Nov. 22--The next time you open your mouth to have your teeth cleaned, your dentist might learn a whole lot more about your personal life than your conversation discloses.

Dentists are detectives of a sort, but they don't have to follow patients around to get answers about their lifestyle. It's all there between the lips.

Bleeding gums? The patient could be anemic. Eroded tooth enamel? Perhaps a sign of binging and purging. Wisdom teeth infected? Heart disease might be taking hold.

Although problems such as cavities or tooth decay send people to a dentist, it's the gums that need attention in most patients, said Dr. Richard Weaver, 53, of Beaumont, a family practice dentist for 27 years.

"If a patient has a periodontal problem -- swelling of the gums and bleeding -- you treat it the normal way. If it doesn't respond to conventional therapy, you look a little deeper and order blood tests," Weaver said.

Weaver remembers a patient who came in for routine treatment. He asked her to open her mouth wide and say, "Ahhh," as he does all patients as part of the exam.

"I saw a growth on her tonsils, so I sent her to an ENT (ear, nose and throat specialist). She had a squamous cell carcinoma on her tonsils. It was limited to her tonsils and hadn't spread, so she was fine," Weaver said.

"She sent me a sweet letter. It made me feel good to know that I had possibly saved her life. In dentistry, we don't get too many life and death experiences, so it left an impression. It motivates you to be very thorough in your exams."

Dr. Dave Carpenter, 50, a general practitioner of dentistry for 23 years, said many diseases, such as diabetes and heart disease, cause changes in the mouth.

"Patients with poorly controlled diabetes are more likely to develop periodontal disease. They have that breath that smells like finger nail polish remover. Another thing we see is cheilitis, which is sores in the corner of their lips that don't heal well," Carpenter said.

"What researchers are discovering is that there is absolute link between inflammation of the gums and plaque in the coronary arteries. People with periodontal disease are almost twice as likely to suffer from coronary artery disease as those without periodontal disease."

Diseases and health conditions that create changes in the mouth include:

Bulimia: Binging and purging stimulate the body to produce acid that destroys tooth enamel. Gum recession and lots of cavities also are indicators.

Diabetes: The giveaway is the tell-tale "sweet" acetone breath. Inflammation of the gums in people who brush and floss regularly could indicate impaired white blood cell production, a byproduct of diabetes. Abscesses also can occur.

Gastro esophageal reflux disease (GERD): causes the same symptoms as bulimia -- eroded tooth enamel and multiple cavities.

Heart Disease: Infection around the molars (pericoronitis), especially the wisdom teeth, is a strong predictor of heart disease, since the bacteria in the mouth and the plaque the bacteria causes also can appear as plaque in arteries.

Infection: A foul odor from the mouth often is a byproduct of infection in the mouth, lungs or stomach.

Leukemia: Gums often turn fiery red and are very inflamed and "spongy."

Osteoporosis: The spine isn't the only place where bone loss shows up. A decrease in bone mineral density (accompanied by tooth loss) is an indicator of osteoporosis.

Premature and Low-Weight Births: The risk of premature birth and low weight babies increases seven-fold in women who have gum disease during pregnancy. The culprit is the chemicals inflammation causes to be released in the bloodstream, passing to the baby.

Vitamin deficiencies: Sores at the corners of the mouth, small taste buds and a sore tongue can indicate iron deficiency. Gums that easily bleed and bruise can indicate a vitamin C deficiency. Jaw fractures and gum disease can follow vitamin D deficiency.

Sources: American Dental Association and WebMD

jmcbride@hearstnp.com (409) 838-2808

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Copyright (c) 2006, The Beaumont Enterprise, Texas

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