Semi-annual dental exams are important, but they’re particularly significant if you are a tobacco user or if you have chronic health problems like heart disease or diabetes. Recent studies have increasingly shown a strong connection between dental disease and these chronic health problems.

Tooth Pain

"Pain is one of the worst indicators of a problem," says Dr. Kevin O’Leary of Stone Ridge Dental in Waukesha. "Dental decay is hardly ever painful. By the time you are feeling pain, you are likely pretty far along with whatever problem you have," he says. Possibilities include a broken tooth, a broken filling or an infection.

Bad Breath

"Everyone thinks bad breath comes from the mouth, but you really need to have a dentist do an evaluation to find out exactly where it originates," said Dr. Ralph Pamenter of Brookfield Dental Care. "Bad breath may come from a large cavity or from periodontal (gum) disease. You may not be brushing carefully enough. Or, sometimes a film is left on the tongue," he says. "If those things are not present in an evaluation, then you need to seek the opinion of a physician because it could be a problem with the stomach or throat."

Sensitive Teeth

It can be normal for some people to have teeth that are sensitive to hot and/or cold temperatures, Pamenter says. "On the other hand, it can mean that gum tissue is receding. The root surface of the tooth may be exposed, which can cause pain," he says.

A fluoride varnish can be applied to the teeth and that will eliminate the sensitivity, according to Pamenter. "If that doesn’t help, something else is going on. It could be a bad filling or crown or maybe a cracked tooth. The dentist has to do a more detailed exam to determine the problem so it can be addressed,"he says.

Tooth sensitivity can also be triggered by toothpastes that contain tooth whitening ingredients, O’Leary says. "You may want to steer clear of the more abrasive toothpastes," he suggests.

Tooth Erosion

Distinct from the wearing down of teeth caused by tooth grinding, tooth erosion is caused by a chemical reaction that destroys the enamel of the teeth, says Dr. Rodica Iancu, whose practice is located in Mequon. "It can be caused by gastric acid from the stomach coming up through the mouth. I saw a lot of this 15 or 20 years ago when I was seeing a lot of young women who had eating disorders," she says. "I also see this in people who have gastric reflux disease," she says.

"Drinking soda is a big culprit in tooth erosion, too. If I could discourage people from drinking soda, I would love to do so," Iancu says. "It pulls the calcium out of your body, it ruins your teeth, it contributes to obesity. It is so very bad for you."

Receding Gums

As we grow older our gums may shrink or recede. But the problem also can happen prematurely if we brush our teeth with too much force, says Dr. Paul S. Levine of Levine Dental Associates in Milwaukee. "You don’t need to brush your teeth so hard. You need a small, soft brush that follows the contour of your teeth. You need to hit all of the surfaces of your teeth, and, you need to brush for two to three minutes," he says. "If you do that along with flossing, you can remove most of the debris from your teeth."

Mouth Sores

Like sores that appear on the skin, mouth sores can fit into different categories, says Iancu. "It may be caused by toothpaste that has certain additives or by medications. Elderly people in particular may be taking many different medications that have side effects," she says. "In fact, medications can be the cause of other problems such as dry mouth, too. People should tell their dentist about any medicines they are taking."

Most dentists also do a screening exam to check for sores and other signs of disease such as tumors. "We look for abnormal areas in the mouth. The mucosa is very fragile and it can be disturbed by a number of things," Iancu says.

Bleeding Gums

"When you brush your teeth, you are not supposed to see blood on your tooth brush," says Dr. Roberto Monteagudo of the Monteagudo Center for Smile Design in West Allis. "A patient will say their gums are bleeding but it doesn’t hurt, but I tell them gum disease doesn’t hurt until it is too late. Plaque multiplies in your teeth and it causes an infection. The bacteria works itself down between the gum and teeth, the gums become irritated and they bleed. When the infection becomes severe, then an abscess forms and the teeth become loose," he says.

"Gum disease is nasty stuff. We now know for a fact that gum disease lowers your immune system and leads to larger health problems," Monteagudo says.

Infections in the mouth can play havoc in other parts of the body, says Dr. Dale Rottman of Successful Smiles Dental Care in Thiensville. "For a long time it was thought that bacteria was the factor that linked periodontal disease to other infections in the body. A lot of new research has shown that inflammation does link periodontal disease to other conditions such as diabetes and cardiovascular disease. So, treating inflammation in the mouth may not only help manage periodontal disease but may also help with the management of other chronic inflammatory conditions," he says. "It does not pay to ignore your dental health. Regular checkups are important." M