What Your Dentist May Not Tell You about Your Oral Health

Linda J. Dobberstein, Chiropractor, Board Certified in Clinical Nutrition

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What Your Dentist May Not Tell You about Your Oral Health
Your mouth, teeth, tongue, and gums provide clues to the health of your body. Many of these clues are related to nutritional deficiencies or hidden underlying problems. Some of these signs are frequently passed off as normal or missed. Recognizing these clues often give us the first hint related to loss of optimal health. The body will sacrifice nutrition needed for superficial tissues and keep the best resources for the internal organs and brain to maintain health. Knowing that chapped lips, canker sores or other common mouth symptoms are linked with nutritional problems can make a difference in managing your health. Here are some of the more common problems.

1. Cracks at the Corner of the Mouth


This is also known as angular cheilitis. This may happen at one or both corners of the mouth. There may be redness, pain or burning, scaling of the skin, or bleeding at the cracks. There are a number of reasons for why this may happen. It may be related with simple irritation from excessive mouth washing, aggressive use of dental floss, or allergic reaction. It may be related with young children who use pacifiers or suck their thumbs. It may reflect a localized infection of Candida albicans or Staph. aureus is infection. Poorly managed diabetes is associated with a greater likelihood of developing these sores. It is possible to mistake this symptom for a problem with a Herpes cold sore or to have the presence of a cold sore with the cracks at the mouth corners. Poorly fitting dentures, inhalers, saliva disorders and smoking may co-exist or even contribute to the nutritional deficiencies associated with the skin cracks at the corners of the mouth.

Common nutritional deficits can cause cracks at the corners of the mouth. Vitamin B2, or riboflavin, is most frequently noted to cause this symptom. In addition, insufficient folate, vitamin B6, B12, iron, and low ferritin can also cause this skin breakdown around the mouth. These nutritional deficits are easily missed or ignored. Simply adding these nutrients to the diet and daily routine can readily improve this minor, uncomfortable problem.

Cracks in the corner of the mouth can also be a sign of bigger problems within the digestive tract. Inflammatory bowel disease and celiac disease are two digestive disorders that may present with angular cheilitis. It may also be seen with other systemic conditions like lupus. If the sores do not improve after improving nutrition and changing some of the irritating behaviors; work with your health care provider for further evaluation.

2. Recurrent Canker Sores


This is medically known at recurrent aphthous stomatitis. It is a small shallow ulcer or sore inside the mouth or at the base of the gums. This very common problem can be related with a number of concerns. Some of the causes may be related dental or tooth brush trauma. Smoking or other tobacco products may contribute. A number of medications can trigger the canker sore. These include some NSAIDs (diclofenac, proprionic acid, and piroxicam), gold salts, captopril, phenobarbital, and others.

Nutritional deficiencies are very common causes of canker sores. Lack of iron, vitamin B12 and folate increase the likelihood of recurrent mouth ulcers. Gluten intolerance, celiac disease, and inflammatory bowel disease are common autoimmune disorders that cause the reoccurring canker sores. Research has shown that repetitive canker sores may be the only sign of gluten intolerance or inflammatory bowel disease (Crohn’s disease and ulcerative colitis).

Other research has found that the common additive in toothpaste, sodium lauryl sulfate, increases the risk of canker sores. Researchers have looked for infectious agents that lead to canker sores. H. pylori and various herpes virus are suspect, but research is inconclusive on these particular germs. However, Epstein Barr Virus (EBV) has been linked with canker sores. If the mouth ulcers continue repeatedly, it can be related with other types of autoimmune disorders. Work with your provider for tough problems.

3. Smooth Tongue or Atrophic Glossitis


Atrophic glossitis refers to the appearance of the tongue. The tongue appears smooth, glossy or shiny with a red or pink background. The papillae on the tongue or the tiny red bumps/taste buds have atrophied. It is easily dismissed or under-recognized.

There are a number of health concerns related to atrophic glossitis or smooth tongue. These include problems with Candida overgrowth in the mouth, a number of autoimmune disorders like Sjogren’s syndrome, pernicious anemia, and sarcoidosis.

Several nutritional deficiencies can cause this tongue appearance. It is related to insufficient vitamin B2, B3, B12, folate, and iron, along with insufficient protein intake or poor protein digestion. It is also related to celiac disease or atypical celiac disease/gluten intolerance. Digestive symptoms are often absent or very few. The only clue may be related with a physical change of the tongue. Sometimes, individuals are misdiagnosed with burning mouth syndrome because of the painful inflammation of the tongue.

4. Fissured or Cracks in the Tongue


This is a tongue that appears to have cracks or grooves on the surface. The fissures can be deep or shallow, single or multiple. Often, there is a significant groove down the center of the tongue. This appearance has been considered a benign problem and not affiliated with any disorder. New research, however, shows that it may be linked with asthma, psoriasis, Down’s syndrome and another common tongue finding – geographic tongue. Researchers have also found a higher incidence of hypertension and diabetes in those with a fissured tongue. Research 3 published in February 2016 has identified inflammatory bowel disease and celiac disease related to the cracks in the tongue. The cracks are related to vitamin B3/niacin deficiency. Niacin is one nutrient essential for blood pressure and blood sugar management. Asian or acupuncture medicine may relate it to chronic dehydration and significant adrenal stress.

5. Chapped Lips


Chapped lips can easily happen because of environmental exposure to the elements like sun or wind, but there are other elements and reactions that cause chapped lips. Chapped lips are not a sign of insufficient Chapstick. Chapped lips may present as the only outward sign of a food allergy. For children with ear infections and swollen adenoids, the chapped lips may be part of the whole picture. The swelling that accompanies the chapped, peeling lips is an inflammatory reaction. Research shows that chronic chapped lips may be related with Crohn’s disease, an inflammatory bowel disease problem. The chapped lips may be the only symptom of this disease. Taking nutrients like vitamins A, D, and beta carotene help protect the skin and lips from oxidative stress and further damage.

6. Burning Tongue Syndrome


Barring the effects of burning the tongue from a hot beverage or food item, some individuals have chronic painful, burning or intense itching in their tongue. New research shows that this painful condition may be related to a type of neuropathy. The small nerve fibers in the tongue are hot, irritated, and inflamed causing the burning sensation. The medical treatment for burning tongue syndrome is often nerve deadening anti-seizure medications like Klonopin. This is why the antioxidant r-alpha lipoic acid works so well for burning tongue syndrome and other nerve related injuries.

There are numerous other changes that can occur with the mouth, like problems with thrush and Candida overgrowth. Many of these concerns provide the first clues that something else is going on in the body. Providing nutritional support with a high quality B-vitamin complex and if needed iron and r-alpha lipoic acid can go a long way towards a healthier mouth. Identifying food allergies, gluten intolerance, or the presence of other silent inflammatory bowel disease problems is essential if the problem persists. Ensuring adequate hydration and nourishment for the adrenal glands may also provide improvements to the appearance and oral health.

Improving the flora of your gut with healthy probiotics and fermented foods and digestive enzymes can help the absorption of the nutrients. We have seen that many times the mouth irritation provides the only clue that something bigger is happening with the entire digestive tract and immune system. The mouth is the first entry point of your digestive tract and is often not considered with digestive ailments or more systemic complaints, but yet it provides great insight into your health. If you have anything but a normal pink tongue covered in very small nodules or papillae (taste buds), then you need to have someone evaluate your tongue. What does your tongue or mouth say about your health?

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