The oral cavity serves as a powerful window into overall health, often reflecting early signs of systemic diseases. Oral symptoms—such as unexplained pain, lesions, or discoloration—can point to deeper health issues like brain tumors, HIV-linked Kaposi’s sarcoma, heart disease, stroke, diabetes, premature birth, osteoporosis, and Alzheimer’s. This highlights the importance of oral health in overall well-being.

Shahid Akhter, Editor, Healthyouonline, spoke to Dr. Prashanth K. Haribabu, Oral & Maxillofacial Surgeon, St Louis, Missouri, US, to understand how the oral cavity can reflect systemic diseases, and the role of dentists in multidisciplinary care for various conditions. Prashanth K. Haribabu, DDS, MDS, MSD, FICD

Inside the Oral Network: How Mouth Microbes Influence Gut and Brain Health

From a biological standpoint, there are numerous factors and agents within the oral cavity that have been shown to communicate with various parts of the body.

Recent research has revealed that the oral bacteria and microbiome in the mouth interact with the microbiome in the gut and other body systems, which, in turn, are connected to the brain. It forms a continuous cycle—almost like a WhatsApp group where all the bacteria exchange messages and signals with each other.

These signals travel from the mouth to the gut, to the brain, and across other areas of the body, highlighting how interconnected we truly are. As oral healthcare professionals, we are part of a larger system, all working to treat the same person as a whole. This concept of whole-body healthcare is extremely important.

The alignment between oral health, mental health, and overall well-being underscores the need to view health care as an integrated, unified system.

How Oral Pain Can Signal Underlying Health Problems

Oral health conditions—particularly the signs and symptoms—have been shown to reveal certain hidden medical issues. For example, I was involved in the care of a patient who was experiencing persistent pain in the oral cavity.

Despite consulting several dentists and undergoing multiple treatments, the pain did not subside. Upon further examination, we suspected that the source of the pain was not within the oral cavity itself. Although the discomfort was felt in the mouth—near the gums and teeth—it was not originating from there.

Non-odontogenic pain

This type of condition is known as "non-odontogenic pain," meaning the pain does not arise from the teeth. Such pain syndromes can occasionally occur in certain individuals, and it’s important to remain vigilant in identifying the actual source of pain.

In this particular case, our evaluation led us to suspect an issue in the body’s central pain processing center—the brain. When we performed a brain scan, we discovered a small tumor located near the area where nerves emerge to supply sensation to the face. This explained the patient’s persistent facial and oral pain.

Fortunately, we were able to make the correct diagnosis, refer the patient to the appropriate medical specialty, and initiate the necessary surgical intervention. After the procedure, the patient experienced complete relief from pain.

Oral Clues to Hidden Cancers: When the Mouth Reveals Distant Disease

There are many conditions that manifest in the oral cavity and can indicate significant underlying medical issues. For example, various types of cancers can present symptoms in the mouth. It might be a primary oral cancer, or it could be a cancer originating in another part of the body that shows early signs in the oral cavity.

We’ve seen cases where patients had tumors in distant organs, such as the lungs, but presented with a small lesion, ulcer, or abnormality on the tongue or the floor of the mouth. Upon further investigation, we discovered that the oral lesion was not the primary source of the disease—the actual cancer originated elsewhere in the body.

Unseen Signals: How Oral Health Helped Uncover an HIV-Linked Cancer

In patients with HIV/AIDS, a very unique type of cancer can sometimes present in the oral cavity, known as Kaposi’s sarcoma. It is quite distinct, often appearing as a purplish-blue lesion. In fact, we published a paper on this during the COVID-19 pandemic, a time when access to healthcare—whether oral or general—was severely limited.

We encountered a young patient who had been diagnosed with HIV but was not under proper medical supervision due to difficulty in accessing healthcare services. When this patient came in for an oral health evaluation to have a tooth extracted, we noticed an unusual tissue discoloration—shifting from a healthy pink to a purplish-blue hue in the gums.

Oral Cavity as the First Alarm: Detecting Kaposi’s Sarcoma Before It Spread 

We took a small tissue sample and sent it for a biopsy—a pathological evaluation under a microscope. The results confirmed an invasive form of Kaposi’s sarcoma.

What made the case more critical was that the cancer was not confined to the oral cavity. It had spread to other parts of the body, including the lungs. Thankfully, due to early detection during the oral examination, we were able to alert our medical colleagues. A CT scan of the lungs confirmed distant metastasis—the cancer had spread beyond its original site.

This case underscores the crucial role of oral health professionals in detecting systemic diseases and coordinating timely intervention.

The Dentist’s Role in Cancer Care: A Vital Voice on the Tumor Board

Typically, in a hospital—especially in a cancer center—dentists are integral members of the tumor board committee. For example, during my training in New Jersey, we attended tumor board meetings almost every Monday morning to review cases. These meetings were not just for diagnosis but also to plan post-treatment care.

As dentists, we actively participate in these discussions and advise oncologists on the necessary preparatory oral care that patients may need before starting cancer treatment.