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Q: for crabcakes-ga . . . blood tests ( Answered 5 out of 5 stars,   2 Comments )
Subject: for crabcakes-ga . . . blood tests
Category: Health > Conditions and Diseases
Asked by: timespacette-ga
List Price: $10.00
Posted: 20 Jul 2006 18:31 PDT
Expires: 19 Aug 2006 18:31 PDT
Question ID: 748165
hi crabcakes,

I have a friend who is the kind of person who does not generally take
himself to a doctor; he has to be bamboozled.  He has serious tooth
decay and is going soon to begin the process of
extractions and getting full dentures.  His health has deteriorated
dramatically in the past several
months, with hip pain, low energy, he has lost 20 lbs, etc.  He smokes
twice a day, morning and evening.  It has been difficult for him to
eat because he has already lost several molars.  He seems so run down
that I am concerned about his ability to get through the dental
procedures.  I am also concerned that he has more going on than just
tooth decay effecting his overall health, which is what he attributes
it to.

My question is this:  if he had a full panel of blood tests, what
could they find out, what would they look for in this situation? 
Specifically, could blood test results descriminate between a general
infection (from tooth decay) and, say, cancer or heart disease as a
diagnostic tool?

thanks in advance . . .

Subject: Re: for crabcakes-ga . . . blood tests
Answered By: crabcakes-ga on 21 Jul 2006 13:33 PDT
Rated:5 out of 5 stars
Hello Timespacette,

   How kind of you to worry about your friend, who may have several
concurrent conditions ? periodontal disease, and some underlying
health condition. For example, he could have some form of heart
disease, a respiratory disease, Vitamin deficiencies, arthritis, and
on and on. Inflammation from periodontal disease *may* even be
responsible for his hip pain. This is why I recommend a complete check
up further down in my answer. This will be the only way to get him on
the road to good health.

    There seem to be few esoteric and experimental testing available
for dental cavities, but they are not specific for the cause of poor
health. A performing laboratory for that type of test is also hard to
find. Such tests are cytokine tests and include:
fibroblast growth factor (FGF)
platelet-derived growth factor (PDGF)
insulin-like growth factor (IGF)
transforming growth factor-beta (TGF-beta)

?Particularly, inflammatory cytokines--such as IL-1 alpha, IL-1 beta,
IL-6, and IL-8--are present in the diseased periodontal tissues, and
their unrestricted production seems to play a role in chronic
leukocyte recruitment and tissue destruction. It is possible that
monitoring cytokine production or its profile may allow us to diagnose
an individual's periodontal disease status and/or susceptibility to
the disease. In addition, although the hypothesis is still
controversial, it has been suggested that discrete T-cell subsets (Th1
and Th2) with different cytokine profiles play specific roles in the
immunopathogenesis of periodontal diseases.?

   The effects of edentulism (lacking of teeth) can create poor
health, ad poor health can trigger poor dental health! With few or
painful teeth, people do not eat a healthy, balanced diet, leading to
poor overall health. Likewise, a poor diet can lead to poor oral
health. Of course, a person who does not maintain proper oral health
by tooth brushing, flossing, and regular check-ups is very prone to
tooth decay.

?The current theory is that bacteria present in infected gums can come
loose and move throughout the body.  The same bacteria that cause gum
disease and irritate our gums might travel to your arteries.
     Researchers are unsure what causes the bacteria to become mobile,
but it has been suggested that bacteria can be dislodged and enter the
bloodstream during tasks as simple as brushing, flossing or even
    Research shows that risk varies according to the level of gum
infection.  The worse the infection, the more likely the bacterial are
to become blood-borne.  Infected gums bleed, making it easier for
bacteria to enter your bloodstream.  If bacteria become dislodged, the
bacteria enter through cuts or sores in your mouth and travel to other
parts of the body through your bloodstream.
    Once bacteria reaches the arteries, they can irritate them in the
same way that they irritate gum tissue.  This could cause arterial
plaque to accumulate in the arteries; which can cause hardening and
affect blood-flow.?


   ?The relations between oral and general health are dynamic. When
oral health is compromised, overall health and quality of life may be
diminished.16,33,45 On the other hand, the rewards of good oral health
are not insignificant. The optimal function of the oral cavity depends
on the integrity of the dentition and supporting structures. The five
most serious oral functional impairments of the older adult are (1)
perioral and oral mucosal tissue pathologies (cancers and precancerous
formations); (2) severe, untreated caries and periodontal diseases;
(3) tooth loss resulting from oral diseases and conditions; (4) oral
expressions of systemic diseases and side effects from medications;
and (5) orofacial pain (including dry mouth and pain of undiagnosed
origin). Reduced oral function is usually associated with the
occurrence of a combination of these impairments.?

