A case report published in the June issue of the Journal of Periodontology provides another reason why abnormalities in the mouth, such as swollen or bleeding gums and oral sores, should be taken seriously.
"We have been hearing more about various health concerns lately, but one important area that is often overlooked is the mouth," said Kenneth Bueltmann, DDS, president of the American Academy of Periodontology. "It is important for patients to have regular oral exams to not only maintain oral health, but to identify possibly risks for serious medical conditions."
The 2000 Surgeon General's Oral Health Report published recommends a thorough oral examination to detect signs of nutritional deficiencies as well as a number of systemic diseases, including microbial infections, immune disorders, injuries and some cancers.
The case report published in the Journal of Periodontology describes how excessive swollen gums, fatigue and weight loss experienced by a 53-year-old man lead to the diagnosis of acute myelomonocytic leukemia. The patient consulted his dentist regarding abrupt gingival inflammation throughout the mouth. The dentist referred him to a periodontist who took a biopsy, which revealed leukemia. Blood tests confirmed the findings and chemotherapy treatment was administered.
"Oral health professionals, especially periodontists, should be aware that enlarged gums may represent an initial manifestation of an underlying systemic disease, such as leukemia or diabetes, and they should collaborate with health providers for diagnosis," said Dr. John Fantasia, chief, division of oral pathology, department of dental medicine at the Long Island Jewish Medical Center.
He continued, "In fact, many patients see their dentist more often than their physician, thus oral health professionals should conduct a thorough examination of the mouth to identify potential abnormalities."
The Surgeon General's report further reiterates that oral health means much more than healthy teeth. It means being free of periodontal diseases, chronic oral-facial pain conditions, oral and throat cancers, as well as many other diseases and disorders that affect the mouth area.
"It is important not to become alarmed by every change in the way your gums look or feel in light of this information," said Bueltmann. "We just want people to realize that oral health shouldn't be taken for granted."
He continued, "Gum swelling is quite common and may involve one area of the gums surrounding a tooth or the entire gums in the mouth. In addition, there are many causes of swollen gums that could be as minor as hypersensitivity to chewing gum, reactions to prescription medications or a popcorn kernel logged into the gums."
One of the most common reasons for swollen, bleeding gums is gingivitis, the mildest form of periodontal disease where gums become red, swell and bleed easily with brushing or flossing due to plaque buildup. There is usually little or no discomfort at this stage, and it is reversible with professional cleaning and good oral home care. Research shows that nearly one in three U.S. adults aged 30 to 54 have this or a more serious form of periodontal disease. However, gum swelling could also be a way your mouth is telling you that something is amiss with your health. Other reasons for swollen, bleeding gums could be more serious conditions, such as leukemia or diabetes.
"The most important message this tells us is that if you experience swollen gums, bleeding upon brushing or flossing or any other abnormal symptoms in your mouth, you should call your dentist or periodontist for a complete examination sooner rather than later," said Bueltmann.
A referral to a periodontist and free oral health brochures are available by calling (800) FLOSS-EM or visiting the AAP's Web site at www.perio.org .
