Wednesday, January 31, 2007

What a dentist can tell by looking in your mouth

By Dr. Brad Durham

Your mouth can get you in trouble. Research is showing that dental problems can affect your health in areas seemingly unconnected to your mouth, and dentists may be the expert to relieve you of nagging problems or to help prevent and identify serious health problems. One area of dental origin can bring about pain that patients wouldn’t think to connect to their mouth, and that area is the bite. Bite problems can cause headaches, ear pain, neck and shoulder pain, dizziness, clenching and grinding of the teeth, and numbness in fingertips, hands and arms. These symptoms, many seemingly unrelated to the mouth, can lead patients in many directions as they look for relief. It’s not uncommon for patients to have been to their ENT for examinations, to radiologists and neurologists to have CAT scans and to chiropractors for adjustments, only to have the real culprit be bite problems. The dysfunction of the bite can be related to a non-coordination of the muscles, joints or teeth. Symptoms will show up in one of those categories. Headaches are linked to muscle problems with the bite. As a matter of course, patients with recurrent headaches should be examined by a dentist with experience in bite treatment. Ear pain, dizziness and popping are related to bite problems with the joints. Teeth problems include clenching, grinding and toothaches.

Patients experiencing these symptoms should see a dentist with experience in bite treatment using computerized diagnostic equipment. Children are especially sensitive to temporomandibular joint disorder and usually show early signs with ear infections, leaning their head on an arm, lip, cheek, or finger biting, sucking or chewing, headaches, snoring, grinding of their teeth at night, and excessive chewing of gum. The temporomandibular joints, or jaw joints, are the small joints in front of each ear that attach the lower jaw to the skull, and are the most complex joints in the entire body. The area of the face where the TMJ is located is an intricate network of bones, ligaments, blood vessels and nerves. Because of this, TMJ conditions affect many areas of the body, from the top of the head in migraine-like headaches to numbness or tingling in the arms and pain in the neck or shoulders. When the teeth are misaligned, they cannot provide the support the muscles in the face need for chewing and swallowing, forcing the muscles into a strained position that results in pain throughout the face, head, arms, shoulders, and back. Although a person may have had orthodontics to straighten the teeth, the muscles and joints may still not be comfortable. After a neuromuscular dentist realigns the bite, pain that resulted from the imbalance typically disappears. In addition to the relief of the pain, patients often find they look better since getting the bite fixed improves cosmetics, giving better facial structure and a younger appearance.

There are many other dental-related maladies that can affect one’s overall health. Dental infections, especially gum infections, can lead to many other health problems, and good dental health can reduce the likelihood that a patient will be stricken with illnesses as serious as cardiovascular disease. It’s also possible that dentists may note warning signals and be able to help patients by encouraging them to see their primary care physicians for evaluation.

Research is increasingly showing that gum and tooth infections can play a part in or cause a host of other health issues. Gum or tooth infections can easily enter the bloodstream, where C-reactive protein causes inflammation that can lead to so many serious health issues. After treating the infection, dentists may want to explain the possible health risks to patients and encourage them to talk about the infection with their physician. Dental problems are connected to an increased risk of cardiovascular disease, according to recent research. Surprisingly, it seems dental problems are a possible stronger indicator of that risk than the other factors such as cholesterol that we typically consider. Gum infections near molars, serious tooth decay, gingivitis, cavities or missing teeth can put patients at risk of heart disease. Some of the diseases linked to periodontal disease include stroke, osteoporosis, colon cancer, prostate cancer, kidney disease, diabetes, Alzheimer’s, and complications in pregnancy. Appropriate dental treatment can decrease the likelihood that the patient will be stricken with these diseases. Visiting the dentist can decrease pregnant women’s chance of premature delivery and low birth weight for the baby. Other dental issues can indicate serious health problems. Patients with an abscessed tooth, many infections or inflamed gums who have good oral hygiene may have diabetes or immunosuppressive problems such as AIDS. Teeth that show chemical erosion, with enamel that seems to be melting away, likely have gastric problems or bulimia. Inflamed gums can be related to kidney disease. Red, inflamed, spongy gums can indicate leukemia. Iron deficiency can cause sores or in serious cases scarring in the throat. Gums that bleed or bruise easily can be caused by vitamin C deficiency. Research is showing more and more how your overall health is connected to the health of your mouth. Good oral hygiene and visits to your dentist now seem more important than ever – and they might even change your life.

About Dr. Durham: Dr. Brad Durham has been practicing dentistry for 25 years. He received his undergraduate degree from Presbyterian College in Clinton, S.C. and dental training from the Medical University of South Carolina in Charleston. Since beginning dental practice, he has completed thousands of hours in continuing education, with an emphasis on head, neck, and facial pain treatment, dental cosmetics, and complex dental reconstruction. He has pioneered the use and integration of technology in dentistry. He is a consultant, author, and researcher. He is presently an instructor at the world renowned Las Vegas Institute of Advanced Dental Education, where he teaches courses in cosmetic, reconstructive, and TMJ related dentistry. Email him personally at and visit him on the web at

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