The routine of visiting a dentist is well-known: a cleaning of your teeth by a hygienist, a check for cavities and gum disease, and maybe an X-ray. But while seemingly the same, each visit actually serves as a unique opportunity for a dentist to not only play a role in your oral health but also in protecting your overall health. That’s because dentists can be one of the first lines of defence in spotting signs and symptoms of serious health concerns such as cancer and diabetes.
“Screening for oral cancer is an important part of the overall screening that we do,” says dentist Mark McCullough of Capital Dentistry, a group of clinics in the Ottawa-Gatineau region. “Every time people are in for their checkups, we do a thorough look around the mouth, face and neck.
“Even if someone says they have a sore tooth, we do a thorough once-around because it’s important to see the forest for the trees.”
Specifically, oral cancer may present as: white or dark red patches in the mouth or on the lips or tongue, lumps or changes in the texture or colour of mouth tissue, bleeding or numbness in the mouth, sores or patches that do not heal, difficulty swallowing, and changes in taste or tongue sensation. However, in dentistry, diagnosing a disease like cancer takes much more than spotting an abnormality on the lips, cheeks, gums, throat or the bones via X-ray. McCullough says a patient’s personal history plays a key role in determining whether an abnormality may be cancerous.
“Medical history, such as cancer in the family, or habits such as smoking, drinking and spending time in the sun are important,” he says. “HPV is also on the rise, with warts possibly turning into cancer.”
Dr. Timothy Winlow works at one of Capital Dentistry’s Gatineau locations. “Taking the patient’s detailed history also includes asking about the duration of the presentation, whatever it may be, of any sort of symptoms, pain, swelling and loss of sensation,” he adds. “But it’s important to note that oral cancer isn’t common, so if I see a white lesion on the cheek, I’m more likely to think it’s an autoimmune issue.”
In fact, the Canadian Cancer Society reports that in 2020, an estimated 5,400 Canadians will be diagnosed with oral cavity cancer. However, says Winlow, when present, cancer cells can spread from the mouth to other parts of the body. This spread, known as metastasis, can, for example, affect the muscle surrounding the mouth, lymph nodes in the neck, bone surrounding the mouth, the liver, lungs and the brain.
Once a dentist suspects cancer, says McCullough, they will either perform or send the patient for a biopsy and further testing. He also suggests that preventative measures can be extremely helpful in reducing the risk of oral cancer or catching it early enough for effective treatment.
Each visit serves as a unique opportunity for a dentist to not only play a role in your oral health but also in protecting your overall health. PHOTO BY SUPPLIED
“It’s simple things that can make such a difference,” he says. “Make sure you protect your lips from the sun, limit your drinking, don’t smoke, and ensure you have a nutritious diet. Also, it’s important to do checkups routinely and get X-rays because we have to see the bones to ensure nothing has developed. Of course, the sooner cancer is diagnosed, the better.”
The sooner the better philosophy applies to other diseases, too. While diabetes is typically associated with causing harm to eyes, nerves, kidneys, the heart and other systems in the body, it can also create problems in the mouth. For example, those with diabetes have a higher chance of developing periodontal disease, an infection of the gums and bones that hold the teeth in place. Diabetes can also slow healing, interfering with periodontal disease treatment.
“If the diabetes is uncontrolled, people will end up with poor blood circulation, which includes reduced circulation in the oral environment, so there is more of a chance of the body not having a defense against bacteria,” says McCullough. “If bacteria from gum infections enters the blood stream, it also has the potential to worsen or increase the risk of other health issues.”
Again, in addition to getting diabetes under control by monitoring blood sugar levels, regular dental visits are important. The American Dental Association reports that research suggests treating gum disease can help improve blood sugar control in patients living with diabetes, decreasing the progression of the disease.
Beyond diabetes and cancer, Winlow says patients may be surprised to learn dentists can also play a role in spotting other serious health conditions such as vitamin B12 deficiency, syphilis, herpes, HPV, mental health disorders that may cause a patient to cause self-injury, bulimia and drug use.