?Periodontal bacteria can enter the blood stream and travel to major
organs and begin new infections. Research is suggesting that this may:
?	Contribute to the development of heart disease, the nation's leading
cause of death.
?	Increase the risk of stroke. 
?	Increase a woman's risk of having a preterm, low birth weight baby. 
?	Pose a serious threat to people whose health is compromised by
diabetes, respiratory diseases, or osteoporosis.
Don't Ignore Your Oral Health
If you value your oral as well as your overall health, a periodontal
evaluation is a good idea. Sometimes the only way to detect
periodontal disease is through a periodontal evaluation. A periodontal
evaluation may be especially important if you:
?	Notice any symptoms of periodontal disease. 
?	Have heart disease, diabetes, respiratory disease or osteoporosis. 
?	Are thinking of becoming pregnant. 
?	Have a family member with periodontal disease. Research suggests
that the bacteria that cause periodontal disease can pass through
saliva. This means the common contact of saliva in families puts
children and couples at risk for contracting the periodontal disease
of another family member.
?	Have a sore or irritation in your mouth that does not get better
within two weeks.

?Although reports suggest that periodontitis may contribute to these
conditions, it is important to understand that just because two
conditions occur at the same time, doesn?t necessarily mean that one
condition causes the other. The relationship could work the other way.
For example, there is evidence that diabetics are more likely to
develop periodontitis and have more serve periodontitis than
nondiabetics. Or two conditions that occur together may be caused by a
third factor. People who smoke or use alcohol are at increased risk of
developing periodontitis and a number of other health conditions,
including oral cancer.
Researchers are working hard to find out if periodontitis does have an
effect on other health problems by looking at what happens when
periodontitis is treated in individuals with these problems. If there
was a cause and effect relationship, we would expect that a treatment
that leads to an improvement in periodontal health would also improve
other health problems. The results from initial studies are
intriguing. For example, some studies suggest that treating
periodontitis in people with diabetes can improve their blood sugar
control, but other studies have not found this connection.?

As far as blood tests to discern if poor health is due to dental
caries or periodontal disease? there are no specific tests. There are
some experimental tests and antibody tests that can help determine
which bacteria may be causing the dental disease, but it is not
The first step is to get your friend to a doctor for a full medical
exam, and disclosing his poor oral health to this physician. The
doctor will order tests according to his findings.

A general set of screening tests includes a CBC, a CMP, and a UA
(urinalysis). Some physicians also include a Lipid panel, that
includes total cholesterol, triglycerides, HDL (good cholesterol) and
LDL (bad cholesterol). Should any of the tests come back with abnormal
results, the doctor will then order more specific tests geared for
that suspected disorder.

A CBC will check:
White blood cell count (checks for viral/bacterial infection,
non-specific for many conditions)
Red blood cell count (Checks for anemia and non-specific for many conditions)
Hemoglobin (Checks for anemia)
Hematocrit (Checks for forms of anemia)
Platelet count 
Indices (an evaluation of cell size and shape)

A CMP (Comprehensive metabolic panel) - Checks for various blood
chemistries, such as glucose, BUN and creatinine (kidney function),
AST, ALT, ALP, T. Bilirubin, Total Protein (Liver function),
Potassium, sodium, Co2 (Some labs omit the CO2 as unnecessary for
ambulatory patients)
 A test called CRP, C-reactive protein, is a non-specific test for a
protein that is implicated in heart disease and arterial diseases,
that may have been caused by gum disease. There are several cardiac
panels that can be ordered for suspected heart disease.
If the doctor suspects something specific, from the exam, s/he may
order more specific tests for that condition, which would be
impossible for me to determine.
Albumin, CBC, CMP, Electrolytes, Iron Tests, Lipid Profile,
Urinalysis, Prealbumin, Vitamin D, Vitamin B12 and Folate  are tests
that may be ordered for general poor nutrition. Notice that a CBC and
CMP is included, along with others.
Notice near the top of this page is a drop down menu
?Conditions/Disease? where you can select conditions and see what
tests may be ordered. This is not a comprehensive list, but a
guideline. Testing is ordered on an as needed basis, determined by the
examining physician.

