THE HEART OF THE MATTER
a special program of the National Emergency Medicine Association (NEMA) 

Week: 521.2 Guest: Mike Siegel, M.D. Topic: Dental Problems and Indicators Host: Steve Girard Producer: Ed Graham

NEMA: It's said the eyes are the windows of the soul....well, your mouth also provides a window of sorts to your dentist, who looks inside and can find some indicators of your dental ... and overall health. We're spending some time with Dr. Mike Siegel, Associate Dean of Clinical Affairs at the University of Maryland Dental School.....Mike, let's start with the basic conditions you watch out for in a patient's mouth.....

Siegel: The two most common diseases that dentists see in the mouth are dental decay, or dental caries as they're called in the profession, and periodontal diseases, which are those structures which support the teeth and hold them in your mouth.

NEMA: How about a primer on the main cause behind decay and periodontal disease?

Siegel: In your mouth, and for that matter, in your entire gastro-intestinal tract, there are bacteria that live there...they're called host flora. That is these bacteria live within your mouth and don't do any damage, unless given the opportunity to do so. And as you eat things like sugar, the bacteria use that sugar to multiply and to grow, and the by-product of what they produce is acid....that acid, unfortunately demineralizes the surface of your teeth, and sets the teeth up for decay. The acid also starts to break down the gums and the structures that hold your teeth in the mouth and that's what leads to periodontal disease. So the basis of all of this is the sugar in your diet, and removing that from the surface of your teeth.

NEMA: One complication of not taking care of your teeth...and having decay and periodontal disease as a result...is a potential lack of nutrition.....

Siegel: Its very difficult to enjoy a meal, if every time you chew or drink something cold you're in pain! So, what most people do is they avoid what causes them pain and they stop eating and they tend to nourish themselves inappropriately. So clearly it affects you entire body in that way.

NEMA: What can a dentist tell about your overall health from an oral examination? Can't some oral problems have some wide ranging indications or complications?

Siegel: The mouth is almost a mirror of the entire body. Anything from certain allergies to drugs to chicken pox can show up in your mouth...but I think what you're referring to is a disease something like diabetes...when diabetes, when diabetes is not controlled- because your body can't fight infection, any infection, even a minor infection in your mouth, might get blown out of control. And any dental student or dentist is taught that if they see a mouth with terrible periodontal disease, very loose teeth, bleeding gums, inability to chew properly...one of the things they'll ask their patient is about diabetes to make sure the mouth isn't an indicator of diabetes that has yet to be diagnosed. Now the other side of that is if the diabetes is well controlled, the mouth will be well controlled also.

NEMA: If someone notices something out of the ordinary in their mouth...what should they do?

Siegel: Its always good to start with your family dentist. These are people who are trained to know the area...and to know what to look for, and dentists are also trained that if they get an inkling that this might be more than just a local problem to the mouth, to get hold of your family physician, so the two of them can get together to do what's in your best interest.

NEMA: Thanks Dr. Siegel...Y'know the dentist is the first line of awareness to some potentially serious health conditions...develop a good, confident relationship with one. I'm SG.