Besides being classic signs of gingivitis or the more serious periodontal disease, puffy or bleeding gums may indicate a vitamin B or D deficiency, according to Susan Savage, RDH, BSDH, president-elect of the American Dental Hygienist's Association (ADHA). "This type of gum problem can also be the result of the highs and lows of blood sugar in diabetes," Savage says. "Or it could be because of an imbalance in hormones related to pregnancy or hormone replacement therapy." The matter may be particularly urgent if you are pregnant: The American Academy of Periodontology is looking into research that indicates periodontal disease in pregnant women may be related to premature births and low birth weight.
White patches in the mouth are huge red flag. Get to your dental practice right away, says Pam Quiniones, RDH, president of the ADHA. White patches are a common symptom of infection, inflammation, trauma, malignancy and other underlying conditions. Some common causes of these patches can be long-term alcohol use, bacterial infections, canker sores, chewing on the insides of the cheeks or tobacco use. But it's the serious issues you'll want to rule out right away: candidiasis (a yeast infection), celiac disease, Crohn's disease, the herpes simplex virus or the life-threatening conditions of HIV/AIDS and oral cancer.
While the most common culprit in wearing away tooth enamel is brushing too hard and/or too much, enamel loss can also point to the serious issue of bulimia. "We can tell it's related to bulimia when the enamel is wearing off on the tongue side of the lower teeth," says Savage. Enamel dissipation on other areas of the teeth may be caused by habitually sucking on lemons. Sugary drinks also are often a problem, especially soda and sports drinks. "There's a lot of research coming out about sports drinks," Savage says. "Certain colors are especially acidic. I tell my patients not to drink them for pleasure. They should be reserved for intense sports activity."
Most tooth stains are caused by what we consume – coffee, tea, soda, red wine, tobacco -- and a professional teeth cleaning will remove them. But if you don't think you consume enough of these things to cause staining, a more unusual condition may be to blame. "People can actually have bacteria in their saliva that change color," says Savage. "It can stain the teeth green or brown." This isn't a condition that indicates poor health, but it certainly can cause embarrassment and cannot be prevented. The best treatment is to get a professional cleaning every six months, according to Savage.
This is usually caused by loss of a tooth: When you lose an adult tooth, a shift occurs in the remaining teeth. Wisdom teeth also can push teeth out of alignment. "Crookedness in the teeth is often just part of the aging process, especially if the person bites particularly hard when eating," Savage says. "You'll also see this in people who often eat food that is difficult to chew." Ill-fitting dental crowns, bridges and restorations may also be to blame. Have a professional take a look at your mouth to determine the cause.