How your dentist could save your life

A woman smiles as she reclines in a dentist's chair.

"Open wide." It's our main task when we sit in the dentist's chair, and we might assume our dentist has one job, too — to assess the condition of our teeth.

But looking for plaque, cavities, and gum disease is only part of the picture. Dentists have a prime vantage point to be the first line of defense in identifying problems all over the body. More than 100 conditions can produce signs in the mouth, according to the American Heart Association, and dental training enables these clinicians to spot telltale clues in the teeth, gums, tongue, palate, lips, jaw, face, and neck.

"I think individuals should view their dentists as an indispensable part of their health care team," says Dr. Christine Riedy, an associate professor in oral public health and epidemiology at the Harvard School of Dental Medicine. "Some people describe the mouth as the gateway to the body and oral health as the canary in the coal mine. It's true — dentists might see things that can indicate other things happening in the body."

A lengthy list of threats

What conditions can dentists detect, and what signs are they looking for?

Oral cancer. Rough spots, swelling, bumps, or unexplained bleeding in the mouth might signal head and neck cancers, as do irregularities in the face, lips, jaw, or neck. While head and neck malignancies account for only about 4% of all cancers in the United States, they're more prevalent in older adults. "Patches of mucosa that are either red or white, as well as lumps or sores, are some of the things dentists would find suspicious," Dr. Riedy says. "Seeing your dentist on a regular basis is really important to pick up those changes." (See "Anxiety-busting strategies for visiting the dentist.")

Diabetes. About 9% of Americans have been diagnosed with diabetes, but an estimated 23% of adults who have the condition don't know it, according to the National Institutes of Health. When sugar levels are elevated in the blood, they're also elevated in saliva. Bacteria in dental plaque feed on that, fueling inflamed and bleeding gums. Diabetes can also lead to dry mouth and infections in the mouth that take longer to heal. "Some dentists have put HbA1c tests [which measure average blood sugar levels over the past three months] into their screening toolkit to better understand whether a patient has diabetes," Dr. Riedy says.

Sleep apnea. More than a quarter of American adults are believed to have sleep apnea: a pattern of frequent lapses in breathing during sleep, often accompanied by heavy snoring. Untreated, the condition raises risk for serious conditions such as heart disease, diabetes, and stroke. Dentists might suspect sleep apnea if they notice enlargement of the tonsils, tongue, or jaw muscles; a red throat; or signs of teeth grinding. "Because people with sleep apnea sleep with their mouth open, they can get dry mouth, which also creates an environment for oral disease," she says.

Osteoporosis. Four times as common among older women than men, the progressive loss of bone density characterizing this condition might show up on x-rays of the teeth and jaw. Missing and loose teeth can also be a tip-off. "With the loss of bone density, the jawbone becomes weaker, and teeth lose their stability," Dr. Riedy says.

Acid reflux. Eroded enamel on back teeth is a major clue someone has acid reflux, and their teeth may also be discolored. "People may experience heartburn and not realize that gastric acid has actually reached their mouth," she says. "They think it's only centered in the chest."

Eating disorders. Surprisingly, Dr. Riedy says, dentists are often the first health care providers to recognize signs of eating disorders, particularly among people who purge by vomiting. Many people with eating disorders — which affect girls and women twice as often as males — engage in binge-purge cycles that don't substantially affect their weight or appearance. "Outwardly, maybe they don't look like they have an eating disorder, but dentists can see deterioration of the back teeth and enamel erosion due to acid," she says.

Anxiety-busting strategies for visiting the dentist

Dentists can root out our health problems — whether in the mouth or elsewhere — only if we schedule an appointment. But while we're supposed to see our dentist every six months, many people view that recommendation as optional. Only two-thirds of American adults visited a dentist in the past year, according to the CDC.

Why the low attendance? A big part of it is fear, says Dr. Christine Riedy, an associate professor in oral public health and epidemiology at the Harvard School of Dental Medicine. An estimated 15% of people across the world report dental anxiety — women more often than men, according to an April 2023 study in Health Affairs.

Whether it's pain, needles, or a loss of control, various aspects of dental care might contribute to reluctance to see a dentist. So can an unpleasant encounter in the past or embarrassment about oral health. Some people don't like when a dentist or hygienist leans close to their face. Some worry about how their breath smells.

But there are ways you can reclaim a calmer frame of mind when you approach the dental chair. Dr. Riedy suggests these strategies:

Distraction. Listen to music or a podcast through headphones. Some dentists also offer music or videos that help divert your attention. "Try to focus on something other than what's happening in your mouth," she says.

Relaxation techniques. Meditation can lower stress levels, and "deep breathing can slow your heart rate and help you get yourself more in control," Dr. Riedy says.

Sedation. Ask your dentist if she can administer medication that calms and relaxes you during treatment, such as nitrous oxide (laughing gas). Some dentists will provide a prescription for an oral sedative you can take at home before your visit, as long as you have someone to drive you.

Bring a buddy. "Having someone you trust come with you to the appointment can help reduce some of your anxiety," she says.

Maximizing your dental check ups

If your dentist notices signs of another health problem, she'll likely refer you to your primary care doctor or an appropriate specialist. But you can also make it easier for her to gather as much useful information as possible during dental check-ups.

"It may sound basic, but often your dentist will ask if you have any health updates," Dr. Riedy says. "Sharing your health history and any updates can be really important, and asking questions is crucial."

It's also essential to voice any health concerns to your dentist, just as you would with your primary care doctor. You may believe a problem with another aspect of your health has nothing to do with your oral health, but you might be wrong. "Be an advocate for your own care," she says.