Recently in a report of a news channel it was shown that an Okohoma’ s girl’s life may have been saved by routine checkup with dentist. When a 11 year old took a seat in dental chair, a hygienist noticed that her eyes looked yellow. The hygienist brought attention of the dentist. When the dentist examined and looked for the same he agreed. Dentist informed the patient’s mother. It was the good thing they did and just days later the young girl underwent a nine hours surgical procedure to remove a tumour the size of a grapefruit. When spoke to local news outlet the dentist was found to say it’s hard to feel like a hero insisting that he and his hygienist were merely doing their job.
There have been many true stories like this before. Apart from dental things, by examining the condition of your gums, the number of teeth present, the presence of missing teeth, condition of your oral mucosa, your tongue size and color, misalignment of teeth, bleeding of gums, size of you gums and other oral manifestation of systemic diseases, a dentist may tell you about your overall health. Some systemic diseases whose signs can be seen in your mouth are:
- Diabetes Mellitus Patients with diabetes have increased risk for tooth decay, oral fungal infections, and dry mouth. Patients with poorly controlled diabetes experience greater loss of tooth supporting gums and bone attachment compared with patients without diabetes and those with well-controlled diabetes. Treatment for periodontitis may improve glycemic control, but additional studies are needed to confirm these findings.
- High/low blood pressure: While doing slight invasive treatment like scaling or while doing tooth removal, you dental professional may tell you if you have any blood pressure problems.
- Liver disorders
- Auto immune diseases like
Systemic Lupus Erythematosus (SLE) Systemic Lupus Erythematosus is rare in children, but increasingly common in teenagers and adults, especially females. Prevalence ranges from 4 to 30 per 100,000 children, varying by race and ethnicity. Oral lesions are seen in 9% to 45% of patients with SLE, with prevalence depending on the form of lupus. Oral ulcers are the most common manifestation and often present as painless, palatal lesions. Mucosal atrophy can also occur. Parotid involvement of SLE can result in xerostomia.
Xerostomia Â Xerostomia is a common side effect of some drugs like antidepressants, antihypertensives etc. Patients experiencing this side effect should be monitored and encouraged to maintain good oral hygiene and frequent dental visits.Recommendation includes frequent sips of water and non-sugary drinks. Sugar-free lemon drops and sugar-free chewing gum can stimulate saliva production. Lubricating mouth rinses and toothpastes (e.g. bioteneÂ) can also provide xerostomia relief.
HIV Vertical transmission of HIV is far less common in the U.S. with maternal and infant antiretroviral therapy. In children who do become HIV infected, oral candidiasis and gingivitis are the most common soft tissue oral lesions. Oral candidiasis may be the presenting infection in HIV in newly infected adolescents. Oral hairy leukoplakia occurs in 20% of asymptomatic HIV-infected adults and can also occur in children (3%). Triggered by EBV infection
- Blood cancer i.e. leukemia,
- Vitamin deficiency
Vitamin C Most common in children 6-12 months of age who are fed a diet deficient in citrus fruits and vegetables. Clinical manifestations of scurvy include malaise, anorexia, limb tenderness and swelling, chest enlargement, easy bleeding, and bleeding dots. Oral manifestations include gingival swelling and discoloration with hemorrhages on the mucous membranes, loosening of the teeth, and early tooth loss.
Vitamin D Vitamin D deficiency presents as long bone deformities. Dental manifestations can also occur, including delayed eruption, enamel defects, and dental caries.
Vitamin K Several factors in the clotting cascade are Vitamin K dependent, so Vitamin K deficiency may manifest as bleeding of the gums, especially with brushing.
- Stomach problems
Bulimia Many patients with bulimia and some patients with anorexia nervosa engage in self-induced vomiting. Recurrent vomiting results in enamel erosion, especially the inside surface of the maxillary incisors in a specific pattern termed perimolysis.
Enamel erosion may expose nerve endings, causing tooth sensitivity, and increase the risk of decay, tooth fracture, and gingivitis.
Patients should rinse their mouth with water, water with baking soda or a fluoridated mouth-rinse to neutralize the gastric acid after all episodes of vomiting. Counsel patients not to brush the teeth for 30-60 minutes after vomiting to reduce risk of toothbrush abrasion.
All patients with recurrent vomiting should be counselled to avoid acidic drinks such as soda and to use a soft toothbrush.
Patients with self-induced vomiting should be referred to a dentist for evaluation and treatment in addition to a comprehensive medical and psychological evaluation of the eating disorder.
This article is intended as a general overview of conditions that have oral manifestations but also involve other organ systems. It is not intended to provide details about the diagnosis and management of all of these conditions in detail.