NEW YORK, New York--Though beauty is often in the eye of the beholder, one characteristic shared by beautiful things is that they are healthy.
Some of the most admired images of beauty: radiant skin, shiny hair and a fit body are a result of a healthy and well-maintained lifestyle. Most gym enthusiasts are loyal to their workouts because it's an effective way to achieve an aesthetic physical goal and the benefit to their internal health is considered a bonus.
However, these same people often approach their dental care with less determination and more as a hygienic practice. They brush their teeth to keep them clean and to avoid bad breath. When discoloration appears or a tooth loosens, they chalk it up to getting older without realizing just how deep the connection between oral health and overall health runs.
Looking into a person's mouth is a lot like taking a look under the hood of a car. It provides an inside peek into what's working properly and what isn't.
"More than 90 percent of systemic conditions such as heart disease and diabetes are linked to symptoms in the mouth," said Dr. Daniel Noor, a New York City dentist. "People are hesitant to address what they see as exclusively cosmetic issues like inflamed gums, missing or discolored teeth and loose teeth; however, these conditions are not only aesthetically unattractive, but may be symptoms of very serious illnesses."
A healthy smile is a beautiful smile
The most common issues that tarnish a smile are malaligned teeth, tooth discoloration, missing or loose teeth and gum disease. Dr. Noor says that these problems are also indicative of an underlying health concern and once that concern is addressed, cosmetic measures are very successful.
Malaligned teeth: While crooked teeth are common, when the problem originated needs to be considered. If a person's teeth have always been crowded and overlapping, the case can be treated as solely cosmetic, but movement that happened later in life or the loosening of teeth in adulthood often indicates a problem with the tooth's supporting structures.
Osteoporosis, the most common metabolic bone disease in the United States, is characterized by a reduced amount of calcium and phosphorus in the body. Since about 99 percent of the body's calcium is stored in bones and teeth, the mouth is particularly vulnerable to osteoporosis and bone loss in the oral cavity only worsens with age. As many as 94 percent of American women age 65 and older have dental bone loss. Since osteoporosis and the resulting oral bone loss are both largely asymptomatic, Dr. Noor says that it is very important to let your dentist take a look when teeth loosen or shift.
Invisalign and Lumineers: For adult women, who are at greatest risk for osteoporosis, it is especially important to consult a dental professional when they notice that a tooth has become loose.
"Women tend to ignore their own needs, especially mothers and especially when that need is viewed as cosmetic," said Dr. Noor. "But they don't realize that what they thought was an ugly tooth is also an early indicator of a serious disease."
Once the disease is addressed, Invisalign and Lumineers are options to correct the esthetic. Since Invisalign is removable, patients are able to maintain their oral health routine easily, especially when osteoporosis is in the picture and oral health is a priority. Furthermore, Dr. Noor adds that the technologically advanced Lumineers do not require a doctor to shave down a patient's teeth, bypassing significant pain and rendering the process reversible.
Discoloration: Discolored teeth can be caused by drinking coffee, tea and soda or by smoking but they also can be a sign of severe nutritional deficiencies and bulimia. The acid in vomit causes tooth enamel to erode and when someone is bulimic that exposure is constant and actually destroys the enamel. Some patients may mistakenly believe that the discoloration is superficial and can be treated with a simple whitening agent but most often, the tooth has actually lost its white coating. Sensitive situations like this should be handled with special care because these patients are often embarrassed and have avoided treatment for the underlying problem. When a cosmetic issue arises from the practice of regular purging, a dentist is often the only health professional that the patient consults.
"My specialty is dentistry but first I am a doctor and my patients depend on me for the best care possible," said Dr. Noor. "When a young woman comes into my office bearing the signs of bulimia on her teeth, I counsel her to seek the help of a physician before I treat the cosmetic signs of her illness."
Crowns: Dr. Noor says that patients struggling with bulimia often come to him for dental whitening but the damage done to teeth from habitual purging far exceeds the capabilities of any whitening agent. The only way to reverse the damage done to enamel is by rebuilding the tooth with crowns. This cosmetic measure should be taken after the illness is under control. Dental crowns, and the existing tooth structure, are subject to damage if the patient continues to vomit.
Missing Teeth: Diabetes wreaks havoc on a patient's mouth. It can increase the risk of gum disease, cavities and cause uncomfortable bouts of "dry mouth" as well as a variety of oral infections. It can also trigger sudden tooth loss thanks to the high blood sugar caused by diabetes. That higher-than-normal blood sugar leads to the production of greater levels of acids. More acid leads to more bacteria, which feed on the sugars literally eating away at the tooth. Tooth loss in an adult who is in the prime of their life can be an early warning sign of diabetes.
"Diabetes is a disease that we know bears an impact on infections in the bones and gum around the teeth. I let patients know that we can help them cosmetically but when signs of illnesses are present, treating the cosmetic issue along is like sweeping dirt under the rug," Dr. Noor said.
Restorations or dental implants: Damage to teeth due to the high blood sugar levels of diabetes can be minimized with regular visits to the dentist. Once the underlying issue is addressed and handled properly, very effective cosmetic approaches can be taken. Dr. Noor says that an expert with an artful and deliberate approach can craft dental implants that often exceed the patient's expectations. He also points out that dental implants are one of the few cosmetic treatments that actually add to the patient's health and are one of the most successful clinical treatments in medicine and dentistry. The pressure they put on the gum and bone is necessary. Without a tooth, the gum and bone will continue to recede. Implants can be either created as a single restoration or if multiple teeth are missing, the doctor can create multiple restorations fashioned to suit the patient's smile. With such implants, patients can eat, drink and talk with ease.
Gum Disease: "When someone has chronic gum inflammation, I take it as a significant indicator that the person may have a number of diseases," Dr. Noor said. "Pericoronitis, an infection in the gum tissue around a tooth, is very difficult to treat without removing parts of the gum or even a tooth and is a precursor to very serious heart illness."
Pericoronitis is a painful infection that causes gum tissue, often around wisdom teeth, to swell though it can appear in any situation where food or plaque gets caught underneath a flap of gum. That infection provides a gateway for the bacteria in the mouth to travel directly into the bloodstream, and likely into the heart. According to the American Academy of Periodontology, pericoronitis is the strongest predictor of coronary disease--a fact of which many people are unaware. Bleeding gums and other fungal infections can mar a smile and are also among the most infamous oral signs clueing dentists into other serious health issues like diabetes, leukemia and HIV. They attack the immune system, increasing the risk of gum disease and according to a UCLA study, 90 percent of people living with HIV have at least one dental manifestation of the disease. Some of them materialize before a diagnosis is even made.
Laser gum revision: Addressing unattractive gum diseases is vital. Left alone they will only worsen, leading to heart disease or further compromising the immune system of a patient unknowingly suffering from leukemia or HIV. Laser gum revision can remove the excess or uneven gums that result from pericoronitis as well as use soft tissue grafts to build up areas where the gums may have receded. The cosmetic results are also great: it corrects overly "gummy" smiles (when a person's gums appear too prominently in a smile) as well as "horsey" smiles (when the view of someone's teeth takes up the entire smile).
Taken at face value, most symptoms that appear in the mouth like discolored teeth or inflamed gums are considered strictly cosmetic when in many cases they are actually indicators of serious diseases. Illnesses like diabetes and even HIV frequently trigger symptoms in the mouth before any other part of the body and ignoring these signs can prevent an early diagnosis. By taking these signs seriously, a dentist is often the first line of defense in a person's health care regiment.
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