My Health Weblog

Patient: Question for a dentist please..I have just had a back tooth crowned with a precious metal and porcelain crown but am concerned on two counts..the crown I have already had in the past was all ceramic as I am allergic to most metals (the only exception I know of is gold and silver, so I am unsure if my gum is going to go sore and inflamed with the palladium and gold crown). I requested ceramic crown but dentist overlooked my request & gave me this with metal. He maintains that an all ceramic crown would not be strong enough for a back tooth, but I have one already that has been fine for 10 + years. He suggested I ’see how it goes’ with the crown he had made, and I feel he just wanted me to not waste his crown!! Still so far so good, it is not inflamed and have had it 5 days-but on the inner edge there is a gap between the gum line and the start of the porcelain crown, while the outer edge fits flush to the gumline. Food collects in this gap. Do I need this filled or replaced maybe?

Optional Information
Gender: Female
Age: 53
Already Tried: I am cleaning the gap between gum and start of crown edge very well with water pick and copious regular brushing and rising with a mouthwash. However my mouth felt *cleaner* when I had the lost filling and the original tooth than it does with the crown. It is also slightly high on the bite so my teeth don’t sit in line..the botton row crown hits the top teeth. Will it ‘bed down’ at all as time passes? If I have to have it replaced, should my dentist replace it at his cost or would I have to pay again (I paid £370 as a National Health patient!) I did ask my dentist about the gap on a phonecall and he said it would be fine, that I could just feel a ‘ledge’ and it wasn’t an actual gap where food could reach under the crown..should I trust this remark? I feel he should take a look at it? If so, how soon? Could it get infected or will it be Ok till my next filling appointment in 3 weeks? I am rather concerned as I already had an apisectomy on another crown 8 yrs ago and then months into years of intermittent antibiotics as the infection went into the sinus..then I ended up having the crown and root out anyway, so now have a gap (awaiting a bridge or implant but he wont do it yet).Also I wanted some veneers and he said ‘my type of teeth weren’t suitable for veneers’..is there such a thing as unsuitable teeth? They are sound but crooked in places? I now have seen these very fine veneers (thin as contact lenses) that can be had so maybe I could have those!Thanks in advance!

Doctor: thanks for posting your question on Health.is.edu ,

there is absoulutely no allergy problem with the high noble gold ceramic crown,

the metals are non allergic

if there is a little problem at the inner margin, the most common problem is in adequate brushing and flossing

I suggest you brush and ..Continue reading..

Patient: I have a lump on the gum, under a tooth that had a root canal done,with a gold crown, about 25 years ago. Could this be an abcess? They lymph nodes are not swollen

Optional Information
Gender: Female
Age: 70
Already Tried: just brushing and flossing

Doctor: hi,
thanks for posting your question on Health.is.edu.

there is a high possibility of this lump being an abcess.

you will need a   antibiotics such as amoxycillin and then you will need an x ray

the x ray will determine if you have a

1) gum abcess
2)root abcess

the treatment for both varies is

please DO NOT apply heat, this tends to spread the infection around the face.

please feel free to ask any follow up question you have

Sincerely

Dr. Craig

Patient: hi there , my forearms are very itchy, no rash at all

Optional Information
Gender: male
Age: 33
Already Tried: Calamine lotion

Doctor:

a few questions for clarity:

1) any medical problems

2) any medications

3) any new products (detergent , soap)

4) are your arms exposed to sun?

5) any other symptoms- fever, cough, cold etc

6) are you an allergic type?

7) How long have you had this?

That should do it for now- then I can answer efficiently for you!!

Patient:

1) any medical problems – NO I AM IN VERY GOOD HEALTH

2) any medications – NO

3) any new products (detergent , soap) – NOT THAT I CAN REMEMBER,

4) are your arms exposed to sun? YES

5) any other symptoms- fever, cough, cold etc – NO

6) are you an allergic type? – I WAS AS A CHILD. MILK, DUST ETC.. I JUST GREW OUT OF IT.

7) How long have you had this? FOR 1.5 YEARS , NOT ALL THE TIME THOUGH.

Doctor:

OK
There are many cause of itching- unexplained to us, but there are ways to clarify.

Being a healthy man and ..Continue reading..

Patient: A couple of my fingernails are curling downward as they grow. Is this due to a poor diet?

Optional Information
Gender: female
Age: 60
Already Tried: nothing

Doctor: Fingernail changes are due to SO many things, it is hard to say without a picture.

