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 › Lifestyle › Health and Fitness › Doctor's Diary

Doctor's Diary: A dental infection could

be a sign of something else

CREDIT: CLARA MOLDEN/TELEGRAPH

By James Le Fanu
14 DECEMBER 2015 • 7:00AM

Hidden dental problems

Like everything else, medical diagnoses go in and out of fashion. Thus,
back in the 1930s, it was not unusual to attribute poorly defined
abdominal symptoms to a “floating kidney” which, under the influence of
gravity, shifted its position downwards. The cure, by common consent,
was to “fix” the kidney in place by putting a stitch through it and hitching
it to some nearby muscle. Improbable, certainly.

But then a decade ago, American urologist Donald Urban resurrected the
floating kidney as a cause of pain due to obstruction of the flow of urine
into the bladder. The modern keyhole version of the original operation is
apparently highly effective.

CREDIT: GETTY

Similarly, the currently unfashionable diagnosis of local sepsis has also

been rehabilitated. In the early decades of the 20th century, many
illnesses (rheumatism, gastritis, pernicious anaemia) were attributed to
localised infection, usually of the teeth. Here, again, the solution of total
dental extraction seemed obvious enough. This did nothing to control the
progress of these conditions, though certainly added to the distress they
caused. Then, one by one, their true cause was identified where, for
example, pernicious anaemia was found to be caused by vitamin B12
deficiency – and so, like the floating kidney, local sepsis disappeared from
the medical textbooks.

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Rightly so, one might think. But hidden dental infection can undoubtedly
be responsible for otherwise unexplained symptoms. “At one time, my
wife became very lethargic and depressed,” writes a gentleman from
Torquay. “She had all the usual tests, which revealed nothing of note,
until an acquaintance remarked how his very similar problem was
eventually traced to a septic tooth. Sure enough, my wife’s dentist
discovered an abscess under an upper molar. This was duly treated and
her lethargy resolved.”

CREDIT: ALAMY

Challenging current dietary advice for diabetics 

The vexatious issue, highlighted in this column, of the potential harm of
the prevailing official dietary advice for those with diabetes, which
favours a generous intake of bread, rice, pasta and other carbohydrates,
has predictably prompted much interest. The experience of a reader who,
for the past 20 years, has required twice-daily insulin injections, is
particularly instructive.

Eighteen months ago, he had the additional misfortune of developing

chronic bowel symptoms (flatulence, discomfort, diarrhoea etc) that
proved to be due to irritable bowel syndrome, which required him to
exclude the usual gas-inducing culprits – wheat, lentils and legumes. This
left oats, brown rice and spelt as his only source of carbohydrates and,
given his family’s aversion to such foods, he opted to give them up as well
and stick instead to a predominately high-fat intake of meat and dairy
products.

Since then, he has lost two stone in weight, is “bounding with health”, and
his diabetes is so vastly improved, he no longer requires his insulin
injections. When he told his doctor he was more than a bit surprised that
“breaking every shibboleth” of the current diabetic mantra should have
had such a favourable outcome, “she muttered there had been some new
research” which challenged the current dietary advice.

Meanwhile, he is optimistic that his mother, who also has diabetes, may
benefit from his fortuitous (if felicitous) discovery of the merits of a high-
fat diet.

CREDIT: ALAMY

Medical check ups which make you feel worse

Finally, the experience of a woman, recently featured in this column, who
was rudely (and wrongly) informed by letter following a check-up that
she was obese and needed to lose weight, is echoed by other readers. “I
never sit still,” writes an 11-stone, 69-year-old lady with an acre of garden
that keeps her occupied in all weathers. This did not prevent her being
labelled both obese and inactive and thus “at risk” of heart problems,
warranting treatment with statins. She was then asked whether, at any
time in the past year, she had had more than six drinks in one day, to
which she replied “no”, as she rarely consumes that amount in a week. “It
then occurred to me that on Christmas Day, by the time I had enjoyed a
glass of champagne and wine with dinner, I probably had drunk that
amount,” she writes. This admission of her once-yearly indulgence
merited her being categorised as a binge drinker. 

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