Ask the doctor - oral health
Read expert medical advice on oral health with doctors' questions and answers from Prima and Good Housekeeping
I had two courses of antibiotics for helicobacter pylori and now have a heavily coated tongue, feel sick and the roof of my mouth is orange. Ive tried mouth washes but nothing works. I havent felt well for almost a year.
As this has been going on so long, your GP should be happy to give you a full medical and request screening blood tests to look for any underlying cause. Mouthwashes can themselves cause discolouration of the mouth, especially those containing chlorhexidine, so try using warm green tea instead. A tongue scraper can help to clean away the thick coating. Probiotics are always a good idea after antibiotics, and may help to improve intestinal symptoms. While waiting for the results of your test, try eating a detox-style diet of fresh fruit, vegetables, salads, soups and bio yoghurt with pulses, cottage cheese and fish for protein. Avoid caffeinated drinks and alcohol instead, drink water, herbal teas, homemade smoothies and fruit juices. Use organic produce if you can. Milk thistle (£5.95 for 120 tabs from www.healthspan.co.uk) and globe artichoke supplements DigestHerb (£9.99 for 30 caps from www.schwabepharma.co.uk) or pharmacies) will help to support your liver function.
Dr Sarah Brewer, Prima (Apr 11)
I have bad breath. Is there a natural remedy I could try?
Bad breath (halitosis) usually results from a build-up of bacterial plaque in the mouth or on the tongue. Visit an oral hygienist, and use dental tape regularly to clean between teeth. Investing in an electric toothbrush that removes plaque and a tongue scraper to remove bacterial accumulation can also help. A variety of mouthwashes designed to improve bad breath are available. Dentyl (£4.29 for 500ml) contains a solution that binds to bacteria in the mouth and helps to remove them in visible clumps, while Retardex mouthwash (£4.99 for 250ml) breaks down compo in the mouth responsible for bad odours. Both are available in pharmacies. Green tea can also have a natural deodorising effect on breath.
Dr Sarah Brewer, Prima (Dec 10)
Ive noticed two white patches inside my cheeks. They dont hurt, but are they anything to worry about?
Painless white patches in the mouth are known as leukoplakia. Consult your doctor or dentist to see if you need any immediate treatment. They are usually kept under close review, or even removed surgically as a precaution, in case they develop into mouth cancer. If the diagnosis is confirmed, and you do not need any immediate medical treatment, ask your doctor whether or not you should try taking antioxidants. In one study, taking vitamin E (800iu or 536mg a day) for 24 weeks caused regression of oral leukoplakia in two out of three patients. Taking 1g of olive leaf extract (such as Solgar Olive Leaf Extract, £9.49 for 60 caps) three times a day also seems to be beneficial.
Dr Sarah Brewer, Prima (Nov 10)
What can I do about dry lips?
When the weather gets cold, I suffer terribly from chapped lips. They really feel as if they're peeling off and no amount of lip salve seems to help. It not only looks unsightly but they usually crack and bleed too, which is very painful. Can you tell me why I have this problem and how I can help prevent it?
Chapped or cracked lips are very common in the winter. Protecting your lips with a simple oil-based lip salve usually does the trick - choose one that contains cocoa butter or beeswax; one with a sunscreen can help too. When you go outdoors, use a scarf to protect your mouth and try to avoid licking your lips; drink plenty of fluids too to keep yourself hydrated. If, however, you have tried everything and there's still no improvement, you may need to find out if there's an underlying reason. It's possible that you're suffering from contact dermatitis - a skin condition caused by an allergy or irritation from something you're putting on your lips.
It may be that your lip salve is doing more harm than good. Avoid perfumed or medicated' lip balms, as they may irritate and steer clear of flavoured lip salves, as they encourage you to lick your lips more often. There's also a chance that you may be suffering from angular stomatitis, which is generally the result of a fungal infection. Your GP may prescribe a steroid cream to reduce the inflammation and treat the infection. Other possible causes include a vitamin or mineral deficiency, especially low levels of B vitamins or iron. Try taking a multivitamin supplement to rule out a nutritional deficiency.
Dr Lousie Selby, SHE (Feb 10)
Will flossing prolong my life?
Is it true that flossing your teeth may help you live longer? If so, why?
Adults with healthy mouths are less likely to die at any age than those with inflamed. This is probably because inflammation of the gums allows mouth bacteria to enter your circulation where they may trigger hardening and furring up of the arteries, and increase your risk of a heart attack or stroke. Some evidence also suggests that chemicals entering the circulation from inflamed gums may affect glucose control and increase your risk of type 2 diabetes, but this is not conclusive. If nothing else, flossing makes you nicer to kiss!
Dr Sarah Brewer, Prima (July 09)
Why is my tongue yellow?
My tongue has a thick yellow coating, which looks horrid. My mouth feels dry, too, and my GP is unable to suggest a remedy. Help!
A furred-up, coated tongue can be due to a build-up of mouth bacteria and may reflect a lack of saliva if your mouth also feels dry. A pharmacist can advise on lozenges and sprays available to stimulate or replace saliva flow. It also helps to drink a glass of citrus juice and eat two pieces of fruit each morning, and drink at least 2 litres of fluid per day. Use a tongue scraper each morning, and follow this with a mouthwash formulated to trap and remove bacteria such as Dentyl pH (£2.14 for 250ml, from Boots). It's also best to use an electric toothbrush designed to remove plaque, and dental tape or floss to dislodge bacteria between your teeth. Your dentist can refer you to a dental hygienist for regular, thorough descaling of your teeth and cleaning of gum pockets, if necessary.