But in general, if your fingernails are strong, but curling this is less of a concern than if they are weak and “bendy”.

Specifically:

Curling down is very much associated with respiratory problems- asthma, chronic bronchitis, emphysema and the like.

Iron deficiency will produce pale nails which can curl.

There are many other causes-

See this site at Mayo-

http://www.mayoclinic.com/health/nails/WO00055

There has not been shown that any dietary change can produce real changes.

However, it depends on what exactly is wrong.

Here is a site talking more about nutrition- but in general, protein, calcium, Vit, B and C have all been used to give better nail health.

http://www.essortment.com/lifestyle/bestvitaminshe_senw.htm

So-

You want to be examined- think of the nails as the windows to ..Continue reading..

Patient: Hello I have been having some rather serious anxiety for no reason combined with aggravating depression for about 3 months solid. It comes in waves – I feel nromal about 20% of the time and then revert back to teh high anxiety and depression feeling the rest of the time. I noticed that these symptoms all started in June when they put me on high blood pressure meds (Lisonopril 20-30mg). I talked to the doctor already about ity and he shrugged it off. Some days I think I need to just drive down and check myself in to a mengtal hospital it gets that bad.

Optional Information
Gender: Male
Age: 50
Already Tried: I tried talking to my Doctor – he shrugs it off. I contacted a family friend who is a Phd Psychology professor to ask him for a referral – he blew me off like I was bothering him. No help. No answers. Just reading on the internet.

Doctor: Greetings and welcome to Health.is.edu ,

Do you have memory impairment, fatigue, dizziness, headache?

what are the other drugs you are taking?

Patient: All of the above – not too many headaches but just one this morning when I woke up.
Other drugs are for Diabetes – Insukin N and Insulin R 50u ea 1x daily

Doctor: Thank you for the information,

The depression, stress, anxiety , woory and other psychological causes may cause such symptoms in you.The other possibility could be the sid effect of the drug lisinopril.

The drug lisinopril may cause the CNS symptoms like dizziness, headache, ataxia, memory impairment, tremor, peripheral neuropathy, confusion, insomnia, somnolence, hypersomnia, irritability, and ..Continue reading..

Patient: Hi– i take fluoxetine/prozac and for the last few months or so i have not taken it at all or i have taken it approx. 3 times –im supposed to take it everyday. i know that im not supposed to do that–ive just been really bad about taking it. i have been on it for approx 2 years but i dont think it really works, and i keep changing doctors because they keep leaving or are they are terrible, so i don’t really have a doctor i like or trust. anyway i have had severe headaches the last few days and im guessing its because i have stopped taking the fluoxetine. Should I just stop it all together? or should i start taking it again right away?not sure what to do…
thanks for any advice

Optional Information
Gender: Female
Age: 29

Doctor: Hi,
It is very difficult to be able to tell if the medication is working unless it is taken consistently as prescribed. I think you should take the medication as prescribed, but be sure to schedule an appointment with either a new psychiatrist or the one you have seen before. If you take this medication appropriately until you see your physician, you can determine whether it really is or isn’t working. You can discuss this with your doctor and hopefully receive assistance with alternate or additional medications. Hope this helps.

Mark

Patient: Hi Mark–thanks–
i dont care so much about if the meds work bec like i said i have been taking it for 2 years–and just recently have stopped taking it and i know they dont work. what im worried about is the headaches. so you think i should just get back on them and ..Continue reading..

Patient: Hello, is there any medicine to help avoid the withdrawals symptoms from getting off benzodiazepines?

Optional Information
Gender: Male
Age: 34
Already Tried: 10 mgs. of valium daily to treat an anxiety disorder. For 4 years. Whenever I try to quit the medicine, even in small steps, strong withdrawal symptoms appear. Is there any treatmente to get off benzodiazepines?

Doctor: Hi, Yes there are treatments available. Many professionals and physicians prefer you to do this inpatient such as a t a rehab or hospital. The reason is the withdrawals are very severe and can cause seizures and other problems. You are probably experiencing these symptoms: tremors, headaches, anxiety, skin crawl, at times hallucinations, night sweats, nausea, or any other symptoms.

Some physicians will taper you off these over a period of time on an outpatient basis, but the taper is much longer than an inpatient facility. Please phone your physician before attempting to do this on your own. It can cause many problems for you.

