Medical Conditions

It’s important to realize that your dentist sees much more than just your teeth. Some health-related conditions that show up in the mouth include:
• diabetes
• oral cancer
• HIV/AIDS
• thyroid problems
• iron deficiency/anemia
• leukemia
• eating disorders (bulimia and anorexia)

Communication with your dentist is vital. During your visit, talk to your dentist about your ongoing health concerns so that he or she may help you.

Your dentist may adjust your treatment if you have certain medical conditions, use certain prescription drugs or are currently undergoing medical treatment, such as radiation or chemotherapy.


Diabetes
Research shows that gum disease and diabetes may affect one another. For instance, gum disease can intensify the complications associated with diabetes by increasing blood sugar levels. High blood sugar levels over an extended period of time are associated with premature degeneration of eyes, kidneys, nerves and blood vessels.

Studies have also shown that people with diabetes face a greater risk of developing oral infections and gum disease than those who do not have diabetes. The good news is that the treatment of either gum disease or diabetes can lead to improvements in the other.

Your dentist has the training and experience necessary to assess your oral health, and to determine a course of treatment that is best for you. Some of the most common oral health problems associated with diabetes are:
• tooth decay
• gum disease
• dry mouth
• fungal infections
• lesions in the mouth
• taste impairment
• infection and delayed healing

If you are a diabetic, speak to your dentist about the best course of treatment for you. Make sure to let him or her know:
• if the diabetes is under control
• if you take insulin and when your last usual dose of insulin was administered
• if there has been any other change in your medical history
• the names of all the herbal medicines, prescription and over-the-counter drugs you are taking

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Oral Cancer
Understanding the risks and being able to identify the signs or symptoms of oral cancer are good first steps in the prevention of the disease. If you are concerned or feel you may be at risk for developing oral cancer, speak to your dentist.

Here are some key risk factors for developing oral cancer:
• smoking, particularly when combined with heavy alcohol consumption
• excessive sun exposure to the lips
• age; most common in people over 50
• gender; more men than women develop oral cancer

Symptoms may include:

• a sore lip or a sore in the mouth that does not heal within two weeks
• a sore throat that doesn’t go away, or a feeling that something is caught in the throat
• a lump on the lip or in the mouth or throat
• a white or red patch on the gums, tongue or lining of the mouth
• unusual bleeding, pain or numbness in the mouth
• difficulty or pain with chewing or swallowing
• swelling of the jaw that causes dentures to fit poorly or become uncomfortable
• a change in the voice or pain in the ear

Diagnosis
A complete medical history is required before conducting an oral cancer assessment. Any lesion or damaged area that your dentist determines is unlikely to be cancerous should be observed for seven to 14 days to ensure that the healing process is ongoing.

If the lesion persists, it may be treated non-surgically with:
• antibiotics
• cleaning or rinsing with a medicated solution
• repair of a sharp or failing restorative or prosthetic (a sharp edge could cause a cut or lesion inside your mouth – one way that oral cancer can start)
• elimination of external factors such as smoking and tobacco chewing

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Testing
When there is a high suspicion of cancer, an immediate biopsy will be needed to determine if the lesion is cancerous. In these cases, waiting for seven to 14 days is not advised. Depending on the degree of difficulty, your dentist may decide to remove the tissue in the office or refer you to a specialist. Lab tests may also be done before or with the biopsy to help determine a diagnosis.

Such tests could include:
• blood tests
• culture and sensitivity tests
• glucose tolerance tests for diabetes
• skin tests for allergies
• radiographic surveys
• dietary tests

Treatment
Treatment plans are developed to fit the specific needs of the patient and must consider the patient’s age and general health as well as the location, size, type and extent of the tumour and stage of the disease. In most cases, treatment involves surgery, chemotherapy, radiation therapy or, in many cases, a combination of the above. Some patients receive chemotherapy treatment with anti-cancer drugs.

Follow-up & Rehabilitation
Rehabilitation often involves the entire health-care team. It can include dietary counselling, surgery, a dental prosthesis, speech therapy, and other services.

Sometimes a patient needs reconstructive and plastic surgery to rebuild the bones or tissues of the mouth or an artificial dental or facial part.

Regular follow-up exams by your dentist and doctor are very important for anyone who has been treated for oral cancer. Patients suffering from dry mouth due to radiation therapy should have dental exams three times a year.

Patients who continue to drink or smoke are strongly advised to quit.

Related Web Sites:
Canadian
• Canadian Canadian Cancer Society
• Cancer Care Ontario
• Health Canada
  

U.S.
• American Cancer Society
• American Dental Association
• The Oral Cancer Foundation

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Bulimia & Anorexia Nervosa
Both anorexia and bulimia are serious eating disorders. They occur when men or women have an extreme fear of becoming overweight. This can lead not only to excessive dieting, but sometimes, death.

Both conditions have implications for your teeth because your body is not getting the minerals, vitamins, proteins and other nutrients that are needed to maintain good oral health and good overall health.

In addition, a person who is bulimic may binge eat and then vomit. When this occurs the acids that break down your food eat away at the tooth enamel and may wreak havoc on your mouth. Translucent and worn teeth, bad breath or a swollen mouth, throat and glands may result.


Your Dentist Sees More Than Just Your Teeth
Your dentist plays a very important role in your health-care team. Dentists have the skills and the expertise — not only to treat oral health disease — but to help you with all of your oral health needs.

It’s important to keep your dentist up-to-date on your health and medications. Let’s say you have a heart murmur, or have just had a hip or knee replaced. You may need antibiotics before dental work to reduce the risk of infection.

Many dental procedures involve some bleeding of the gums and healthy blood clotting is important to recovery. Conditions such as liver disease and medications such as aspirin, blood thinners, and some herbal remedies may affect the ability of the blood to clot normally.

Your dentist can also spot emerging medical problems. For example, the onset of bleeding from your gums may suggest the beginning of gum disease that could also be related to adult-onset diabetes if your gums have otherwise been healthy.

Speak to your dentist about the relationship between good oral health and overall health.


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