QUESTION: In the past few months, I have had trouble eating because my mouth is so dry. I have to take great gulps of water. Even when I'm not eating it's disturbing. And now I read where this can affect my teeth. Should I see a dentist about this? - Mrs. R.M.
ANSWER: Eventually, you will want to see a dentist, but first you want to get at the cause of this saliva deficiency.Some of the most common causes lie in the medicine cabinet. Many blood pressure drugs can cause it, as can drugs used to combat depression. Antihistamines and Parkinson's disease medicines are also high on the suspect list. See your family doctor, and bring along all the drugs you may be taking. He will check them out as potential dry-mouth causers.
Secondly, he will look into the several ailments associated with dry mouth. Sjogren's disease comes to mind. In that, both saliva and tear glands come under attack by the body's immune system. And Sjogren's is often associated with other illnesses, rheumatoid arthritis, for example.
I don't want to dismiss your very sensible dental reference. Yes, lack of saliva can really compromise dental health. You need saliva for both tooth and gum well-being. You need a careful dental hygiene program. Start chewing sugar-free gum and look into one of the artificial saliva products at the drugstore. Carry a little plastic squeeze bottle of water for periodic moisturization. The dentist may suggest fluoride treatment to prevent cavities in the absence of normal saliva output.
QUESTION: My grandmother has Alzheimer's. What does this bode for my own family and me? Heredity? - Mrs. V.U.
ANSWER: I've seen no evidence that heredity is a large factor in Alzheimer's. In fact any hereditary factor remains in doubt. It is doubtful for one reason alone. With heredity, we would see Alzheimer's develop in identical twins. Genetic influences do affect such twins, which inherit matching genes from their parents. We don't see such a genetic Alzheimer's relationship in such twins.
This is not to say that there might not be some general family vulnerability to some of the predisposing factors. It's a fine distinction but an important one. However, you can consider any link to heredity as unlikely. I know people who worry themselves sick because of the appearance of Alzheimer's in the family tree. They shouldn't. We have enough many truly inherited illnesses to concern us without creating flimsy specters of unlikely ones.
QUESTION: My husband has a rash at the top of his leg. The doctor called it ringworm and prescribed an ointment. It didn't work. He tried over-the-counter ointments. No help. Please explain ringworm. He's had this several months now. - P.N.
ANSWER: Ringworm is skin fungus. In the groin, it causes a red scaly patch, usually on the inner thigh. Ringworm is doggedly persistent. Along with ointments, you need tincture of patience.
Is your husband using the ointments according to directions? Improper use is not uncommon. If the rash persists despite treatment, then it can be time for oral antifungal medicine.
Consider hygiene. Try cotton underwear and keep the skin clean, aired and dry. A last thought: If "ringworm" persists, the doctor must consider other causes, specifically psoriasis or seborrhea, for which treatment differs from that for fungal rashes.
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Dr. Donohue welcomes reader mail but regrets that, due to the tremendous volume received daily, he is unable to answer individual letters. Readers' questions are incorporated in his column whenever possible.