chronic health conditions. “We have an
advantage over the physicians, because we
see patients more frequently—normally
twice a year, possibly three or four times,”
says Costco member Dr. Joseph V. Franco
Jr., an assistant professor and assistant
director of dental clinics at Creighton
University’s School of Dentistry in Omaha.
“I think we have a better rapport with the
patients from seeing them more often.”
Dentists may be concerned by the fol-
lowing common symptoms.
Bleeding gums. Bleeding gums are a
classic sign of periodontal disease, but if
they don’t improve with treatment, you
may have other problems. “When somebody goes through the periodontal work, is
flossing and brushing, everything looks
great, but they’re still bleeding, we may
suspect Type ; diabetes,” Franco says.
Mouth sores. Certain sores are signs of
human papillomavirus, which can develop
into cancer. Other sores aren’t cancerous
but may indicate other health problems. “A
common one is shingles, which is ... very
painful ,” Franco says. “We see it a lot in the
oral cavity. It’s a fairly easy one for us to distinguish, because shingles never goes past
the midline of your mouth.”
Damaged enamel. Long-term exposure
to acid can wear away the protective
enamel on teeth. People with gastroesoph-ageal reflux disease or bulimia often have
stomach acid in their mouths, which
causes problems that only dentists see.
“On the inside, the enamel will be all gone,
and the teeth will have a yellow color,”
Franco says. “On the lip side, the teeth are
white, the normal color.”
Dry mouth. Diabetes, Sjögren’s syndrome, antidepressants and blood pressure medications can cause dry mouth,
which makes you prone to cavities. “The
first thing we’re going to look at is [the
patient’s] medication list, because I think
that’s the most common reason for dry
mouth,” Franco says. “If you don’t have
that saliva, that food just sits there on
your teeth all day.”
Bad breath. Poor oral-hygiene habits
and periodontal disease are the usual culprits. If bad breath persists, stomach acid
Costco members will find manual and
electric toothbrushes and replacement
heads, a variety of toothpastes, floss, oral
rinse, teeth whiteners and more at Costco
and on Costco.com.
may be to blame. “They could have gastric
reflux, which could be giving them bad
breath,” Cram says.
Sugary breath is also concerning.
“Sweet-smelling candy breath is an indicator of our uncontrolled diabetics,” says
Costco member Dr. Diane Sullivan, a clinical associate professor at the University of
Texas Health Science Center at San
Antonio School of Dentistry.
Tooth loss. Older patients are more
likely to lose teeth. Osteoporosis may play
a role, but poor brushing is often to blame,
especially among patients with dementia.
“They may lose dexterity and their ability
to provide oral care for themselves,”
Sullivan says. “Maybe they don’t have the
hand strength or the grip to hold a tooth-
brush properly or to floss.”
By seeing your dentist regularly, you
can stay on top of your overall health.
“A lot of times, when we see something, it’s in the early stages, and it’s really
easy to correct,” Franco says. C
Lisa Fields is a New Jersey–based freelance
writer who covers health and other issues.
FOR YOUR HEALTH
Focusing on your
a lot about your
DENTISTS sometimes uncover
clues about health, like:
Heart attack warnings.
Panoramic X-rays show the
carotid artery; dentists may
see that it’s blocked. “We tell
them to go immediately to the
physician, because that could
be a warning sign for a heart
attack,” says Dr. Joseph V.
Thyroid problems. A thorough dentist looks beyond the
oral cavity. “We do a head and
neck exam,” Dr. Diane Sullivan
says. “We look for abnormali-ties in the thyroid, lymph
nodes, salivary glands.”
Sleep apnea. Dentists
can guess your sleep habits.
“With mouth breathing, [the
patient’s] mouth is going to be
open, and you’re going to see
the tissue be a little bit red in
the front,” Franco says. “The
tongue has little indentations
on the side of it on both sides,
and the indentations match up
with the teeth.”—LF
BY LISA FIELDS
WHEN YOUR DENTIST peers into your
mouth, she isn’t just checking for cavities
and gum disease. She’s also looking for
signs of oral cancer, diabetes, acid reflux
and more. If she spots anything worrisome, she’ll send you to a doctor.
“For so long, dentistry and medicine
were their own separate entities,” says
American Dental Association spokesper-son Dr. Sally Cram, a periodontist in
Washington, D.C., and a Costco member.
“It has become more commonplace now for
physicians and dentists to work together.”
Dentists have become front-line
health care providers, screening for