THE state of NHS dentistry has been blamed for an increase in the number of mouth cancer deaths.
The disease is often picked up by dentists during check-ups.
NHS GP Dr Zoe Williams answers health questions sent in by readersThe Sun
But it’s important to see your GP if you have any symptoms.
These include a mouth ulcer which does not heal after three weeks, or red or white patches on the mouth, lips, gums, inside of cheeks or roof of mouth.
Unusual lumps or swellings in the mouth, head or neck can also be warning signs, as can a husky or quieter voice.
Generally, cancer can cause unintended weight loss, fatigue and pain.
Here is a selection of the questions readers have asked me this week . . .
Q) I’M a 64-year-old man and still suffer from spots on my nose.
Throughout life I’ve tried every face wash, spot cream and serum there is, but none of these treatments seem to work.
At any time, I could squeeze my nose and sebum would appear.
A) In cases like this it’s helpful to see a picture and to understand a little bit more about your symptoms, as diagnosing the underlying condition is important before advising how best to treat it.
There are two common skin conditions that are most likely to be causing spots on the nose.
The first is “acne vulgaris”, the medical term for common acne, and while we tend to associate this with adolescence, many adults have acne too.
It is less common in adult men than women, though, affecting around just three per cent of men over the age of 25.
Acne vulgaris is caused by a number of factors, including hormones, excess sebum production and sticky skin cells which can clog the pores and interact with the bacteria that live on the skin, sometimes causing inflammation.
The other common skin condition is rosacea, which mostly affects the cheeks, forehead, chin and nose.
The cause is not fully understood but certain triggers do tend to cause the blood vessels in these areas to dilate, resulting in redness and flushing.
The skin can be very sensitive, feel hot or sting. Acne is also sometimes a feature of rosacea.
Common triggers include spicy food, hot drinks, stress, exercise and extreme temperatures — both hot and cold.
While rosacea also affects more women than men, men are more likely to develop a complication called rhinophyma, where the nose becomes enlarged, bulbous and red.
Rhinophyma is associated with an overgrowth of the glands that produce sebum on the nose, so it does tie in with your description.
Acne and rosacea are treated differently, so it’s important to consult your GP to get a clear diagnosis.
It’s clearly affecting you and has for a long time, so please don’t delay making that appointment.
You’ve tried lots of washes and creams designed for common acne, so perhaps rosacea explains why they have not been effective.
Q) FOR the past month I’ve often had pains throughout my lower left leg, from around my knee then down the side of my leg to my ankle.
It kind of fluctuates. If I bend my legs while on the sofa, the pain gets worse.
A) Any new pain always warrants investigation so, if you haven’t already, please make an appointment at your GP surgery or do an online consultation, in the first instance, to see what they say.
Your GP or nurse is likely to want to know: “Did it start suddenly one day or come on gradually?
“Was there any trauma? How active are you and do you get worsening of symptoms when exerting yourself?”
Your practitioner may also ask: “Is there swelling? Any changes to the colour or appearance of the skin? What makes it feel better?
“What else, other than mentioned, makes it worse? Is it getting worse over time or staying the same?”
There are so many things that can cause pain in the lower leg, from a circulatory issue to a blood clot, an overuse injury such as shin splints, or a stress fracture of the fibula bone.
Q) On a recent visit to her NHS dentist, my granddaughter asked if she could bring her four-year-old daughter for a check-up.
The answer was, “No, we’re only taking private patients”. What can she do?
A) Sadly, this scenario is not uncommon. A BBC investigation last year found that eight in ten NHS practices are not taking on children and young people as new patients.
That said, every child in the UK is eligible for free dental care on the NHS until they reach the age of 18. The NHS website has a link to search for an NHS dentist (nhs.uk/service-search/find-a-dentist).
If you can’t find one locally, you can contact your Integrated Care Board to raise a concern. It might be worth chatting to the Dental Wellness Trust.
They promote oral wellness in children and young people and might be able to advise on how to get a dentist for your great-granddaughter.
It’s something to persevere with.
Some 48,000 children a year go into hospital to have rotten teeth taken out — so maintaining dental hygiene while your great-granddaughter waits to find a dentist is vital.
‘I attack wife in my sleep’
Q) I am a 61-year-old married man and find myself having dreams that make me attack my wife, sometimes hurting her.
She has to bite me to wake me up. Trying to get an appointment to see my GP is impossible
A) It sounds like you may have REM sleep behaviour disorder. This is one of several sleep disorders collectively known as parasomnias.
Your type, as you describe, can be very disturbing for both the person with it and the person they’re hurting.
REM stands for rapid eye movement and it’s the part of the sleep cycle where we have vivid dreams.
Normally we will experience temporary paralysis during REM sleep to stop us from acting out our dreams.
Most of our skeletal muscles are paralysed, but not the muscles involved in breathing, digestion and movement of the eyes.
When people have REM sleep behaviour disorder this paralysis does not happen, so the person is able to act out their dreams.
This can mean anything from small twitches, talking or shouting, to acts such as hitting, grabbing and getting out of bed.
It’s estimated that around 0.5 per cent of the population have REM behaviour disorder and it’s common in men and adults over 50.
It’s important to persevere in getting an appointment with your GP. You have a right to move to a different practice if your GP practice cannot manage to see you.
Melatonin may help, and consider sleeping separately from your wife in the meantime.