Diagnosing diseases from the oral cavity
Common oral cavity complaints can be a sign of something more
From the dental chair, Dr Chelsia Sim can diagnose systemic diseases and make timely referrals for early treatments.
This is because some conditions rear their ugly heads in the form of common oral cavity complaints - think chronic ulcers or a burning sensation in the mouth.
One such example is autoimmune vesiculobullous disorders, said the consultant in the department of oral and maxillofacial surgery at the National Dental Centre Singapore (NDCS).
Patients develop oral blisters and skin lesions when the immune system attacks and destroys healthy body tissue by mistake.
Oral blisters may appear before skin lesions when the immune system attacks more epithelial cells in the oral mucosa - mucous membrane lining the inside of the mouth - than in the skin, Dr Sim said.
Most dentists should be able to recognise in the oral cavity signs and symptoms of some diseases, but they may not be comfortable with making the diagnosis.
They will usually refer the patient to a dentist trained in oral medicine for diagnosis and treatment.
To ensure timely referrals to the NDCS for early detection and screening, Dr Sim is steering an outreach programme to give educational talks to medical doctors.
A timely referral means a patient can receive early treatment, which usually translates to a better outcome, said Dr Sim.
"I believe that creating awareness can help one seek professional help in a timely manner and reduce the anxiety and stress one may face when their oral signs and symptoms are not properly dealt with," she added.
Here are some signs you can look out for in your mouth.
What: Glossy tongue; redness at the corners of the mouth, and at times, oral ulcers on the tongue, floor of mouth or inner aspects of the lips and cheeks; or burning sensation in the mouth, especially the tip of the tongue.
It could be due to: Nutritional deficiencies, such as a lack of folic acid, vitamin B12 or iron.
What: Recurrent oral ulcers.
It could be due to: Underlying gastrointestinal diseases, such as Crohn's disease, a type of inflammatory bowel disease; or allergies to certain foodstuffs, toothpastes or mouth rinses.
What: Oral candidiasis, an oral fungal infection that presents itself in the oral cavity as white patches that can be wiped off easily, leaving a red and raw surface.
Candida yeast normally lives on the skin or mucous membranes in small amounts. If the environment inside the mouth or throat becomes imbalanced, the yeast can multiply and cause symptoms.
It could be due to: Poorly controlled or undiagnosed diabetes; respiratory disorders that require a corticosteroid inhaler, such as asthma; and a compromised or impaired immune system.
What: Fluid-filled blisters that rupture into diffuse and chronic oral ulcers. Skin or ocular lesions can later develop.
It could be due to: Autoimmune vesiculobullous disorders, which involve blistering and sores in the skin and mucous membrane.
What: Prolonged dry mouth, which can lead to an increased risk of developing tooth decay
It could be due to: Sjogren's syndrome, a chronic disorder of the immune system in which the patient's white blood cells attack the saliva and tear glands; and other salivary gland diseases or infections.
Dry mouth can also be due to dehydration or drugs used to treat other ailments such as allergies, urinary incontinence, psychotic disorders and Parkinson's disease.
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