Open Wide!

Posted on May 22nd, by staff in Health. 13 comments

Open Wide!

Besides not flossing, your dentist can tell a lot about your health and habits (past and present) just by examining the inside of your mouth. We asked Dr. Phillip Tzemis, a Toronto-based dentist to fill us in on the top five things he see when we open wide. No judgement here! The following list below is meant encourage you to stay on top of your oral health—as diligently as you do with your skin health.

#1. You might have diabetes.

The Clues: Bad breath and dry mouth.

The Doc says: Bad breath is more than just a social faux pas; it can be an important signal for seeking medical attention. Often referred to as halitosis, bad breath can result from various conditions. Infection, diet, systemic disease, poor oral hygiene and even malignancies can all produce oral malodor. The most common one, fortunately, is from odor-producing bacteria which release sulfur based gases during their activity. We can also have malodor resulting from more serious systemic conditions such as diabetes. Diabetes, more commonly causes dry mouth, which in turn leads to halitosis. Sipping water regularly helps a lot. More seriously however, a fruity type or nail varnish type of bad breath, may be a sign of  diabetic ketoacidosis, which if left untreated may result in a diabetic coma. Recognizing this distinct odor is essential in recognizing a dangerous situation.

#2. You abuse Crest Whitestrips.

The Clue: Your pearlies are more clear-looking than opaque.

The Doc says: Extensive over use of over-the-counter tooth bleaching products may create a more translucent appearance to the teeth, which may not be what you were striving for. Like most things, too much of a good thing isn’t always beneficial. Dentist-supervised tooth bleaching systems, such as Zoom Whitening, avoids this potential outcome. Your dentist is the best resource for answering the question ”How often can I whiten?”

Remember Ross’ glow-in-the-dark whitened teeth on Friends?

#3. You had braces as a teenager.

The Clue: Crowded or shifted teeth.

The Doc says: If I had a loonie for every time I heard “I was supposed to wear my retainer after my braces but….”; you know the rest. The truth of the matter is that our teeth, our gums, our mouths are a dynamic system; always adapting to the stresses and forces of day-to-day use and abuse. Relapse or minor crowding of previously straightened teeth is quite common. Most adults are aware of these changes and look for comfortable and effective solutions to correct them. The most recognized non-braces treatment modality is Invisalign. With the use of a series of clear removable appliances called aligners, your dentist can carefully straighten or re-align your teeth. The bonus with Invisalign is that you can see the final result in a virtual representation on the computer monitor before you say yes to the treatment.

Country singer Faith Hill recently sported metal braces at the 2013 Grammy awards. We’re not sure why she opted for the old-school route to straighter teeth.

#4. You have a “geographic tongue.”

The Clues: Red patches on the top or side of the tongue, surrounded by raised white borders.

The Doc says: Tongue lesions or altered sensation tells us a lot about our overall health. On occasion our tongues do undergo changes that many think are problematic. Geographic tongue, (benign migratory glossitis) although visually disconcerting, is not one of them. Characterized by irregular smooth red patches on the top or side of the tongue, surrounded by raised white borders, these lesions often appear as “moving patches”. These red patchy areas may be sensitive to spicy or acidic foods, drinks or cigarette smoking. No treatment is indicated unless there is discomfort upon which anti-inflammatory medication can be prescribed.

#5. You have “tonsil stones.”

The Clues: Bad breath and that white lump at the back of your throat.

The Doc says: Convoluted, lobular and swollen looking tissue, tonsils are often removed for medical reasons. For those who were spared that surgery and enjoyed the bliss of endless hours of ice cream, we sometimes notice white growths embedded within the tonsillar folds. These are referred to as tonsilloliths or “tonsil stones”.  They are calcifications of debris that may cause irritations or pain on swallowing (even ear pain) and unfortunately have a putrid odor to them; often creating terrible halitosis. If they haven’t hardened, tonsilloliths are easily “plucked out” by the dentist or sometimes by pushing along the throat opposite the tonsil area and creating a hacking type cough. I often encourage patients to gargle with luke warm water and 3% hydrogen peroxide (50/50) or salt water for 1-2 minutes weekly to discourage formation. Good oral hygiene goes a long way in helping to prevent the formation of tonsilloliths.


Dr. Tzemis has been practicing dentistry for over 25 years. His bustling practice is located in the Yonge and Eglinton area of Toronto, visit

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