Dr. Ligia Stanca Muntianu, LSDM
Generally, many illnesses have early signs in the oral cavity. Not only that your dentist can recommend a visit to other specialties in order to improve your health, but she can collaborate with other specialists in order to be able to deliver dental treatment with the best outcome.
Integrative medicine sounds very complicated but if we think a little, it is quite very simple.
Gums, teeth, and the whole person
As a dentist, you can not just think about teeth and gums because your patient is not just teeth and gums, but a whole human being. Teeth and gums are integrated into a body. And that body functions as a whole. Whatever disfunction of dis-ease affects the whole body not just locally the spot where it happens. Even if you don’t realize when a tooth hurts, maybe you can also have a headache, pain by itself produces changes in all your body, and signals are being transmitted through the neuro-vegetative system in order to mobilize mechanisms of defense and repair.
When a person suffers from a disease, this illness determines modifications all over including the oral cavity. There are two main aspects to discuss when talking about integrative medicine
One is how can a general illness affect the structures of the oral cavity
The other is about early signs present in the oral cavity that can indicate the presence of a certain illness which is not yet manifested of the patient does not know about yet
In the dental office at the first visit, your dentist will perform a consultation. This consultation does not involve only the oral cavity but also your head and neck. The methods used for clinical examination include inspection, palpation percussion, and auscultation.
Inspection refers to everything the doctor can see when looking at a patient. In dentistry it means, the overall aspects of somatic development, nervous tics, body appearance, body symmetry, the form of the face, skin color and integrity, symmetry of the face, lips aspect color symmetry, plenitude, aesthetic aspects, eyes position, the opening of the mouth, particular signs, etc. Inside the mouth, an inspection gives information about the aspect, color integrity, and symmetry of all structures present there and the oropharynx. Palpation means information a doctor can gather by touching the body either with his hands or with a blunt instrument.
In dentistry, we palpate manually with the hands, nervous points, muscles of the head and neck, lymph nodes, bone structures, temporomandibular joint (TMJ), maxillary sinus, the oral floor of the mouth. Instrumental palpation usually is performed in the oral cavity and is involves typical instruments in the dental kit. We palpate teeth, muscles of the palatal veil, edentate ridge the depth of the periodontal grove.
Percussion means gathering information by hearing and listening when a structure is being hit either by hand or an instrument. Dentists do that with an instrument and usually inside the mouth
Auscultation means also gathering information by hearing and listening only this time you want to hear and listen to how a function or activity is being done. Like listening to the heart or the lungs. In dentistry, we want to hear if the temporomandibular joint produces any sound at all because this means there is a profound injury there.
These methods are the same in all medicine.
Patient history means your dentist has to know your medical history in order to realize your general health state is, what illnesses you suffer from, what you are sensitive to, or what allergies you have, what medication you take. This information orients the dentist in customizing dental treatment according to each patient. There are of course paraclinical investigations which include various analyzes, imagistic investigations, all depending on what the doctor discovers or what's to see in this stage of consultation.
How does a general illness affect structures in the oral cavity
General diseases as I said previously produce modifications in all the body. Everyone knows that when one has hepatitis jaundice is present. That means his skin is lemon yellow. A person with a liver problem should receive anesthesia with an anesthetic that is eliminated through kidney metabolization and not through the liver.
If a patient has diabetes there are a lot of modifications in the oral cavity. Diabetes produces capillary fragility, put’s patient at risk of quick injury he bleeds easily, has a long and complicated healing time and they are prone to risk infection. They often suffer from paradontotic problems. Oral mucosa is very fragile.
The patient should inform the dentist about anticoagulant medication because otherwise, a simple extraction might put the patient at risk of losing his life.
Osteoporosis is a condition that requires special medication. This medication affects all body’s bones. In the oral cavity, it is a contraindication of implant treatment for someone who is on osteoporosis medication. It provokes osteonecrosis and implant failure. Extractions and sutures are difficult in such cases because the gingiva is more fragile than a jelly.
So it is important not to hide any information from your dentist when you go for a visit. Your own good is not only the dentist’s responsibility it is yours as well.
Signs in the oral cavity or around the head and neck that can indicate an ongoing disease the patient is not aware of
Very pale keratinized oral mucosa is characteristic of anemia.
A sore on the lip that doesn’t go away or pain in the mouth that does not go away may be signs of oral cancer.
Severe headaches may be the response of dental treatment when oral splints are involved but also might be a sign of brain cancer.
Gingivitis may be present one or two days before menstruation in women.
The use of contraceptive pills increases the inflammatory response to dental plaque. Acromegaly is an excess of growth hormone and results in an exaggerated growth of soft tissues tongue included.
White lacy patches, swollen tissues, or open sores present in the oral cavity may cause burning, pain, or another discomfort. These are signs of oral lichen planus. This is a chronic inflammatory condition that affects the mucous membrane inside the mouth. It is a condition that can lead to malignancy. Inflammation of supraclavicular lymph nodes on the left side is a pathognomonic and early sign of gastric cancer. So the dentist can immediately refer the patient to a specialist.
Generally, many illnesses have early signs in the oral cavity. Not only that your dentist can recommend a visit to other specialties in order to improve your health, but he can collaborate with other specialists in order to be able to deliver dental treatment with the best outcome.
So, it is worth visiting your dentist. When?...
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