If you suffer from irritating ulcers or bleeding gums, it could be your body giving you signs that something’s not quite right. Oral Health Expert and Gum Specialist Dr Reena Wadi, Founder of RW Perio, has the lowdown on the signs that can indicate other health conditions.
Redness around the mouth
Redness or inflammation around the corners of the mouth with or without skin breakdown and crusting can be symptomless, itchy or painful. This commonly affects the elderly, although it is thought that in about 25 per cent of people, an iron or vitamin B deficiency is involved. Chronic iron deficiency can also cause a red tongue.
Bleeding gums are not normal—it is a way of your body telling you that something isn’t quite right and shouldn’t be ignored. After all, you wouldn’t ignore bleeding from another part of the body. Bleeding gums after brushing or flossing is usually the first sign of gum disease, also known as periodontal disease or periodontitis. Periodontitis is the most common chronic inflammatory disease in humans but unfortunately amongst the least acknowledged. The mouth is connected with the rest of the body, and there is now lots of evidence which suggests links between gum disease and health conditions such as diabetes, heart disease and kidney disease. Very rarely, sudden and profuse bleeding gums can be a sign of a more serious disease such as leukaemia.
Medication often taken for high blood pressure, epilepsy or after a transplant can cause the gums to overgrow in the presence of plaque. Often it’s possible for your dentist or gum specialist to liaise with your GP to substitute the medication to something which doesn’t have such an unpleasant side effect. It’s important to address this as overgrown gums are difficult to clean, and will increase your risk of gum disease.
Gum colour varies from person to person and pigmentation is usually racial, a bit like freckles on the skin. However, there are two health conditions where pigmentation of the gums is a key sign: Addison’s disease is a disorder which stops the adrenal glands from producing enough hormones and as this disease progresses, a person may experience pigmentation or darkening of the gums, while Peutz-Jeghers syndrome is a genetic condition that can increase the risk of developing polyps or cancer. One of the early symptoms is the appearance of dark blue or dark brown freckles which can appear on the mouth, as well as on the skin of the fingers and toes.
Stress has a big impact on the body and doesn’t miss out the mouth. Tooth-grinding, which can lead to worn down flat teeth, is often related to stress or anxiety. Most teeth grinders aren't aware they're doing it, often while sleeping, concentrating or under stress. Flat teeth are also often associated with headaches and jaw pain. If you are grinding in the night, your dentist can make you a mouthguard to help reduce this or at least prevent damage.
Translucent, shiny teeth are usually due to ‘dental erosion’, caused by acid wearing away the enamel part of the tooth. Teeth can also start to chip and look more yellow. The acid can be from the diet or internal acid from the stomach due to acid reflux—your stomach produces natural acids that help your body digest food. Sometimes, these acids travel up the throat and into the mouth, especially after a large meal. Ordinarily, our saliva rebalances the acid levels in our mouth, but for those who suffer from gastroesophageal reflux, also known as acid reflux or GERD, gastric acids reach the mouth throughout the day. About 5 to 10 per cent of people with GERD develop Barrett's oesophagus, which is where stomach acid causes precancerous changes in cells. The good news is that only one per cent of people with Barrett's oesophagus will get oesophageal cancer. Doctors can remove the abnormal cells when they diagnose you early on.
Mouth ulcers are painful, swollen sores that that can be white, red, yellow or grey in colour. Stress and anxiety are a common trigger. Mouth ulcers can sometimes be caused by certain medical conditions, such as viral infections (including the cold sore virus), vitamin B12 or iron deficiency, Crohn’s disease, Coeliac disease, a weakened immune system (e.g due to HIV/AIDS or lupus) and Behçet’s disease.
White patches in the mouth are usually harmless and can be as a result of smoking, local irritants or oral thrush. However, on rare occasions, these white patches may be a sign of HIV or cancer.
Bad breath, or halitosis, affects one third of the population and concerns about halitosis are estimated to be the third most frequent reason for seeking dental care. The two most common causes are a tongue coating and gum disease. However, sometimes halitosis may originate from other parts of the body and may be a sign of another disease: a sweet, fruity odour can be a sign of ketoacidosis, an acute complication of diabetes, a fishy smell
may indicate kidney disease, an acidic smell
can be a sign of asthma or cystic fibrosis, a scent of ammonia
can indicate kidney problems and a sweet, musty odour
may signal liver cirrhosis.
The main cause of dry mouth is dehydration. There are many different opinions on how much water you should be drinking—health authorities recommend around two litres a day. Another common reason is due to side effects from medications. Sometimes a dry mouth that doesn't go away may be caused by a condition like diabetes or Sjögren's syndrome.