult chompers. So why worry?



Dental caries are a big deal. Cavities lead to inflammation and infections that could seriously harm a child's health. And they can affect the growth and development of permanent teeth even before they break the surface of the gums. To combat the recent increases in dental caries, health experts have announced new dental recommendations for kids that they hope will reduce the number and severity of cavities in kids.



Cavities are caused when bacteria sit around in the mouth and start to erode tooth enamel. According to a recent study by the American Academy of Pediatrics (AAP), 59 percent of kids between 12 and 19 have at least one cavity, and poor and minority children are disproportionately affected. A child's chances of getting dental caries depend on a number of factors, namely diet, genetics and oral hygiene.



The AAP recently announced new recommendations for dental hygiene for children, stating that all children should start using toothpaste with fluoride when their teeth appear, regardless of their risk level for cavities. Previously, health experts worried that fluoride toothpaste might be harmful for young children who may be more likely than older kids to swallow the paste. But these new recommendations reflect the view that a small amount of fluoride is necessary to protect teeth and keep kids healthy. The AAP recommends that parents use only a teeny bit of fluoride toothpaste — about as big as a grain of sand — to brush their child's teeth. And that they start doing so as soon as the teeth start popping through the gums.



Talk to your child's doctor or dentist for more information about kids and cavities and the best ways to protect your kids from tooth decay.



Source: http://www.mnn.com/health/fitness-well-being/blogs/new-recommendations-for-fighting-dental-caries



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Saliva Really Does Help Protect Teeth From Cavities

Salivary mucins work to actively protect the teeth--what's otherwise known as the cariogenic bacterium. Now, recent findings published in the journal Applied and Environmental Microbiology reveal that bolstering these native defenses could help to fight dental caries instead of simply relying on exogenous materials such as sealants and fluoride treatments.



Lead study author Erica Shapiro Frenkel of Harvard University and principal investigator Katharina Ribbeck, a professor at Massachusetts Institute of Technology, both in Cambridge, Mass., found that the body's natural defenses work in a better way to prevent tooth decay while relaying on external agents such as sealants and fluoride treatments.

"We focused on the effect of the salivary mucin, MUC5B on S. mutans attachment and biofilm formation because these are two key steps necessary for cavities to form," said Frenkel, via Medical News Today. "We found that salivary mucins don't alter S. mutans' growth or lead to bacterial killing over 24 hours," she added. "Instead, they limit biofilm formation by keeping S. mutans suspended in the liquid medium. This is particularly significant for S. mutans because it only causes cavities when it is attached, or in a biofilm on the tooth's surface."

Furthermore, she went to say that the oral microbiome is better preserved when naturally occurring species aren't killed. "The ideal situation is to simply attenuate bacterial virulence," she concluded.

Researchers said they believe that the research makes a fundamental contribution to scientific understanding of host-microbe interactions.



Source: http://www.scienceworldreport.com/articles/18973/20141117/saliva-really-does-help-protect-teeth-from-cavities.htm



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