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As long as your smile is pearly white and your breath is kissable (go ahead and check), you probably don't give too much thought to your oral hygiene. Which is a shame because even if you brush and floss daily, you could be overlooking some clear signs of the state of your overall health.
"Research has shown that there is an association between oral problems and serious health conditions in the rest of your body," says Sally Cram, D.D.S., a periodontist based in Washington, D.C. So next time you pick up your toothbrush, stop and check your kisser for these clues that something may be amiss so you can remedy the issue.
A slight discomfort in your mouth is likely a piece of popcorn or nut lodged between teeth-something you can easily self-treat. But a sudden, sharp pain in your teeth when you bite down or chew is reason to see your dentist immediately, as it could indicate dental decay or a cavity, says Steven Goldberg, D.D.S., a Boca Raton, FL-based dentist and inventor of DentalVibe. For throbbing, aching pain, he says to wait three days. If your mouth is still unhappy after that time, make a visit to your dentist.
However, an ache that's located in your top teeth may signal a sinus infection, Goldberg says, as the sinuses are located just above the upper roots of your upper teeth. A dentist should be able to tell if your sinuses are clogged with an x-ray, and a decongestant should help the pain subside.
"Contrary to what some people think, it is not normal for your gums to bleed," says Lory Laughter, a registered dental hygienist in Napa, CA. Seeing red while brushing or flossing could mean you need to step up your home care or that you have periodontal (gum) disease.
Make a trip to your dentist as soon as possible for a thorough cleaning, and be sure to brush your teeth twice a day and floss once a day, as gum disease can be extremely dangerous to the rest of the body. "The harmful bacteria that's causing your gums to bleed can leave the mouth and enter the bloodstream, potentially affecting your heart by inflaming your arteries," Goldberg says. In certain people with pre-existing heart valve conditions, this can even lead to death.
Some studies have also found a possible link between gum disease and premature pregnancy and low birth weights. Although other research has found no association, Goldberg recommends that all pregnant women pay close attention to oral hygiene, ramp up their brushing and flossing regimen, limit sugar intake, and avoid major dental procedures that could in any way influence the baby's growth and development.
First, the good news: "Most yellow or brownish stains are superficial, usually caused by drinking coffee, tea, soda, or red wine," Cram says. She recommends polishing them away with whitening toothpaste that contains a derivative of hydrogen peroxide such as carbamide peroxide. You can also ask your dentist about over-the-counter treatments.
But for darker stains that won't go away, it may be time to see a professional. "Dark black or brown spots on a tooth can signal a cavity, while red or blue hues that appear suddenly could mean the tooth has cracked to the pulp, where the nerves and blood vessels are located," Cram says. This sort of crack cannot be fixed, and the tooth will have to be removed.
If you have white, yellow, or brown spots and grooves or pitting on the tooth's surface, you could have celiac disease. "About 90 percent of people with celiac have these problems with their teeth enamel," Goldberg says. "When the onset of celiac disease occurs during childhood, the resulting poor nutrition can lead to a malformation of the developing tooth enamel." If you notice these types of marks, see your dentist who may refer you to a physician for an evaluation.
Lastly, some stains may have occurred during childhood as a result of tetracycline antibiotics, and unfortunately bleach cannot make these go away, Cram says.
Cracking, crumbling, or suddenly crooked teeth can indicate that you may need to check on your mental-rather than physical-wellness. "These problems are usually a sign of tooth grinding, which is caused by stress," Cram says. "Stress triggers muscle tension in your jaw, causing you to clench it closed at night." This can lead to headaches, difficulty closing your mouth, or permanent damage to your jaw joint.
Relieving stress is much easier said than done, but try to relax before going to bed by doing whatever will take your worries off your mind. Your dentist can also give you a bite guard to wear at night to keep your teeth apart, protecting them from wear and tear, Cram says. Other options for alleviating the symptoms of grinding include muscle relaxation techniques, physical therapy, and applying heat to the facial muscles. However since these may only relieve tension and not stop the grinding, you often still need a bite guard. Talk to your dentist to discuss your choices.
It's key to know what kind of sore you're dealing with: Crater-like sores that appear inside or outside the mouth are canker sores and ulcers, Cram says. Stress, hormones, allergies, or a nutritional deficiency of iron, folic acid, or vitamin B-12 may be to blame, and eating certain acidic or spicy foods can exacerbate sores. To alleviate them, an OTC topical cream or gel should work.
