Your Mouth Is a Window to Your Health

After 25 years in dentistry, I'm still learning!

I recently spent 14 hours over a weekend attending a course on Dental Wellness, and it was a really interesting reminder of just how closely our oral health is connected to our general health.

We've always said that the mouth is a window to the rest of the body, but the more we learn about these connections, the more we realise how much they can influence the way we care for our patients.

The connection between gum disease and diabetes

Diabetes and periodontal (gum) disease are a good example. People with diabetes are approximately two to three times more likely to develop periodontal disease, particularly when their blood sugar is poorly controlled. What's interesting is that this relationship works both ways. Periodontal disease is also associated with poorer blood sugar control, and the inflammation associated with gum disease can make diabetes more difficult to manage.

This is particularly relevant when we're planning dental treatment, as poorly controlled diabetes can affect healing and increase the risk of infection and other complications following certain procedures. For example, if we're planning an implant for a patient whose blood sugar is poorly controlled, it may be better to delay dental treatment and work with their physician to improve their diabetic control before proceeding. In certain cases it could make a significant difference to the outcome.

It's a good example of why treatment planning isn't always just about what needs to be done, but also when it's best to do it.

What else can your mouth tell us?

Diabetes isn't the only medical condition with connections to oral health. Certain conditions, including inflammatory bowel diseases such as Crohn's disease, can sometimes cause changes in the mouth, such as persistent ulcers or unusual inflammation, months or even years before the condition is diagnosed.

As dentists, we may be the first to notice these changes, which gives us an opportunity to ask further questions and, where appropriate, recommend that a patient seek medical advice.

Why we check your blood pressure

We've been routinely checking our patients' blood pressure at Serpentine Dental Care since 2023, and there are several reasons why we feel this is important.

Dental treatment can be stressful for some patients, and anxiety or discomfort can cause blood pressure to rise temporarily. For patients with hypertension or other cardiovascular concerns, knowing their blood pressure helps us assess the risks and make safer decisions about their treatment.

But something else we've discovered is that we're sometimes the first healthcare professionals to identify that a patient's blood pressure is elevated. We've had patients who haven't visited their physician in years and were completely unaware that they had high blood pressure. It's often called the silent killer because it usually doesn't cause any noticeable symptoms.

In other cases, we find that patients haven't been taking their prescribed medication regularly, or that their blood pressure is still elevated despite taking medication. This may be an indication that they need to return to their physician for a review.

Of course, an elevated reading doesn't automatically mean that dental treatment cannot proceed. Sometimes it's related to dental anxiety, and allowing the patient time to relax, repeating the measurement or helping them manage their anxiety may make a difference. In other situations, we may recommend a medical review before proceeding, particularly if we're planning an elective procedure.

This could be frustrating for patients, especially when they're feeling perfectly well and have come in expecting to have their dental treatment completed. But we also have a responsibility to consider their general health and avoid putting them at unnecessary risk. Most of our patients appreciate the extra care, and we're always happy to work with them to find a way forward that allows them to receive the dental treatment they need as safely and comfortably as possible.

What this means for your dental care

One of the things I took away from the Dental Wellness course was the importance of considering what else might be contributing to a problem we're seeing in the mouth.

If a patient has unusually severe gum disease, recurrent infections or unexpected healing problems, perhaps we need to ask a few more questions rather than simply advising them to floss more.

Sometimes it may be useful to ask whether they've had recent bloodwork, particularly if we're concerned about conditions such as diabetes. We're not suggesting that everyone needs additional medical tests, but reviewing existing medical information or communicating with a patient's physician can sometimes help us understand what's happening and make better treatment decisions.

The overlap between medicine and dentistry is becoming increasingly important, and I am particularly interested in this connection. Our mouths are part of our bodies after all, so it makes sense that what happens in one can affect the other.

So the next time we ask questions that don't seem directly related to your teeth, check your blood pressure or suggest addressing a medical concern before proceeding with treatment, you'll have a better understanding of why we do these things.

We want our patients to have healthy teeth and gums, of course, but we're also interested in their overall health and wellbeing. Another very good reason to keep up with your regular dental visits!

Dr. Christiana Lee

Serpentine Dental Care | Maraval, Trinidad and Tobago