Dr Sarah Brewer, Prima (May 09)
My partner tells me that I grind my teeth while I sleep, which could explain why I often wake up with tense neck muscles and a headache. How I can prevent this?
Teeth grinding, or bruxism, is a common problem. It's mainly harmless but can lead to headaches and jaw pain and the possibility of damaged tooth enamel. Teeth grinding is often the result of anxiety or stress, but it can be caused by missing teeth, crooked teeth or an abnormal bite.
Visit your dentist for a check-up and ask if you can be fitted with a night guard - this is a gum shield that prevents your teeth from locking together and stops the grinding action. If there's no dental reason for your bruxism, try to reduce your stress levels. Some people find hypnosis helps - the aim is to re-educate your brain, teaching it to relax the jaw muscles, thereby reducing the grinding. Contact The British Society of Clinical Hypnosis at bsch.org.uk for a therapist.
Dr Louise Selby, SHE (Dec 08)
Why is my mouth so sore?
The corners of my mouth are cracked, sore and very dry. My diet is poor at the moment because I'm stressed and busy at work. What can I do to treat them?
Soreness at the corners of the mouth can be due to a variety of causes, including viral, fungal or bacterial infections. It could also be linked to a lack of iron or B vitamins. Aim to eat more healthily - take bags of fruit and other healthy snacks to work, and try not to skip meals. You may also find a vitamin and mineral supplement helpful, as a nutritional safety net, and a probiotic supplement to help boost your immunity. The most common cause of cracks at lip corners is fungal infection, so try Daktarin Oral Gel (£4.89 from Boots). If this doesn't clear it up quickly, see your GP.
Dr Sarah Brewer, Prima
Sunlight triggers my cold sores
I get a cold sore on my lips most summers. Ive heard that light therapy can help, but arent they triggered by sunlight?
Triggers for recurring cold sores include ultraviolet light, stress and fatigue. The new light treatment phototherapy uses a special red light, which doesnt create heat or burn the skin. It increases blood flow to the affected area and stimulates the activity of local immune cells. Clinical trials showed that phototherapy halved normal recovery time, so that almost 60 per cent completely healed within five days, and 80 per cent within seven days. Treating at the first sign of a sore can also prevent it developing. Try Bio-Stick, a battery-powered device that produces red light and allows you to target your cold sore as soon as you see it coming. You simply place it against the sore and apply red light for two minutes, two or three times a day. Its also helpful for treating mouth ulcers. Its priced £34.95 from anhealth.co.uk or 0870 350 1264.
Dr Sarah Brewer, Prima
My toothbrush quandary
How often should I change my toothbrush?
Ideally, once every three months. Every time you clean your teeth, your brush picks up lots of bacteria and decaying food particles, which encourage their growth. Even worse, hundreds of thousands of germs are sprayed into the air when the toilet is flushed, so put the lid down beforehand if you have a loo in the bathroom. The VioClean UV Toothbrush Steriliser kills germs using an ultra-violet light that is automatically activated for six minutes when you insert your brush and close the case. (£13.99 plus p&p from www.vioclean.co.uk or call 0845 800 1111).
Dr Sarah Brewer, Prima
Help, my gums are receding!
What will help my receding gums? Despite seeing my dentist and flossing regularly, my gums are starting to recede, especially around my front crowns. Can anything prevent this?
Receding gums are common as you get older - hence the saying long in the tooth'. Good dental hygiene is vital, and your dentist can advise you on using electric toothbrushes designed to reduce plaque, and refer you to a hygienist to have the pockets between the gums and teeth cleaned. You'll find it helpful to use Gengigel (from pharmacies), which is a lemonbalm-flavoured oral gel containing hyaluronic acid. When applied externally, it hydrates the gums and stimulates production of collagen to promote new gum formation, and significantly reduces redness and inflammation (gingivitis). Diseased gum tissue contains reduced levels of coenzyme Q10 compared with healthy gum tissue, so CoQ10 supplements can also help. A clinical trial disease found that taking 60mg CoQ10 daily for 12 weeks significantly improved gum disease.
Dr Sarah Brewer, Prima
My ulcers are a pain
I suffer from sore mouth ulcers when Im stressed. I take vitamin C and have no dental problems. What could be causing them?
Stress-related mouth ulcers may be cold sores (due to the herpes simplex virus) or aphthous ulcers (canker sores). These ulcers have been linked with hypersensitivity to sodium lauryl sulphate, the foaming agent in toothpaste (switch to an SLS-free brand such as Urtekram), gluten intolerance, artificial sweeteners, lack of B vitamins and iron deficiency. Assuming yours are aphthous ulcers, the most effective treatment Ive found is Gengigel (from pharmacies). This soothing gel coats the ulcer, relieving pain and promoting healing. If youre stressed, try a herbal remedy, such as Siberian ginseng to help you cope.
Dr Sarah Brewer, Prima
The answers to specific problems may not apply to everyone and are not substitutes for professional medical advice. If you're worried, see your GP.
For more information, visit netdoctor.co.uk