If you have fluid-filled sores on your lips, those are cold sores, which are caused by the herpes simplex virus. They will crust over during healing, which can take up to three weeks, so avoid touching them (or locking lips) while they drain or "weep," as they are contagious.
Any kind of sore that doesn't start to heal or disappear after about two weeks, and especially one that turns red, white, or swollen, requires an immediate trip to the dentist. "This could signal an autoimmune disease or even something more serious like oral cancer," Cram says.
When your mouth tastes like you've been licking an aluminum can, it could be a side effect of a medication you're taking; possible culprits include antihistamines, antibiotics, and heart meds. It may also be a symptom of gum disease, which requires a thorough dental cleaning and vigilant home care.
Or you may have zinc deficiency, Goldberg says. "Vegetarians and vegans are more prone to this, as the mineral is found mostly in animal products," he adds. If you're an omnivore, be sure you're getting plenty of zinc in your diet-good sources include oysters, beef, crab, fortified cereal, and pork chops. Vegetarians can get their share from fortified cereal, legumes, wheat germ, pumpkin seeds, and milk products, or by taking a vitamin supplement, but always talk to your doctor before choosing a supplement or drastically changing your diet.
These cracked areas actually have a name-angular cheilitis-and they're not just a side effect of chapped, dry lips. "These cuts are inflamed areas of fungal or bacterial infection, and may be caused by nutritional deficiencies," Goldberg says, although the jury is out on that. Other triggers can include recent mouth trauma, chapped lips, a lip-licking habit, or excess saliva.
If you see cuts on both sides of your lips, it's likely angular cheilitis and not just a cold sore or irritated skin, Goldberg says. Topical anti-fungal medications can provide relief, but also talk to you doctor to see if you are lacking B vitamins or iron, and to determine how to adjust your diet if necessary.
A white coat on your tongue is reason to see a white coat. While it may be the result of poor hygiene, dry mouth, or a medication, it may also be thrush, Laughter says. This overgrowth of bacteria is more likely to occur in babies and in people who wear dentures, but it can be painful, so you'll need to get it taken care of ASAP.
Swollen white nodes toward the back of your tongue could also indicate HPV, though your dentist would need to biopsy the lesions to be sure. Finally, while a bluish color on your tongue may just be a blood clot where you bit yourself, it could signify a more serious condition such as oral cancer. Don't panic, but if you these colored areas suddenly appear on your tongue, make an appointment to see your dentist, stat.
White strand- or web-like patterns inside your cheek usually mean you have lichen planus, a condition that can also cause shiny red bumps on other areas of your skin such as your hands, nails, or scalp. More common in women ages 30 to 70, the cause of lichen planus is unknown, Goldberg says, and while it isn't contagious or dangerous, there's no known cure for it either. It's more of an annoyance, but it's still something to air to your dentist.
"Dry mouth is a side effect of many medications, including antihistamines, antidepressants, and anti-anxiety meds," Laughter says. So when you talk to your dentist, speak up if you're taking any of these.
Of course if medication is the problem, you still have to address the issue since moisture in your mouth helps prevent cavities, tooth decay, gingivitis, and other oral infections. Try products that contain xylitol, such as sugar-free gum or Salese lozenges, which helps stimulate the production of saliva, Laughter says.
But if you also suffer from cracked lips and swollen, sore, or bleeding gums, you may have Sjogren's syndrome, an autoimmune disease that can be treated with medication or surgery. Bottom line: See your dentist.
That's not garlic from lunch causing your dragon breath, it's a buildup of bacteria-and a sign you need to be more mindful with your toothbrush. "Brush and floss thoroughly using light-not aggressive-pressure, and use a tongue scraper to clean the back of the tongue," Laughter says. "Merely rubbing your tongue with your toothbrush won't be enough to combat bacteria that are responsible for halitosis."
If this doesn't work, something more may be at play, such as a respiratory disease, post-nasal drip, uncontrolled diabetes, gastric reflux, or kidney failure, Laughter says. Or if your breath is fruity, it could be a sign of diabetes. "When the body doesn't have enough insulin, it cannot use sugar as energy, so it uses fat for energy instead," Goldberg explains. "Ketones, byproducts of fat breakdown, can cause this fruity odor." Check with your dental professional if you've been experiencing smellier-than-usual breath for more than a week, and he'll be able to refer you to another professional if further investigation is needed.
