Mon | Sep 24, 2018

Dear Doc | Is it safe to get rid of a cavity while pregnant?

Published:Sunday | September 2, 2018 | 12:00 AM

Q Dear Doc, I really need some help with an issue I am having. I am now pregnant and I think I have a cavity. I have a tooth that is paining a lot, but I don't think I can go the rest of the pregnancy like this. The pain is getting worse to the point now I don't even want to eat. I am being told I cannot go to the dentist or have it filled because I am pregnant, but I also can't take pain killers because I am pregnant, so now I don't know what to do. Please help me.

A Oh No! That truly is an uncomfortable situation to be in, but I am afraid you have been very misinformed.

Dental care is actually very important during your pregnancy, and it is thoroughly advised that you to take good care of your teeth and gums while pregnant. This is because pregnancy causes hormonal changes that can increase the risk of developing gum disease, which can affect the health of your unborn baby.

Now contrary to what you have been told, and what is commonly believed; routine dental care can be done at any time during pregnancy, as well as urgent procedures, such as an extraction or filling for a cavity. All elective (non-urgent) dental procedures, however, should be postponed until after the delivery, for example teeth whitening.

Before you visit your dentist, check with your obstetrician to see if there are any special precautions/instructions for you to share with your dentist.

Tell your dentist the names and dosages of all drugs you are taking, including any medications and prenatal vitamins that have been prescribed by your obstetrician.

Your dentist may need to alter your dental treatment based on this information.

Sometimes dental X-rays may need to be done as a part of your dental treatment. During pregnancy, your dentist will use extreme caution to safeguard you and your baby. Also, advances in technology have made X-rays much safer today than in past decades, so there is no need to be alarmed.

Also, you are able to take pain medications during your pregnancy. Paracetamol is quite safe, but in this case, it may not be sufficient to relieve your pain. Your obstetrician as well as your dentist, will prescribe for you, safe and effective pain medications.

Now that you know all of this, I do advise you visit your dentist as soon as is possible to relieve your discomfort.

 

I sweat too much

 

Q Dear Doc, I have a very embarrassing problem. I am a middle aged woman and I still see my periods, so I know its not menopause, but I sweat a lot. On any given day, by the time I get to work, my clothes are soaked. I have to wear a layer of clothes underneath to absorb the sweat so nobody notices. And I don't mean under my armpit, I mean all over, I have sweat through my underwear and the sweat shows through the groin crease of my pants, making me look like I pee myself. This is very embarrassing and I don't know what to do.

A You may have what is called hyperhydrosis, or excessive sweating.

The cause of hyperhydrosis can be varied. Although some cases are caused by either a neurologic, endocrine, infectious, or some other systemic diseases, most cases occur in otherwise healthy people.

Heat and emotions may trigger hyperhidrosis, but for the most part, many who suffer from hyperhidrosis, sweat nearly all their waking hours, regardless of the weather or their mood.

Treatment usually takes a stepwise approach, which allows many people with this annoying disorder to sometimes achieve good results and an improved quality of life.

The stepwise approach to treating excessive sweating generally goes as follows:

- Over-the-counter antiperspirants containing a aluminium are usually tried first because they are readily available and can be effective.

- Prescription strength antiperspirants, which also contain aluminium chloride hexahydrate.

- Iontophoresis, which uses a device that passes ionised tap water through the skin using direct electricity. How exactly it works is still unclear, but it is thought to work by temporarily blocking the sweat duct. The method uses water to conduct an electric current to the skin for a few sessions per week, for about 10-20 minutes each session initially, then maintenance treatments at one- to three-week intervals, depending on the patient's response.

- Oral anticholinergics medications to reduce sweating. This, however, often produces side effects such as dry mouth, blurred vision, and urinary retention. For this reason, they are typically reserved for people who have failed other treatments.

- Botox (botulinum toxin)-A, has been approved in the United States for the treatment of excess underarm sweating. A small amount of Botox is injected into about 20 - 25 spots in each armpit. This may result in up to 14 months of relief from sweating.

- miraDry. This technique uses microwave energy to permanently kill sweat glands. The electromagnetic energy targets heat on the sweat glands, destroying them. It may require 2-3 treatments for optimal effect.

- Lasers. They focus heat in a narrow beam of heat to destroy underarm sweat glands.

- Surgery. A procedure called thoracic sympathectomy may be considered as a last resort. The operation intended to destroy part of the nerve supply to the sweat glands in the skin.

You will need to see your doctor and explain your symptoms so any of these treatments can be tried.

deardoc@gleanerjm.com