The Surprising Place This MD Checks When Patients Have Mystery Symptoms
Over the years, my specialty as a functional medicine doctor has become treating the mystery patients who can't seem to find answers. They name vague symptoms that plague them: brain fog, joint pains, mood swings, severe fatigue, weight gain, visual disturbances, random aches and pains.
The majority of these patients are younger, between the ages of 20 and 40, but they are much sicker than their grandparents' generation.
I see a lot of common denominators with my "mystery patients"—many end up having chronic Lyme, CIRS (chronic inflammatory response syndrome), mold toxicity from water-damaged buildings, parasites, or a plethora of environmental toxicities.
In my experience, a lot of issues tie back to oral health—which is why I always check patients' teeth and gums if they're experiencing unexplained symptoms. I've found that many of these patients have had certain dental procedures that may, unknowingly, contribute to systemic health issues.
Why does this happen? I liken it to a "toxin bucket theory." In other words, the more full the bucket gets (or the body gets), the sicker you become. Eventually, when the bucket is overflowing, a disease is diagnosed. The oral cavity can add to this.
How oral health is connected to overall health.
Just how important is oral health? I tell my patients that the mouth is the gut. In the mouth, there are approximately 800 species of bacteria that have been identified. Studies are now showing bacteria and fungi can colonize on various surfaces in the tooth cavity.
How does it connect to the rest of your body? Some studies suggest that infections in the oral cavity, or oral dysbiosis (an imbalance of good and bad bacteria), are contributing factors in systemic metabolic diseases, such as diabetes. A 2015 study examining the relationship between periodontal microbiota and early diabetes risk found that higher levels of four species (A. actinomycetemcomitans, P. gingivalis, T. denticola, and T. forsythia) were associated with a two- to threefold higher prevalence of prediabetes. These stealthy pathogens hide from our body's immune defenses in a sticky biofilm, also known as a plaque. What's more, a 2018 systematic review found that periodontitis (severe gum infection) is a risk factor for coronary heart disease.
Beyond cardiovascular disease and diabetes, there have been links between oral health and many other diseases, like atherosclerotic vascular disease, pulmonary disease, pregnancy-related complications, osteoporosis, and kidney disease. There is so much we have to uncover about oral health!
What I look for during an oral exam.
One thing I check is my patients' fillings. For years, holistic dentists and integrative doctors have recommended avoiding mercury amalgams—based on the belief that neurotoxins can leach, potentially causing systemic issues for some people. (Note: If you do have these kinds of fillings, be careful not to remove them the wrong way; look for someone on IAOMT who is SMART certified.)
If my patients are experiencing mystery symptoms, I also take note if they've had a root canal. I've found that my patients with infected root canals often suffer from difficulty with clarity of thought, brain fog, head and shoulder pain, tinnitus, visual disturbances, or fleeting tooth pain or numbness.
Root canals are typically done if there's trauma to the tooth or the infection has breached the inner pulp of the tooth. The pulp chamber, smack-dab in the center of the tooth, houses the living blood supply and nerves—along with an astonishing network of microscopic tubules that supply nutrients to the dentin (the layer just below the enamel). During the procedure, all the soft, living tissue of the pulp is removed so the chamber and root can be filled. But we cannot clean, or fill, those miles of microtubules. In my experience, because these tubules are active, exchanging fluid, bacteria can infect them and continue to replicate—which can be problematic systematically. In these cases, I personally recommend ozone therapy, if it is an option for you.
What are other options besides a root canal? Pulling the tooth is one; however, it's important to take great care in making these decisions. Keep in mind that a cone beam scan X-ray often misses the infection until the tooth is pulled, so I often recommend a CT scan. Ultimately, not everyone is the same, and each treatment plan should be individualized.
I also believe patients with neurodegenerative conditions should have a five-minute oral exam, at a minimum. I have witnessed connections in my own patients to oral health and multiple sclerosis, for example. One of my MS patients had a cavitation problem, or a low-grade simmering infection, after wisdom teeth removal.
How to protect oral health.
Take care of your mouth just as you would your gut: See your dentist regularly (I personally recommend seeking a biological or holistic dentist), and floss daily.
In my experience, I've found using a remineralizing toothpaste daily can be helpful if you are fighting an oral infection or inflammation. Ozone is a wonderful practice that I believe more dentists should utilize. Doctors can do a huge service for their patients by taking the time to address oral health and doing a quick physical exam along with assessing diet, stress, sleep, hormones, other medications, and other important lifestyle changes.
I always believe my patients and their symptoms, over any scan or test.
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