MEDICAL MATTERS
- Medical Matters features questions asked by Members of the ME Association on health-related topics.
- Dr Charles Shepherd and the ME Association's other advisers answer these questions by sharing their expert knowledge.
- Medical Matters is based on the popular ‘Ask the Doctor’ series in ME Essential magazine.
- It is a free resource that supplements the detailed information contained in the full range of literature that can be found in the website shop.
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Questions in the Category: Dental
Dental implants and dentures
Over the last 10 weeks, I have had to have a fair amount of treatment, including four extractions, as a result of irreparable, cracked teeth. When examining a panoral x-ray, my dentist also identified three fillings that needed replacing. Needless to to say, the combination of pain, infection, distress, local anaesthetic and the effort of many visits to the dental surgery, has had a detrimental effect on my ME. I would have classed myself as a moderate to bad sufferer before all this trouble but it's definitely bad now. Hopefully, with careful pacing over time I will improve. That glass of mine is always half full.
My dilemma is what best to do regarding my missing teeth. As well as these four recent extractions, I had previously lost three others. I can still chew well enough on the right side of my mouth but my dentist has suggested implant replacements when my mouth has healed and I am, hopefully, a little stronger. I have to confess I am not keen, due to the potential risk of infection and the need for antibiotics, which I do not tolerate well. I was thinking more along the line of dentures, although I realise these can be troublesome. I would not feel confident at bridging the gaps either, given the fragile nature of my teeth in general. I will be 59 in September, just in case age is relevant.
Dental: Anaesthetics
My dentist has told me about a drug in regular use as a local anaesthetic in dentistry, which is stronger than Citanest, called Mepivacane. I need a lower molar removed and would feel more comfortable with it should the need arise. I occasionally suffer from palpitations so wish to avoid adrenaline if possible. What is your opinion of the relative merits of these anaesthetics for someone with ME/CFS?
Dental: White or Amalgam Fillings
My new NHS dentist said he could only provide Amalgam fillings not white fillings unless I paid privately. Is this correct and are amalgam fillings safe?
Management: Heart Health & ME/CFS
Can I ask what the advice is on heart health for people with ME? As most of us can’t exercise, how do we maintain a healthy cardiovascular system? Is a healthy diet enough?
Dental: Pain
I’m very prone to pain in my teeth. When I mentioned this to my OT she said that she hadn’t heard of that before as an ME/CFS symptom but could be connected to the central nervous system. My dentist tends to say that if there was a problem it would be obvious in a particular tooth or it could be tooth grinding especially at night. I don’t feel it is this as I tend to sleep with my mouth open and I don’t wake up with pain usually but it will come on during the day. Symptoms are varied ranging from a general tension and pressure, generalised aching pain in either the top or bottom teeth, or throbbing pain in certain teeth. The deep throbbing does tend to be in “ vulnerable “ teeth i.e. ones with deep fillings.
Sometimes I will get a very bad pain e.g. back molar on right lower side then the exact same tooth throbs on the other side. Of course I realise I need to discuss this again with my dentist at the next check up. However, I wondered if people with ME/CFS are more susceptible to tooth pain generally? Have even wondered if it’s stress? It’s been particularly bad these last few months and I can’t say I’ve been any more stressed than usual!
Medical Records
I am currently in dispute with my GP – who is refusing to correct some inaccurate medical information that was written in my medical notes. The GP maintains that this reflects a difference of opinion over what was said at a previous consultation. However, I believe the information about what I am capable of doing, both physically and mentally, is inaccurate and could have an adverse effect when it comes to him providing information to the DWP on my benefit claim for personal independence payment. What can I do to get this corrected?
Symptom: Mouth Ulcers
Is there any connection between recurrent mouth ulcers and ME? I have always had them since childhood and have been told that they can be stress-related, and that there is no underlying infection present.
Last year I had quite a few nasty mouth ulcers and was prescribed antibiotics because I had a secondary infection in the ulcers. Since then the ulcers have become more regular and persistent.
Dr Charles Shepherd
Dr Shepherd has been Trustee and Hon. Medical Adviser to the ME Association for more than 40 years. He is integral to the charity's activities and provides information and support based on his professional knowledge, personal experience as a doctor with ME/CFS, and the understanding gained from helping many thousands of people with the condition. He was a member of the comittee responsible for the 2021 NICE Clinical Guideline and is a recognised expert on ME/CFS in the UK. His knowledge extends to Post-Viral Fatigue Syndromes (PVFS), Myalgic Encephalopathy/Encephalomyelitis (ME), Chronic Fatigue Syndrome (CFS), and Post-Acute Sequelae of SARS-CoV-2 infection (PASC) or Long Covid.
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Medical Matters is based on the popular ‘Ask the Doctor‘ series featured in the highly-regarded member’s magazine, ME Essential, and in the healthcare professional magazine, ME Medical. Both are produced by the ME Association and published as hard-copy magazines every 3 months and sent to members and healthcare professionals by post to home or business addresses.
If you are a Health Care Professional you can sign-up to receive ME Medical magazine (people with ME/CFS can also nominate their HCP by completing the sign-up form).