Mark

Patient: I dont know if my question is beyond the expertise of some of the Dr on this board. If not I apologize. I was told yesterday that I am a carrier of the Alpha 1 tris gene. My phenotype is pi mz. I had the test due to elevated liver functions without any cause. numerous MRI ultrasounds and dozens of whacky blood tests. My Dr who is a pulmonary specialist and gp sent me to a liver specialist in mt sinai hospital nyc. Where I was tested. My gp Dr states that being a carrier is of no real risk to me, just that I should not smoke. He said that my body does produce enough AAT My range is 88 mg ref 82 to 169. I read that being a carrier can increase my chances of getting lung disease. I had the flu last week and still have a cough for about two weeks .My Dr says it can take sometime and the cough has nothing to due with my results. The liver specialist said in the report that he has seen in some cases increased fibosis in setting like mine. would the Mri and ultrsound showed this. My alt 93

Doctor:
Thank you.

Your gp is correct, as long as you don’t smoke your chances of developing COPD is not increased. Dr Seersholm wrote a 2004 article that addressed this specific topic. His research showed that people with pimz did not have an increase incidence of lung disease as long as they did not smoke. The reason is because a pimz still has, at a minimum 60% AAT. This is enough to stave of lung disease in someone with A1AT def. The cough, is a response that can last for weeks to even a month or longer. The reason is not the lungs (in this case) but the bronchi. The cough is often the very last thing to leave or get better. This is seen in almost all cases of any respiratory issue. Since your numbers are good I would not worry that all of a sudden you developed a lung disease. As for the liver, the MRI or ultrasound would have shown fibrosis of the liver. Your clotting factors would be out of whack. Your protein would be low. It doesn’t appear that this is the case. I would have to agree with your gp on the lung issue and would say that your hepatologist (liver doc) may have seen some cases of worsening, but I guarantee you this was the ..Continue reading..

Patient: I have old (2005) 25MG effexor and wish to use it,….is it safe? does it change in composition or in strength?

Optional Information
Gender: Female
Age: 85
Already Tried: Using effexor to reduce hot flashes. Am currently using 80Gm CMPD Progesterone 5% and over the counter Estroven. used these for 30 days with no results, what period of time before I see a change? Very hard and repeat flashes throught the day and night. Any other recommendations? I have not used the effexor only once along with the progesterone. use the P cream twice /day. Hot flashes destroying my life. I can’t believe I am subject to hot flashes at the age of 83 though 85+1/2 HELP !!

Doctor: Hello,

Medications such as Effexor have an expiration date – and drugs from 2005 would now be expired. They lose their effectiveness – so they would not work. The strength decreases and it would do you no good.

If you used this effectively before, you can call your doctor and see if they would represcribe it – they will usually require an office visit, but if it helps – that’s worth it!

Patient: Yes,….the effexor did NOT work before, either, but I was willing to try it aain if it was still good. I have been told over many many yrs that old meds should be avoided.

I need help in finding a med that will help with these Hot Flashes that are destroying my everyday life !!! If you canot tell me an alternative or answer how long to take the progesterone before I get any relief,…you have not helped me a bit.The Dr seems at his wits end in his attempt to prescribe anything that will help.

Doctor: Regarding your hot flashes: treatment usually consists of Hormone Replacement Therapy. If you’ve tried both oral and transdermal patches and those have not worked – you may want to try the following:

Some research suggests that soy may have some benefit for reducing hotflashes and ..Continue reading..

Patient: I wore braces at 40 years of age for a slight overbite. Two weeks after the bands were yanked off my molars, I needed a root canal and crown. Two years later the crown broke and a new gold crown was put in place. Two years later I am having horrible pain and my dentist sent me to an endodontist. He said that he will have to go in through the gum and remove the remaining nerves. I thought when you get a root canal that there are no nerves left. I didn’t want 2/3 of a root canal. Is this common? The pain has been horrible. I’ve missed days from work and now the bill is $1400 for a tooth that I have already paid for a root canal and two crowns. What responsibility does my dentist that has performed all this work hold?

Optional Information
Gender: Female
Age: 48

Doctor: hi,

thanks for posting your question on health.is.edu ,

A root canal treatment is used to treat teeth that the decay has reached the pulp,

there is no guaranteed 100 percent success rate in any root canal treatment

http://en.wikipedia.org/wiki/Endodontic_therapy

the root canal treatment usually takes care of the problem, however it ..Continue reading..