The Blood Detective: The Mouth Holds Clues to Your Current and Future Health Potential

Throughout our lives our nutritional needs vary greatly. Newborns require very different nutrition than adults, males require different nutrition than females and the sick require different nutrition than athletes.

Even an individual’s nutritional needs can vary from day to day depending upon stress levels, sleep habits, medications, exercise and other factors. Genetics is always influencing our core nutritional needs.

How does one figure out how to manage optimal nutritional needs throughout our lives? Sophisticated laboratory tests and medical technologies are available, and when considered with medical and health history questionnaires and consultation, can accurately estimate one’s nutritional needs. In teaching my patients how to take care of themselves to a certain degree, I have provided specific physical signs of current or potential illness that are related to diet and overall nutrition as well as lifestyle in general. If you pay attention to these “signs of health status” that should go a long way toward maintaining health longer and avoiding premature chronic disease.

Your mouth tells all

The structures and lining of the mouth offer valuable and easily accessible information on your nutritional status. Lesions in the mouth, often overlooked by even well-trained health professionals, may indicate a nutrient deficiency or may be manifestations of gastrointestinal or other disease. Because of the very rapid cell turnover of the oral mucosa, or cells that line the mouth, these lesions often may precede other manifestations of nutrient deficiency or systemic disease by weeks, months or even years. Some typical lesions are mucosal ulceration, cheilosis, gingivitis and glossitis. Between 5 and 10 percent of the people in the United States are deficient in one or more nutrients, so signs of nutritional deficiency are common, but often go unrecognized producing other symptoms.

Anatomy of the mouth

Before one can start to recognize signs of nutritional problems in the mouth a little anatomy of the mouth is necessary. Don’t be discouraged. Once you learn a small amount of mouth anatomy you will start recognizing signs of nutritional deficiency and disease very quickly.

The top of the healthy tongue is covered with smooth, pink mucous membrane and lymphoid follicles. On the bottom surface, the various specialized cells called papillae (which contain the organs of taste) produce a rough, grayish red appearance. The thick epithelial tufts of the filiform papillae give the tongue its characteristic grayish white coating, whereas the globular, pale red fungiform papillae give it a speckled pink appearance.

Furrows are not a characteristic of the healthy tongue. The buccal mucosa (the sides of the inside of the mouth) has a grayish red color and may be crossed by fine grayish ridges where it touches the closed teeth.

Healthy gums have a light reddish appearance and cover the roots of the teeth completely. Patients should be asked about their dental history and encouraged to have regular dental checkups.

There are some key nutritional considerations for examination of the teeth. However, do not expect your dentist to pick up any or all of the oral signs of nutritional deficiency. It is up to you to take a careful look and bring what you suspect is a problem in the mouth to your dentist or nutritional consultant.

Also, having fewer than 20 teeth as an adult is associated with significantly reduced capacity to eat nutritious foods, such as salads, raw fruit and vegetables, nuts and whole grain products. The same applies even to denture wearers.

Other deficiencies showing up as mouth decay include bulimia, which may manifest itself as erosive tooth wear; osteoporosis, which may manifest itself initially

as changes in jaw structure and/or loose teeth; and  the presence of mercury

amalgams, which may be associated with systemic disease, especially neurologic conditions.

Membranes can be a “pain”

I have summarized some typical oral lesions associated with a particular nutrient deficiency.

In general, ulceration should be considered a nonspecific expression of a disease state. A search for the cause will usually result in a specific therapy. Aphthous stomatitis is a common example of a mucosal ulceration and I see many patients with this particular finding. I visited a 15-year-old girl with ongoing intestinal problems that had gone undiagnosed. I noticed this finding and then tested appropriately and discovered the presence of gluten intolerance. Removal of gluten caused an immediate reduction in intestinal bloating, cramps, weight gain and gas.

Similarly, cheilosis is a common expression for acquired nutrient deficiency. Gingivitis is associated with the classic signs of scurvy, but other nutrients have now been shown to play a role in gingival health. Glossitis is associated with numerous vitamin deficiency states, each with a characteristic appearance.

Dr. Michael Wald is director of nutrition at Integrated Medicine of Mount Kisco. He can be reached by calling 914-242-8844 ext. 1. or visit  www.intmedny.com or  www.Blooddetective.com. Twitter: https://twitter.com/drmichaelwald.