   In the meantime, tell your friend his life depends on getting to a
good physician and dentist. Try getting him to drink several cans of
nutrition packed drinks such as Boost or Ensure a day until he is
evaluated by health care providers. Getting him to brush and floss the
teeth he has, and using a good anti-bacterial mouthwash can help in
the interim. He is fortunate to have a friend like you!

Sincerely, Crabcakes

Search Terms
Effect of edentulism  + health
Systemic disease + dental caries
Antibody test + caries or cavities
Periodontal disease

Request for Answer Clarification by timespacette-ga on 22 Jul 2006 12:59 PDT
Just a clarification . . .

I see that specific heart conditions may be determined from a blood test

but my main question is can cancer be determined in this case, as
distinct from the effects of tooth decay?


Clarification of Answer by crabcakes-ga on 22 Jul 2006 22:30 PDT
Hi Timespacette,

   I didn't realize you were wondering about cancer! While there are a
few tests that for cancer markers, the doctor usually does not order
them for sreening purposes, unless there is a reason.

"If cancer is present, it will usually produce a specific protein in
the blood, that can serve as a "marker" for the cancer. CA 15.3 is the
name of a protein used to find breast and ovarian cancers. CA125 may
signal ovarian and breast cancer recurrence. TRU-QUANT and CA 27.29
are other examples of proteins associated with breast cancer, which
your doctor may test for. CEA (carcinoembryonic antigen) is a marker
for the presence of colon, lung, and liver cancers. This marker may be
used to determine if cancer has spread to other areas of the body."

"These substances are normally present in small amounts in the blood
or other tissues. Cancer cells can sometimes make these substances.
When the amount of these substances rises above normal, cancer might
be present in the body. Examples of biomarkers include CA 125 (ovarian
cancer), CA 15-3 and 27-29(breast cancer), CEA (ovarian, lung, breast,
pancreas, and gastrointestinal tract cancers), and PSA (prostate

"In a study of 50 lung cancer samples and 50 healthy samples, the test
proved 95% accurate in detecting both cancerous and non-cancerous
tissue, he says."

A PSA is recomended for men over 40, as a baseline for prostate cancer.

Its not as simple as testing blood to determine if poor health is
related to poor oral health. Your friends dental and gum health will
have to be evaluated, and his physical health as well, by a doctor.
I'm willing to bet once your friend's dental problems are cared for
his health will improve. If the physician suspects cancer, symptoms
and signs will guide the docotr to order the correct test. There
really is not ONE test to detect cancer in general. Each organ or body
part needs to be worked up individually.

Often, a person with a cancer will have abnormal results of some kind
on the routine screening tests I spoke of. FOr example, forms of liver
cancer will give elevated liver enzymes and an elevated T. bili. If
routine tests come back abnormal, then more specific tests can be
ordered, as a follow-up.

If I have not made myself clear, please ask for another clarification!
I'll be happy to assist you till you are satisfied with the answer.

Sincerely, Crabcakes
timespacette-ga rated this answer:5 out of 5 stars
that's great, crabcakes



Subject: Re: for crabcakes-ga . . . blood tests
From: frde-ga on 24 Jul 2006 06:01 PDT
Tooth ache, Atypical Facial Pain, Neuralgia of the Trigeminal

- are all pretty unpleasant

What will help is impressing on him the need for a salt water
mouthwash about every hour, and to ensure that he is on powerful

Exotic soups could re-kindle his appetite

You could always tell him 'astronauts don't eat solids' 
- it may be a lie - but he'll get the point
Subject: Re: for crabcakes-ga . . . blood tests
From: jshaw-ga on 06 Aug 2006 12:15 PDT
A couple of quick points I'd add, I think that the above information is great...
1. I think the first issue here is that he get his teeth
fixed/removed/whatever, since his other symptoms may simply be from
malnurishment.  If he's still losing weight, having decreased energy,
etc, then I'd move on to further lab testing. (Obviously, if his
history or exam suggest something else going on, then he may need
testing in addition to dental work.  His doctor will sort that out.)
2. If his gums or teeth are infected or inflamed, then a CRP
(mentioned above) cannot be interpreted, since it's simply a generic
marker for inflammation in the body, whether it's from cancer, an
infected toenail, or anything in between.  So again, getting his teeth
fixed up would help with interpreting that test.
3. More than blood tests, if your friend has findings suggestive of
cancer, than CT scans and/or MRI may be more useful.  A doctor will
help here, too.
Good luck, hope he's doing better.

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