PORTLAND, Aug. 19, 2022 — A visit to the dentist's office could provide a glimpse into your heart and brain health. 

More than an estimated 100 diseases can show symptoms in the mouth. For instance, periodontal disease, which results from infections and inflammation of the gums and bone that support and surround the teeth, is more common and may be more severe in people with diabetes. 

Other times, prescription drugs may affect the mouth. For instance, some drugs used to treat hypertension can cause swollen, inflamed gums. 

"Your mouth is the gateway to the body. A look inside your mouth by your dentist can often be an eye-opener to lingering systemic diseases," said Dr. Jill Price, DMD, of Portland, Oregon. 

Dentists might be able to pick up on red flags about a patient's overall health before they even start poking around in the mouth. That’s because dentists routinely evaluate and follow up on patients' medical health histories. 

"Many people see the dentist far more than their primary care provider. Frequently dental patients get seen in the office 2-4 times per year,” Price said. “Through updating medical questionnaires and asking health related questions along with a thorough oral intraoral exam, many early signs of concern can be detected.”   

Dentists find symptoms or concerns in patients every day that might need a consult or referral to a health care professional. The following are some examples. 

Hypertension 

A person's blood pressure may be taken before a cleaning or a dental procedure that requires a local anesthetic. 

"The jury is still out on specifics, but it is known that heart disease presents more frequently in people with gum disease (gingivitis, or the more advanced periodontal disease).  It simply comes down to bacteria which causes inflammation,” said Price.  "I look at it as a cycle.  Bacteria causes the inflammation in the gums, that in turn, can go to the other weakened areas of the body.  The heart is an easy target.” 

 For people already diagnosed with high blood pressure, some hypertension drugs can cause dry mouth. When the salivary glands don't produce enough saliva to keep the mouth wet, tooth decay accelerates, since saliva protects against decay. In those cases, Price said, dentists work with the patient's health care professional to manage side effects. 

"Every contact that a patient makes with the health care system is another opportunity for prevention, and hypertension is a classic example of a condition where this may make all the difference," said Dr. Dhruv Satish Kazi, associate professor of medicine at Harvard Medical School in Boston. Many dental clinics will check blood pressure, he said, "and can therefore identify patients who need to be connected with care." 

Diabetes 

Undiagnosed type 2 diabetes often exhibits signs in the mouth.  Uncontrolled and progressive gum disease (which can lead to tooth loss), fatigue, chronic bad breath and changes in weight are often signs.  To go one step further, some dentists are now doing blood glucose tests, Price said. These concerns are then relayed to the patient’s primary care provider to dive deeper and make the diagnosis.   

“Diabetes can reduce your ability to fight infection and healing,” Price said. “If you have diabetes and it isn’t controlled, you also have a higher risk of tooth decay. High blood sugar, and the higher amount of sugars and carbohydrates in the diet, cause increased acid production that can influence the decay rate.” 

“Early detection on any disease is the key. If you haven’t been to the dentist in a while and you are seeing some of the signs or symptoms of concern, ask your dentist.  It’s wonderful to work with our physician colleagues to bring light to what we see in the mouth,” Price said. 

HIV 

Dentists have treated people later diagnosed with HIV after finding lesions in their mouth that would not appear in someone with a functioning immune system. The risk of cardiovascular disease for people living with HIV is about 1.5 to two times greater than for people without the virus, according to an American Heart Association scientific statement about cardiovascular disease and HIV. 

Although dentists can pick up on various health conditions, Kazi cautioned against thinking dentists are a one-stop shop for health. 

"It's magical thinking that our dental colleagues have the bandwidth to talk at length about heart disease, just like our cardiology colleagues don't have the time to talk about dental health more broadly," Kazi said. "But there are enough synergies for the two to connect and improve cardiovascular screening and care." 

 

About the American Heart Association  

The American Heart Association is a relentless force for a world of longer, healthier lives. We are dedicated to ensuring equitable health in all communities. Through collaboration with numerous organizations, and powered by millions of volunteers, we fund innovative research, advocate for the public's health and share lifesaving resources. The Dallas-based organization has been a leading source of health information for nearly a century. Connect with us on heart.org, Facebook, Twitter or by calling 1-800-AHA-USA1.   

 

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Jay Wintermeyer: 503-820-5309, jay.wintermeyer@heart.org   

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