Some seemingly minor warning signs in the mouth may indicate health problems that go beyond teeth and gums, from infections, diabetes, and heart disease to some types of cancer.
Doctors say the mouth can be a vital window into the body's health, as it contains billions of bacteria and is the entry point for everything we eat, drink, and breathe. In some cases, changes in the mouth can be early signs of other health problems.
Dr. Yev Davidov, a general dentist in New York, said: "The mouth is the only part of the body where a doctor can see bone, soft tissue, blood vessels, and bacteria all at once, without having to make any surgical incision."
Here are the most important signs that should not be ignored:
Toothache may seem like the first sign of a problem, but in many cases it comes too late.
Davidov said that pain usually appears after decay has been developing for a long time. Decay begins when bacteria in the mouth feed on sugars and starches, producing acids that erode tooth enamel after plaque builds up and turns into tartar.
In the early stages, tooth decay may not cause any symptoms, then sensitivity to cold drinks and sweets appears, before pain begins when the decay reaches the tooth nerve.
Dr. Camille Hoss, an orthodontist, warned that the disappearance of pain does not mean the problem is over, as the nerve may have died, while the infection continues to develop.
He added that untreated tooth decay can lead to an abscess, and the infection can spread to the jawbone, sinuses, and surrounding tissues. Untreated dental and gum diseases have also been linked to a number of other health problems, due to the role of chronic inflammation and bacteria.
Frequent bleeding gums is not normal and may be a sign of gingivitis or periodontal disease.
"The gums are not sensitive, they are inflamed," said Hoss, noting that repeated bleeding warrants attention, especially if it continues for weeks.
In advanced stages, bacteria can reach below the gum line, leading to inflammation and damage to the bone that supports the teeth, and may ultimately result in tooth loss.
Periodontitis has also been linked to other health problems, such as heart disease, stroke, and diabetes.
In some rare cases, unusual bleeding, especially if accompanied by bruising, fatigue, or fever, may indicate blood clotting disorders or diseases such as leukemia, which requires medical evaluation.
If a tooth starts to loosen in an adult, it should not be ignored.
Davidov explained that teeth are held in place within the jawbone by ligaments, so loose teeth can indicate damage to the bone or supporting tissues. Advanced gum disease is often the cause, while teeth grinding during sleep can also contribute to the problem.
In rare cases, the loosening of a single tooth without a clear cause may be a sign of a tumor or cyst in the jaw, so the condition may require imaging tests and a thorough diagnosis.
Bad breath may be temporary and caused by certain foods, such as garlic and fish, but if it persists despite brushing your teeth, it may indicate a problem that needs to be diagnosed.
Some types of bacteria that accumulate under the gums or on the tongue produce compounds that cause bad breath, and dry mouth is a common cause that many people may overlook.
Hoss said that saliva helps neutralize acids and wash away bacteria, so a decrease in its secretion due to certain medications, mouth breathing, or the use of mouthwashes containing alcohol may increase oral problems.
A persistent bad taste may also be associated with other health conditions, such as Sjögren's syndrome or kidney disease.
Most mouth ulcers are minor and disappear on their own, but any ulcer, lump, or white or red spot that does not heal within two weeks warrants examination.
Davidoff said that these signs could, in some cases, be an indication of oral cancer, especially if they appear on the tongue.
Oral cancer is linked to several risk factors, most notably smoking, excessive alcohol consumption, and certain human papillomavirus (HPV) infections. Recurrent ulcers may also be associated with iron or folic acid deficiencies, or with some autoimmune diseases.
Prevention begins with simple steps: brushing teeth twice a day with fluoride toothpaste, using dental floss, avoiding smoking, drinking enough water, and having regular professional dental checkups and cleanings.
People with a history of gum disease may need to see a dentist more frequently, depending on their condition.
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